Antipsychotics

Question 1

What is the dopamine receptor target for antipsychotics?

Answer 1

D2

Question 2

What is the serotonin receptor target for antipsychotics?

Answer 2

5-HT2a

Question 3

What is the off target receptor that antipsychotics hit in parasympathetic system?

Answer 3

M2/3

Question 4

What is the off target receptor that antipsychotics hit in histamine?

Answer 4

H1

Question 5

What is the off target receptor that antipsychotics hit in the heart?

Answer 5

K+c channels

Question 6

Name the two first generation high potency anti psychotics

Answer 6

Fluphenazine

Haloperidol

Question 7

Name the low potency first gen anti psychotic

Answer 7

Chlorpromazine

Question 8

Name the four second generation antipsychotics

Answer 8

Risperidone
Olanzapine
Clozapine
Aripiprazole

Question 9

What is the main difference between first and second generation antipsychotics?

Answer 9

First hit only dopamine, second hit dopamine and serotonin

Question 10

What pathway do antipsychotics work in that inhibits positive symptoms of schizophrenia?

Answer 10

Mesocortical dopamine pathway

Question 11

What characteristic of the antipsychotics helps minimize their toxicity?

Answer 11

They only have to occupy 60% of the receptors to achieve a 100% response

Question 12

Do first generation or second generation have worse extrapyramidal symptoms?

Answer 12

First generation

Question 13

What pathway leads to the EPS?

Answer 13

Inhibition of the nigrostriatal pathway

Question 14

Inhibition of the tuberoinfundibular pathway from antipsychotics leads to what issue?

Answer 14

Hormonal effect of prolactinemia because dopamine inhibits the production of it so without dopamine you get more prolactin

Question 15

What are the effects of hyperprolactinemia?

Answer 15

Gynecomastia
Amenorrhea
Decreased libido

Question 16

Do first or second generation Aps cause worse prolactinemia?

Answer 16

First

Question 17

What is neuroleptic malignant syndrome?

Answer 17

Hyperthermia, rigidity, mantal status changes, autonomic instability caused by antipsychotic medication

Question 18

Do first or second generation Aps cause neuroleptic malignant syndrome?

Answer 18

Both cause it

Question 19

What can you treat the muscle rigidity and hyperthermia with in neuroleptic malignant syndrome?

Answer 19

Dantrolene…calcium channel blocker to inhibit muscle

Question 20

What side effect can be caused by the inhibition of serotonin receptors in AP meds?

Answer 20

Metabolic syndrome

Question 21

What is metabolic syndrome symptoms?

Answer 21

Weight gain, dyslipidemia, hyperglycemia

Question 22

Is metabolic syndrome more common in first or second gen Aps?

Answer 22

Second gen

Question 23

Do AP drugs antagonize or agonize M2/M3 parasympathetic receptors?

Answer 23

Antagonize

Question 24

What first gen antipsychotics cause antiparasympathetic issues?

Answer 24

Chlorpromazine (low potency)

Question 25

What second gen antipsychotic is especially bad at causing antiparasympathetic issues?

Answer 25

Clozapine

Question 26

Name the symptoms of anti parasympathetic issues caused by APs

Answer 26

Blurred vision Xerostomia Constipation Urinary retention

Question 27

What generation antipsychotics lead to orthostatic hypotension?

Answer 27

Low potency first gen and second generation

Question 28

What second gen AP is really bad for orthostatic HypoTN?

Answer 28

Clozapine

Question 29

Why do APs (low potency first gen and second gen) cause orthostatic HypoTN?

Answer 29

They can block alpha1 receptors which vasodilate

Question 30

What classes of APs have issue with sedation?

Answer 30

First gen low potency and second gen

Question 31

Why do APs cause sedation?

Answer 31

Because they block H1 (histamine) receptors and are in the brain

Question 32

What first gen AP leads to prolonged QT ??

Answer 32

Haloperidol

Question 33

What second generation APs leads to prolonged QT?

Answer 33

Risperidone | Olanzapine

Question 34

What causes prolonged QT from first and second generation APs?

Answer 34

Inhibit K+efflux in the cardiac muscle therefore slowing repolarization

Question 35

What AP drug has toxicity of agranulocytosis/neutropenia?

Answer 35

Clozapine