Antipsychotics and Parkinson treatments

Question 1

FGAs - high potency

Answer 1

• Haloperidol
• Trifluoperazine
• Fluphenazine
• Treat only positive symptoms, extrapyramidal SEs

Question 2

FGAs - low potency

Answer 2

• Chlorpromazine
• Thioridazine
• Treat only positive symptoms, H & mACh side effects, dangerous side effects: NMS, torsade de pointes

Question 3

SGAs

Answer 3

• Quetiapine
• Olanzapine
• Risperidone
• Aripiprazole
• Ziprasidone
• Clozapine
• Treat pos + neg symptoms (inh D2 & 5HT2A), special side effects: weight gain, dyslipidemia, hyperglycemia

Question 4

Parkinson medication

Answer 4

• Levodopa w/carbidopa, benserazide or a COMT inhibitor
• Trihexyphenidyl (antimuscarinic)
• Benztropine (antimuscarinic)
• Selegiline (MAO-B inhibitor)
• Ropinirole (D2 agonist)
• Pramipexole (D3 agonist)
• Amantidine

Question 5

COMT inhibitors

Answer 5

• Tolcapone (both peripheral + central inh, hepatotoxic)
• Entacapone
• Opicapone

Question 6

D2 agonists - ergot derivatives

Answer 6

• Bromocryptine

- Cabergoline

Question 7

D2 agonists - non-ergot derivatives

Answer 7

• Pramipexole (oral)
• Ropinirole (oral)
• Rotigotine (patch)
• Apomorphine (injection)

Question 8

Centrally acting anticholinergic drugs for Parkinson

Answer 8

mAChR antagonists

• Procyclidine
• Trihexyphenidyl
• Dexethimide
• Benztropine
• Biperiden
• Orphenadrine
• Metiexene
• Mainly for drug-induced Parkinsonism, SE: atropine-like

Question 9

MAO-B inhibitors for Parkinsons

Answer 9

• Selegiline
• Rasagiline
• Safinamide

Question 10

Treatment alzheimers

Answer 10

ACh-esterase inhibitors
- Rivastigmine
- Donepezil
- Galantamine
NMDA antagonist
- Memantine

Question 11

Huntington treatment

Answer 11

• GABAergic drugs
• Tetrabenzine (monoamine depletor)
• Antipsychotics

Question 12

Vascular demetia treatment

Answer 12

Similar to alzheimers
Gingko biloba
Nootropic agents:
- Piracetam
- Vinpocetine
- Nicergoline

Question 13

Wilson’s disease treatment

Answer 13

• D-penicillamine
• Trientine (chelators)
• Zn

Question 14

ALS “treatment”

Answer 14

Riluzole - increase survival w/2 months

Question 15

FGAs - dimethylamines (3)

Answer 15

1) Chlorpromazine (inject)
2) Levomepromazine (H1 inh)
3) Promethazine

Question 16

FGAs - piperazine (1)

Answer 16

Fluphenazine (depot inj)

Question 17

FGAs - Thioxanthines (3)

Answer 17

1) Chloprotixen
2) Zuclopenthixol (depot + acute inj)
3) Flupenthixol (depot inj)

Question 18

FGAs - Butyrophenones (2)

Answer 18

1) Haloperidol (im)
- Acute treatment, high D2 affinity, low aff to other receptors
2) Droperidol
- Post-op nausea
- Neurolept analgesia

Question 19

SGAs - Mixed 5-HT2/D2 antagonists

*Tricyclics

Answer 19

Tricyclics
1) Clozapine (also D4)

2) Olanzapine (depot inj, tbl, tolerance risk)

3) Quetiapine (tbl, tolerance risk)
* Less obesity, decr RR, no EPS/PRL

Question 20

SGAs - Mixed D2/5-HT2A/C antagonists

*Other heterocyclic

Answer 20

1) Risperidone (depot inj, tbl)
* Also blocks NE, less SEs
* May cause anxiety/agitation

2) Ziprasidone (Longer QT)
3) Paliperidone (retard tbl/inj)
4) Lurasidone
5) Sertindole

Question 21

D2 partial agonist, 5HT2 antagonist

Answer 21

Aripiprazole (tbl, inj)

• Neg symp > pos symp treatment
• Few SEs

Question 22

D3>D2 partial agonist (high D3 affinity)

Answer 22

Cariprazine

Question 23

D2/D3 antagonists

Answer 23

1) (Sulpiride)
2) Amisulpiride
3) Tiapride

Question 24

MAO-A selective inhibitors

Answer 24

• Clorgylin

- Moclobemid (RIMA)

Question 25

MAO A/B inhibitors

Answer 25

- Iproniazide - Phenelzine (+tranylcypromine) - Isocarboxazide