Antipsychotics & Mood Stabilizers Flashcards
atypical antipsychotics MOA (3)
block 5-HT & DA receptors
mesocortical system
both positive & negative sx
classical antipsychotics MOA (3)
block DA D2 receptors
target mesolimbic system
alleviate the positive sx
extrapyramidal symptoms occur due to?
blockage of DA receptors in the nigrostriatal pathway
imbalance of striatal DA & ACh
degree of EPS is based on anticholinergic activity of the drug
tx EPS?
Benztropine to restore ACh/DA
chlorpromazine (Thorazine) use, MOA?
psychosis associated w/ mania & drugs of abuse, anti-emetic, pre-anesthetic
blocks DA D2 receptors; also has a-adrenergic
chlorpromazine unique SE?
browning of vision due to retinal deposits
degree of EPS is determined by?
anticholinergic activity of the drug
least likely drugs to cause tardive dyskinesia? (2)
clozapine
olanzapine
haloperidol SE
EPS
clozapine (Clozaril) unique SE (2)
hypersalivation
agranulocytosis
olanzapine (Zyprexa) MOA and unique use
blocks 5HT-2a, D4, and D2
also used for bipolar
olanzapine (Zyprexa) SE (4)
sedation orthostatic hypotension wt gain hyperglycemia (wt. gain and hyperglycemia = Olanzapine, Obese)
first line drug for psychosis?
Risperidone (Risperdal)
Risperidone MOA and unique SE
blocks 5-HT & DA D2
increased QT interval
Ziprasidone (Geodon) MOA (3) and unique uses (2)
blocks DA D2 and 5-HT receptors
5-HT1a agonist
some antidepressant activity
Tourette’s, acute mania
Ziprasidone (Geodon) SE (4)
increased QT interval
sedation, impairs cognition
increased prolactin
caution in hx seizures
Quetiapine (Seroquel) MOA & use
blocks 5-HT2a & DA D2
promotes sleep onset & maintenance
Quetiapine (Seroquel) contraindication
elevated prolactin
Aripraprazole (Abilify) MOA (3)
partial agonist DA D2 & 5-HT
antagonist for 5-HT2a
dopamine system stabilizer: low DA tone –> receptors activated, opposite for high DA tone
Aripiprazole (Abilify) unique SE
decreased esophageal motility
DOC bipolar?
Lithium
Lithium drug interactions (3)
antidepressants: may increase mania
diuretics: alter Li+ clearance
NSAIDs: increase Li+ toxicity, decrease clearance, increase uptake
Lamotrigine (Lamictal) use (3)
prevention of relapse in bipolar
depressive state following mania
acute mania
