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Pharmacology > Antipsychotics - Neuroleptics > Flashcards

Antipsychotics - Neuroleptics Flashcards

1
Q

What does psychosis present with

A

Delusions, hallucinations, thought disorganisation and agitation

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2
Q

What are antipsychotic drugs used to treat

A

Schizophrenia as well as bipolar disorder psychotic depression and drug induced psychosis

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3
Q

List the first generation antipsychotics

A 
Haloperidol 
And azine suffix 
Chorpromazine
Trifluroperazine
Fluphenazine
Thioridazine
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4
Q

First generation antipsychotic mechanism of action

A

Work by inhibiting post synaptic D 2 receptors in CNS mainly in the Mesolimibic system and striatofrontal system

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5
Q

High potency FGAs

A

Haloperidol
Fluphenazine
Trifluoperazine

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6
Q

Low potency FGAs

A

Thioridazine and chorpromazine

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7
Q

Thioridazine side effects

A

QT prolongation

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8
Q

Therapeutic uses of FGAs

A

FGAs treat positive symptoms of schizophrenia and not the negative symptoms
Treats psychosis in Many conditions like :-
Bio polar disorder
Acute agitation
Aggression (haloperidol)

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9
Q

Which FGA is used as a tranquilliser

A

Haloperidol

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10
Q

Other name for Second generation antipsychotics

A

Atypical antipsychotic

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11
Q

Second generation antipsychotics mechanism of action

A
  • Work by blocking D2 receptors in the mesolimbic pathway
  • block 5HT2a receptors
  • enhance dopamine release in mesocortical pathway to reduce negative symptoms
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12
Q

List Second generation antipsychotics

A 
Risperidon 
Ziprasidon
Clozapine 
Olanzapine 
Quetiapine
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13
Q

Most sedative Second generation antipsychotics

A

Quetiapine

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14
Q

Which mechanism of action of Second generation antipsychotics treat positive symptoms

A

Blocking of D2 receptors in the mesolimbic

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15
Q

How long does it take for antipsychotics to show effect

A

After 4-6 weeks of treatment

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16
Q

Antipsychotics side effects

A

Parkinsonian symptoms
Akathisia
Triadive dyskinesia

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17
Q

What other effects does antipsychotics have

A 
Antiemetic effect 
AntiMuscarinic effects 
Hypotension 
Lightheadedness (a1 blockade) 
And due to D2 block in tuberoinfundibular pathway -> 
Amenorrhea, glactorrhea and infertility
18
Q

Antipsychotics mode of administration and metabolism

A

Oral or parenteral administration (typical)

P450

19
Q

Antipsychotics Side effects

A

in acute - dystopia
In medium - term akathisia and Parkinsonism
In chronic - tar dive dyskinesia And dystonia

20
Q

What is acute dystonia

A

Fixed muscle posture with spasm -Clenched jaw muscles, protruding tongue and oculogyric crisis

21
Q

Acute dystonia treatment

A

Anticholinergic drugs (benztropine or procyclidine)

22
Q

What is akathisa

A

Motor restless lower limb

23
Q

Akathisia treatment

A

Reducing drug dose

24
Q

Tardive dyskinesia

A

Lip smacking and tongue rotating

25
Q

Tardive dystonia

A

Specific movements of head, neck and trunk

26
Q

When does tardive dystonia and dyskinesia happen

A

After months - years of treatment

27
Q

Which antipsychotic drugs have low risk of extra pyramidal symptoms and tardive dyskinesia

A

Clozapine and risperidone

28
Q

Adverse effects of clozapine

A

Bone marrow suppression and CV side effects

29
Q

Adverse effects of chlorpromazine

A

Cholestatic jaundice

30
Q

What is neuroleptic malignant syndrome

A

An idiopathic reaction

Presents with Hyperthermia, muscle rigidity, fluctuating consciousness and renal failure due to rhabdomyolysis

31
Q

With which drugs does neuroleptic malignant syndrome usually happen

A

Typical antipsychotics and Parkinson’s

32
Q

Treatment of neuroleptic malignant syndrome

A

Bromocriptine (D1/D2 agonist)

Dantrolene (skeletal muscle relaxant)

33
Q

Contraindications of antipsychotics

A

Alcohol
Seizure disorders
Epilepsy
Agranulocytosis

34
Q

Which antipsychotics are contraindicated in seizure disorders

A

Chlorpromazine and clozapine

35
Q

Which antipsychotics are contraindicated in agranulocytosis

A

Clozapine

36
Q

Which antipsychotics have depot preparations

A

Fluphenazine and haloperidol GIVEN IM

37
Q

What’s 3rd generation antipsychotic

A

Aripiprazole

38
Q

Aripiprazole mechanism of action

A

Partial agonist at D2 D3 and 5HT1a receptors and antagonist of 5HT2A receptors

39
Q

Aripiprazole metabolism and half life

A

Metabolised by the liver to active metabolites with half lives of 75hrs and 94hrs for metabolite

40
Q

Benefits of Aripiprazole

A

Lower risk of extra pyramidal symptoms (haloperidol), hyperprolactinemia and sedation and AntiMuscarinic (clozapine)

41
Q

Aripiprazole adverse effects

A

Increase mortality by stokes

Pharmacology (33 decks)

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