Antipsychotics (neuroleptics) Flashcards
Antipsychotic drugs
Haloperidol + "azines" trifluoparazine fluphenazine thioridazine chlorpromazine
MOA:
Block D2, thus increase cAMP
Clinical use:
schizophrenia (positive symptoms)
psychosis,
acute mania
Tourette’s syndrome
Toxicity:
Highly lipid soluble and stored in body fat:
thus very slow removal from body
1) extrapyramidal (EPS): dyskinesias
2) endocrine: DA block -> hyperprolactinemia -> galactorrhea
3) blocking muscarinic (dry mouth, constipation)
4) blocking alpha 1 (hypotension)
5) blocking histamine (sedation)
+ neuroleptic malignant syndrome
+ tardive dyskinesia
Other toxicity: neuroleptic malignant syndrome
Rigidity,
myoglobinuria,
autonomic instability,
hyperpyrexia
Tx: dantrolene, D2 agonist (bromocriptine)
"Think FEVER:" Fever, Encephalopathy Vitals unstable Elevated enzymes Rigidity of muscle
Other toxicity: tardive dyskinesia
stereotypical oral-facial movement as a result of long term
Often irreversible
High potency antipsychotic
Trifluoperazine
Fluphenazine
Haloperidol
“Try to fly high”
Neurologic side effect: EPS
Low potency antipsychotic
Chlorpromazine
Thioridazine
“Cheating thieves are low”
Non neurologic side effect:
anticholingeric, antihistamine, anti alpha 1
Chlorpromazine toxicity
Corneal dePosits
ChlorPromazine
Thioridazine toxicity
ReTinal deposits;
ThioRidazine
Haloperido toxicity
NMS and tardive dyskinesia
Evolution of EPS side effect
4 hr: acute dystonia: muscle spasm, stiffness, oculogryic crisis
4 days: akathisia (restlessness)
4 wks: bradykinesia (parkinsonism)
4 months: tardive dyskinesia
