Antipsychotics Pharmacology Flashcards
Typical Antipsychotics AE?
AE:
1. EPS symptoms: Dystonia torticollis 4 hrs (head is tilted to one side and cannot straighten out)=> akathisia 4 days =>bradykinesia 4 weeks=>tardive dyskinesia 4 months
- Galactorrhea (decreased dopamine)
- Neuroleptic Malignant Syndrome (Think FEVER)=> No thermostat=> Too Hot=>Muscle breaks down=>Rigidity, myoglobinuria, pyrexia (Tx: D2 agonist)
Typical Antipsychotics
Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine
(haloperidol + “-azines”)
Typical Antipsychotics MOA? Use?
MOA: block dopamine D2 receptors ([cAMP])
Use: Schizophrenia, acute mania, Tourette Syndrome
High Potency Antipsychotics?
High Potency: Try to Fly High
Trifluoperazine
Fluphenazine
Haloperidol
Low Potency Antipsychotics?
Low potency: (Cheating Thieves are low)
Chlorpromazine, Thioridazine
Chlorpromazine AE?
Corneal deposits
Thoridazine AE?
reTinal deposits
Haloperidol AE?
NMS, Tardive Dyskinesia
Atypical antipsychotics What are they?
Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone
Atypical antipsychotics MOA?
MOA: Varied effects on 5-HT2, dopamine, and α- and H1-receptors
Atypicals are 1st line for?
Schizophrenia
Olanzapine/Clozapine AE?
Olanzapine and Clozapine make you look like an O
Clozapine Cills granulocytes (agranulocytosis)
Risperidone AE?
Increase prolactin=>gynecomastia
Menstruation and fertility issues
Aripiprazole Unique?
Partial agonist
CNS Stimulants (Methylphenidate, dextroamphetamine, methamphetamine) MOA? First line? AE?
MOA: Increased catecholamines in the synaptic cleft (NE and DA)
First line for ADHD
AE: suicide
Lithium MOA? First line? AE? What Drug should you not try to use it with?
MOA: Gq=>blocks Gs/Gi receptors
First Line: Bipolar Disorders
AE: LMNOP (Movement (tremor), Nephrogenic diabetes insipidus, HypOthyroidism,
Pregnancy problems)
Drug Interactions: Thiazides increase lithium toxicity (Tx: amilroiode)
BUSpirone MOA, Use?
MOA: stimulates serotonin receptors
Use: Generalized anxiety disorder
“I always worry about whether I can get on the BUS on time”
SSRIs?
Fluoxetine, paroxetine, sertraline, citalopram
Fiery, Peppery, Sizzling Condition
SSRI MOA? 1st line?
MOA: 5-HT–specific reuptake inhibitors
1st line: Bulimia, Depression,
Generalized anxiety disorder, Obsessive-compulsive disorder, Panic disorder, PTSD, Social phobias
SSRI AE: Think of the S’s
SSRI=>Stomach, SIADH, Sexual Stopper, Serotonin Syndrome
Serotonin Syndrome? MOA? Tx?
Any drug that increases 5-HT (Serotonin)
Hyperthermia, Confusion, Flushing, Diarrhea
Tx: Cyproheptadine
How long does it take for SSRIs to work?
4-8 weeks
SNRIs?
Venlafaxine, Duloxetine
Very Different
SNRIs First Line? AE? Why use it?
Panic disorder, PTSD, Generalized anxiety disorder
AE: Hypertension
Why? SNRIs don’t have the 3 C’s (Cardiotoxicity, Convulsions, Coma)
