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Block 3 Pharm > Antipyschotics/antimanias > Flashcards

Antipyschotics/antimanias Flashcards

1
Q

Alliphatic side chain and D2 antagonist

A

Chlorpromazine

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2
Q

Chlorpromazine
potency:
sedative?
effects

A

Low-medium potency,
sedative,
large anti-cholinergic.

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3
Q

Acute psychotic episodes, chronic schizophrenia, tourette’s, antiemisis.
Typicals only do Positive symptoms

A

Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol

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4
Q

Low potency, sedative, less EPS, anticholinergic.

Piperidine side chain

A

thioridazine

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5
Q

thioridazine
potency
sedative?
effects

A

low potency
sedative
less ExtraPyramidalS and anticholinergic

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6
Q

*Early Rx (dystonia, parkinsonism, akathisia),
Late Rx (Tardive dysnkinesia).
Neuroleptic Malignant Syndrome.
Sedation, neuroendocrine effects, orthostatic hypotension, weight gain - *diabetes related events.

A

Extrapyramidal symptoms

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7
Q

High potency, less sedative, less anticholinergic, more EPS. Piperazine side chain

A

Fluphenazine

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8
Q

Fluphazine
potency:
sedation?
extras

A

High potency
less sedation/less anticholinergic
more extrapyramidials

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9
Q

typical with piperazine side chain

A

fluphenazine

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10
Q

Initial control of manic episode

A

Haloperidol

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11
Q

Butyrophenone Derivative

A

Haloperidol

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12
Q

High potency, less sedation, more EPS

A

Haloperidol

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13
Q

Haloperidol (typical) use

A

initial control of manic episode

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14
Q

Atypicals

for both + and -

A 
Clozapine
Olanzapine
Risperidone
Quetiapine
Arpiprazole
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15
Q

What does Clozapine act on?

A

D4 (D2 like) and 5-HT2 antagonist

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16
Q

Side effect of Clozapine

A

Seizures, agranulocytosis.
Really gonna close line you with this agranulocytosis
*Atypicals have less EPS, and more diabetes events.

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17
Q

Can cause agranulocytosis and seizures and make you fat

A

Clozapine

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18
Q

Less seizures than Clozapine, and no agranulocytosis, but worse weight gain and diabetes related adverse events.

A

Olanzapine

“O” is round… just like your waist on this drug, but at least you wont die from agranulocytosis

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19
Q

D1, D2, and 5-HT2 antagonist

A

Olanzapine

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20
Q

atyipical good for manic episodes

A

olanzapine

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21
Q

Olanzipine has more or less EPS

A

LESS

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22
Q

Risperidone (atypical) acts on

A

D2 and 5-HT2 antagonist

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23
Q

Less seizure and less antimuscarinic than Clozapine.

A

Risperidone

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24
Q

Paliperidone is its active metabolite

A

Risperidone

25
MEch of Quetiapine
D2 and 5-HT2 antagonist
26
Uses of Quetiapine besides schizo
augmentation in depression, manic episodes
27
Partial D2 AGONIST, and 5-HT2 antagonist
Aripiprazole
28
uses of aripiprazole
augmentation in depression and manic episodes
29
what two atypicals can help with depression and manic episodes
risperidone and aripiprazole
30
Interferes with Phosphoinositide cycle -> less DAG/IP3
Lithium
31
Use of Lithium
Manic episodes and prophylaxis of bipolar depression and mania, cluster heacaches
32
Manic episodes and prophylaxis of bipolar depression and mania, cluster heacaches
Lithium
33
What's worrisome about Lithium?
Narrow therapeutic window. Fatigue and muscle weakness, tremor, GI symptoms, goiter, slurred speech, ataxia. Serious toxicity - impaired conciousness, rigidity and hyperreflexia, coma.
34
What type of meds should we be careful of when prescribing Lithium?
anything that increases Na+ excreation
35
Use of Valproic acid
sedation and bipolar
36
5-HT1 partial agonist, dopamine agonist for anti-anxiety
Buspirone
37
Anxiety, sleep disorders, seizures , Panic disorders, IV sedation and anesthesia
Alprazolam
38
Alprazolam is a
benzo agonist on GABA (enhances it)
39
BDZ Withdrawal:
anxiety, insomnia, irritability, headache, hyperacusis, hallucinations, seizures (thus, wean off or switch to long-acting or Buspirone)
40
Contraindications of Alprazolam
Other CNS depressants, hepatic metabolized drugs (cimetidine)
41
Benzo for Muscle relaxant, Alcohol withdrawal
Diazepam
42
How does Diazepam work
Benzo GABA agonist
43
Fast onset (lipophilic), rapid into brain, rapid redistribution, active metabolites (Desmethyldiazepam)
Diazepam
44
Slow onset, long duration of action, no active metabolites, Benzo for sleep
Lorazepam
45
Lorazepam uses
anxiety and sleep disorder but is especially hypnotic!
46
anxiety and sleep disorder but is especially hypnotic!
Lorazepam
47
Cause increase in sleep stages 1-2, and decreased 3-4 and REM and rebound insomnia on withdrawl
Lorazepam
48
Lorazepam mech
benzo GABA agonist
49
Rapid onset, long duration and is a more hypnotic benzo
Flurazepam
50
Flurazepam mech
benzo GABA agonist | Hypnotic, weak anxiety
51
Difference between Flurazepam and Lorazepam
Flurazepam is weakly anxiolytic and is longer acting with rapid induction... both are hypnotic
52
Side effects of Zolpidem
Daytime sedation, ataxia, rebound insomnia, tolerance/dependence, occasional idiosyncratic stimulation
53
Mech of Zolpidem
NON-BDZ agonist on GABA | hypnotic
54
Flumazenil mech
BDZ antagonist ~~~~ | Antagonize Zolpidem.
55
BDZ antagonist ~~~~ | Antagonize Zolpidem.
Flumazenil
56
Pentobarbital (barbituate) side effects
Acute poisoning: stupor, coma, resp. depression. Withdrawal can cause life-threatening seizures.
57
Pentobarbital mech
Barbiturate site on GABA
58
Pugent, caustic taste. Metabolized to trichloroethanol (active)
chloral hydrate

Block 3 Pharm (19 decks)

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