Case 8 DRUGS

Question 1

What type of medication is Chlorpromazine? What does it treat?

Answer 1

Antipsychotic - Schizophrenia

Question 2

What receptors does Chlorpromazine affect?

Answer 2

Dopamine D2 receptor antagonist.
Seretonin 5-HT receptor antagonist.
Histamine H1 receptor antagonist.
a-adrengergic receptor antagonist.
Muscarinic M1 receptor antagonist.

Question 3

How does Chlorpromazine work on different receptors?

i.e. name each receptor and its effects on them

Answer 3

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Histamine H1 receptor antagonist - sedation

a-adrengergic receptor antagonist - lowers blood pressure, ergo postural hypotension and reflex tachycardia, small pupils (sympathetic antagonist)

Muscarinic M1 receptor antagonist - dry mouth, sore throat, blurred near vision, tachycardia, urinary retention, abuse, confusion

Question 4

Is Chlorpromazine a typical or an a-typical antipsychotic?

Answer 4

TYPICAL antipsychotic.

Question 5

What type of medication is Haloperidol? What does it treat?

Answer 5

Antipsychotic - Schizophrenia

Question 6

What receptors does Haloperidol affect?

Answer 6

Dopamine D2 receptor antagonist.
Seretonin 5-HT receptor antagonist.
Histamine H1 receptor antagonist.
a-adrengergic receptor antagonist.
Muscarinic M1 receptor antagonist.

Question 7

How does Haloperidol work on different receptors?

i.e. name each receptor and its effects on them

Answer 7

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Histamine H1 receptor antagonist - sedation

a-adrengergic receptor antagonist - lowers blood pressure, ergo postural hypotension and reflex tachycardia, small pupils (sympathetic antagonist)

Muscarinic M1 receptor antagonist - dry mouth, sore throat, blurred near vision, tachycardia, urinary retention, abuse, confusion

Question 8

Is Haloperidol a typical or an a-typical antipsychotic?

Answer 8

TYPICAL antipsychotic.

Question 9

What type of medication is Risperidone? What does it treat?

Answer 9

Antipsychotic - Schizophrenia

Question 10

What receptors does Risperidone affect?

Answer 10

Dopamine D2 receptor antagonist

Seretonin 5-HT receptor antagonist.

Question 11

How does Risperidone work on different receptors?

i.e. name each receptor and its effects on them

Answer 11

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Question 12

Is Risperidone a typical or an a-typical antipsychotic?

Answer 12

a-typical

Question 13

What type of medication is Clozapine? What does it treat?

Answer 13

Antipsychotic - Schizophrenia

Question 14

What receptors does Clozapine affect?

Answer 14

Dopamine D2 receptor antagonist, but binds best to Dopamine D4***

Seretonin 5-HT receptor antagonist.

Question 15

How does Clozapine work on different receptors?

i.e. name each receptor and its effects on them

Answer 15

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Question 16

Is Clozapine a typical or an a-typical antipsychotic?

Answer 16

a-typical

Question 17

What type of medication is Quetiapine? What does it treat?

Answer 17

Antipsychotic - Schizophrenia

Question 18

What receptors does Quetiapine affect?

Answer 18

Dopamine D2 receptor antagonist.

Seretonin 5-HT receptor antagonist.

Question 19

How does Quetiapine work on different receptors?

i.e. name each receptor and its effects on them

Answer 19

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Question 20

Is Quetiapine a typical or an a-typical antipsychotic?

Answer 20

a-typical

Question 21

What type of medication is Olanzopine? What does it treat?

Answer 21

Antipsychotic - Schizophrenia

Question 22

What receptors does Olanzopine affect?

Answer 22

Dopamine D2 receptor antagonist.

Seretonin 5-HT receptor antagonist.

Question 23

How does Olanzopine work on different receptors?

i.e. name each receptor and its effects on them

Answer 23

Dopamine D2 receptor antagonist - reduces postive symptoms by lowering DA in associative striatum.

Seretonin 5-HT receptor antagonist - weight gain

Question 24

Is Quetiapine a typical or an a-typical antipsychotic?

Answer 24

a-typical

Question 25

What CAUSES the major side effects seen from anti-psychotics?

Answer 25

D2 receptor antagonism in other pathways gives rise to a range of related side effects.

Question 26

What ARE the major side effects seen from anti-psychotics?

Answer 26

``` Hyperprolactinaemia Parkinsonian symptoms Weight gain Deterioration in working memory Blurred near vision Sedation ```

Question 27

How are each of the main side effects caused? ``` Hyperprolactinaemia Parkinsonian symptoms Weight gain Deterioration in working memory Blurred near vision Sedation ```

Answer 27

Hyperprolactinaemia - D2 antagonism in tuberoinfundibular pathway Parkinsonian symptoms - D2 antagonism in receptors of nigrostriatal pathway (sensori-motor pathway dorsal striatum) Weight gain - 5-HT2 receptors + effects on leptin Deterioration in working memory - D2 antagonism in mesocortical pathway Blurred near vision - Muscarinic M1 acetylcholine Sedation Sedation - antagonism of histamine H1 and a-adrengeric receptors

Question 28

Main worrying side effects of Clozapine? (Rare)

Answer 28

Agranulocytosis Therefore close blood monitoring needed.

Question 29

Why are normal antipsychotics sometimes added with clozapine?

Answer 29

Clozapine binds best to D4 dopamine receptors. So other APS that bind better to D2 are said to "fill in gaps" e.g. sulpiride and amisulpride