Chapter 22 - Psychotherapeutic Agents

Question 1

Chlorpromazine (I)

Answer 1

Typical Antipsychotics

Management of...
Manifestations of psychotic disorders
Relief of preoperative restlessness
Adj treatment of tetanus 
acute intermittent porphyria 
Severe behavioral problems in children
Control of hiccups N/V

Question 2

Chlorpromazine (A)

Answer 2

Blocks synaptic dopamine receptors in the brain, depresses those parts of the brain involved in wakefulness and emesis, anticholinergic, antihistaminic, alpha-adrenergic blocking.

Question 3

Chlorpromazine (AE)

Answer 3

Extrapyramidal symptoms
Ortho hypoTN
photophobia

Question 4

Chlorpromazine (CI-DD)

Answer 4

CI: CNS depression, circulatory collapse, Parkinson’s, coronary disease, patients experience increased CV events and death. children younger than 12 years of age.

DD: Beta blockers
Alcohol
Other antipsychotic agents (^anticholinergic)

Question 5

Clozapine (I)

Answer 5

Management of severely ill patients with schizophrenia who are unresponsive to standard drugs; reduction of risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder.

Blocks dopamine and serotonin receptors, depresses the RAS, anticholinergic, antihistaminic, alpha-adrenergic blocking.

Question 6

Clozapine (AE)

Answer 6

Headache, neuroleptic malignant syndrome, syncope

Question 7

Lithium (I) (A)

Answer 7

Antimanic
I: Treatment of manic episodes of bipolar, manic depressive illness.
A: Alter sodium transport in nerve and muscle cells; inhibits the release of norepinephrine and dopamine, but not serotonin, from stimulated neurons; increases the intraneuronal stores of norepinephrine and dopamine slightly; and decreases the intraneuronal contents of second messengers.

Question 8

Lithium (AE)

Answer 8

Central nervous system problems, including with RG, slurred speech cardiovascular collapse, coma,

Question 9

Lithium (CI-DD)

Answer 9

CI: significant renal or cardiac disease, Leukemia, Dehydration, diuretic use, Sodium depletion, suicidal or impulsive pt, Infection with fever

DD: thiazides increase lithium toxicity cus of loss of sodium
antacids (v effect of lithium)
NSAIDS

Question 10

Methylphenidate (I-A)

Answer 10

CNS stimulants

I: narcolepsy and attention deficit disorder
A: mild cortical stimulation with central nervous system actions similar to those of amphetamines

Question 11

Methylphenidate (AE)

Answer 11

Increased or decreased pulse rate and blood pressure, Loss of appetite

Question 12

Methylphenidate (CI-DD)

Answer 12

CI: marked anxiety, agitation or tension, glaucoma, cardiac disease, drug dependence including alcoholism

DD: MAO inhibitor leads to an increased risk of Adverse effects an increased toxicity; CNS stimulant w/ tricyclic antidepressants