Drugs - Antipsychotic - Atypical 02

Question 1

Which is the most used antipsychotic for the treatment of schizophrenia?

Answer 1

Risperidone

Question 2

Which is the most potent 5HT2A and D2 blocker of the atypical antipsychotics and why is that significant?

Answer 2

Risperidone. Doses above 6-10mg per day may produce breakthrough EPS due to increased D2 blockade

Question 3

What are the side effects of risperidone?

Answer 3

Orthostatic hypotension in the elderly but no agranulocytosis and minimal sedation because it does not have anti-muscarinic or antihistaminic activity

Question 4

What are the adverse drug reactions of risperidone?

Answer 4

Insomnia, difficulty concentrating, prolactin elevation (at higher doses)

Question 5

Which was the first extended-release antipsychotic on the market?

Answer 5

Paliperidone

Question 6

Which atypical antipsychotic is less than 10% metabolized by the four major CYP450 isoforms therefore drug interactions are less likely?

Answer 6

Paliperidone

Question 7

What are the side effects of paliperidone?

Answer 7

Prolactin elevation similar to risperidone but lower risk of orthostasis than risperidone

Question 8

What are the side effects of olanzapine?

Answer 8

• Considerable sedation due to H1 and muscarinic blockade

- weight gain similar to clozapine (H1 and 5HT2C blockade)

Question 9

Which atypical antipsychotic has the highest incidence of hyperlipidemia and hyperglycemia?

Answer 9

Olanzapine

Question 10

What is the disadvantage of quetiapine?

Answer 10

Low potency requires BID or TID dosing

Question 11

Why is Quetiapine useful in the treatment of bipolar depression?

Answer 11

Because it’s primary metabolite is a potent norepinephrine reuptake inhibitor. The metabolite is also responsible for moderate anticholinergic effects

Question 12

Which atypical antipsychotic is also known as expensive Benadryl because it is used more often for sedating, tranquilizing, and anti-and side effects than for schizophrenia?

Answer 12

Quetiapine