Exam 1: Psychosis

Question 1

Class: 1st Generation Anti-Psychotics (↑ POTENCY)
Drug: Haloperidol (Haldol)

Answer 1

• BLOCK DA receptors (antagonize)

Question 2

Class: 1st Generation Anti-Psychotics (↑ POTENCY)
Drug: Haloperidol (Haldol)
Indications:

Answer 2

↓ SE → sedation, orthostats, anticholinergic effects

• Schizophrenia
• acute psychosis - Tourette’s

↓ cost
↓ acute/chronic psychosis
+ d/o **Initially shown to be
effective for schizophrenia

Question 3

Class: 1st Generation Anti-Psychotics (↑ POTENCY)
Drug: Haloperidol (Haldol)
Side effects:

Answer 3

↑EPS
- Neuroendocrine effects
- Prolonged QT - dysrhythmia
- Prolactin release - Sedation
- ↑weight
- Orthostats
- Insulin resistance
- Anticholinergics
- Neuroleptic malignant
syndrome
- Prolonged QT - Sudden death

Question 4

Class: 1st Generation Anti-Psychotics (↑ POTENCY)
Drug: Haloperidol (Haldol)
Interactions:

Answer 4

Anticholinergics
↑ effect of ↑ CNS Depressants
↑ depressant effect
L-dopa + Direct DA receptor agonists
- counteracts antipsychotic effects of FGA

Question 5

Class: 1st Generation Anti-Psychotics (↓ POTENCY)
Drug: Chlorpromazine
MOA:

Answer 5

• BLOCK DA receptors (antagonize)

* * need higher dose to achieve effect

Question 6

Class: 1st Generation Anti-Psychotics (↓ POTENCY)
Drug: Chlorpromazine
Indications:

Answer 6

↓ EPS
↓ cost
↓ acute/chronic psychosis
\+ d/o **Initially shown to be
effective for schizophrenia

Question 7

Class: 1st Generation Anti-Psychotics (↓ POTENCY)
Drug: Chlorpromazine
Side effects:

Answer 7

↑ sedation
- EPS symptoms (Movement d/o)
- Prolactin release - Sedation
- ↑weight
- Orthostats
- Insulin resistance
- Anticholinergics
- Neuroleptic malignant
syndrome
- Prolonged QT - Sudden death

Question 8

Class: 1st Generation Anti-Psychotics (↓ POTENCY)
Drug: Chlorpromazine
Interactions:

Answer 8

Anticholinergics
↑ effect of ↑ CNS Depressants
↑ depressant effect
L-dopa + Direct DA receptor agonists
- counteracts antipsychotic effects of FGA

Question 9

Class: 2nd Generation Anti-Psychotics (Atypical)
Drugs:

Answer 9

• clozapine (Clozaril)
• risperidone (Risperdal)
• olanzapine (Zyprexa)
• quetiapine (Seroquel)
• ziprasidone (Geodon)
• aripiprazole (Abilify)
• paliperidone (Invega)

Question 10

Class: 2nd Generation Anti-Psychotics (Atypical)
MOA:

Answer 10

• BLOCKS Serotonin → only moderate block of DA receptors

Question 11

Class: 2nd Generation Anti-Psychotics (Atypical)

Answer 11

↓EPS symptoms
**1st line of treatment for
Schizophrenia
- Dementia-related agitation

Question 12

Class: 2nd Generation Anti-Psychotics (Atypical)

Answer 12

↑weight
↑risk DM
↑risk dyslipidemia
- Dementia = ↑risk mortality (CV/infx events)
↓WBCs → labs 1st 6mo
**Esp. Clozapine
**Absolute neutrophils