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Pharmacology > Exam 11: Antipsychotics > Flashcards

Exam 11: Antipsychotics Flashcards

1
Q

4 Phenothiazines

A 
-Azines
Chlorpromazine
Fluphenazine
Prochlorperazine
Trifluoperazine
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2
Q

Name 1 Butyrophenone

A

Haloperidol

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3
Q

6 Second Generation (Atypical) Antipsychotics

A 
Clozapine
Olanzapine
Risperidone
Ariprazole
Quetiapine
Ziprasidone
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4
Q

What kind of symptoms are 1st generation antipsychotics (Phenothiazines and haloperidol) good at treating?

A

Positive symptoms of schizophrenia

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5
Q

General effects of typical/1st gen antipsychotics

A

Decreased initiation of behavior, flattened affect

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6
Q

What is a major problems with the use of antipsychotics that affects their use?

A

their effects are perceived as unpleasant by the patient

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7
Q

What effect occurs before the antipsychotic effects in treatment?

A

Sedation

Tolerance develops to the though in time

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8
Q

CNS side effect of antipsychotics

A

Lowered seizure threshold

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9
Q

Which antipsychotic is also an especially good antiemetic?

A

Prochlorperazine

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10
Q

Autonomic side effect of antipsychotics

A

Anticholinergic

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11
Q

2 Cardiovascular side effects of antipsychotics

A
  1. Orthostatic hypotension

2. Tachycardia

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12
Q

Endocrine side effects of typical antipsychotics

A

Increased prolactin due to dopamine antagonism
Gynecomastia, lactation, menstrual problems
May affect other GH, corticosteroids, gonadotropins, insulin

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13
Q

Common unwanted side effect of antipsychotics

A

Weight gain, metabolic disturbances

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14
Q

How safe are antipsychotics

A

Very large margin of safety, but there is a small risk of idiosyncratic and allergic reactions that can be serious

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15
Q

Neuro side effects of antipsychotics

A

Extrapyramidal

Can be severe and limit their use

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16
Q

Mechanism of antipsychotics

A

Inhibition of DA receptors
Typical inhibit D2
Others may affect other DA receptors/other neurotransmitters

17
Q

Which DA pathway is involved in psychosis

A

Mesolimbic and mesocortical systems

18
Q

Tardive dyskinesia

A

too much dopamine activity relative to cholinergic activity

opposite of parkinson’s

19
Q

Aliphatic phenothiazine

A

Chlorpromazine

20
Q

3 piperazine phenothiazines

A

trifluoperazine
fluphenazine
prochlorperazine

21
Q

Trifluoperazine

A

Phenothiazine
More potent than chlorpromazine
less sedation/anticholinergic
More extrapyramidal problems

22
Q

Fluphenazine

A

Phenothiazine

Comes in long acting injections (decanoate and enathate), good for compliance

23
Q

Prochlorperazine

A

Phenothiazine

Commonly used as an antiemetic

24
Q

Haloperidol

A 
Butyrophenone
Less anticholinergic than chlorpromazine
more extrapyramidal side effects
less sedation
Available in long acting form
25
Q

Clozapine

A

2nd gen antipsychotic
blocks D4 and 5-HT2 receptors
Can cause granulocytopenia and agranulocytosis*
Can cause weight gain and type 2 diabetes
Strongly anticholinergic
Few extrapyramidal side effects
Very expensive

26
Q

Olanzapine

A

2nd gen antipsychotic
like clozapine, but doesnt cause bone marrow toxicity
Also causes weight gain and hyperglycemia

27
Q

Risperidone

A

2nd gen antipsychotic
Blocks DA and serotonin receptors
More extra pyramidal side effects than clozapine/olanzapine, but less than the typicals

28
Q

Quetiapine and Zirprasidone

A

2nd ben antipsychotics
mechanism similar to clozapine
metabolic side effects (fewer with quetiapine)

29
Q

Aripiprazole

A

2nd gen antipsychotic
Partial agonist at D2 and 5-HT1 receptors
No extrapyramidal problems
Also approved for refractory depression

30
Q

general pharmacokinetics of antipsychotics

A

metabolized in liver, excreted in kidney

Long half lives

31
Q

Most effective antipsychotic. Problem?

A

Clozapine

2nd line due to it’s potential toxicity

32
Q

General rule of thumb about side effects of antipsychotics

A

high potency drugs have fewer cardiovascular and anticholinergic effects, but more extrapyramidal effects
the opposite is true of lower potency drugs.

Pharmacology (34 decks)

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