First Generation Antipsychotics Flashcards
Four Dopamine Pathways
Mesocorticol
Mesolimbic
Nigrostriatal
Tuberoinfundibular
Alternative Names for FGAs
Typical Antipsychotics
Neuroleptics
Dopamine Antagonists
Symptoms of Neurolepsis Syndrome
Psychomotor slowing
Emotional Quieting
Affective indifference
Which receptors do FGAs have a higher affinity for?
D2 receptors
What is the most common class of FGAs
Phenothiazines
Which dopamine pathway is associated with EPS
Nigrostriatal Pathway
What hormone (involved in milk production) is inhibited by Dopamine?
Prolactin
Which dopamine pathway is associated with the FGA side effect of hyperprolactinemia?
Tuberoinfundibular pathway
Why is blockade of D2 Receptors in nigrostriatal pathway associated with EPS?
Because this pathway is involved in production of movement.
What system involved in movement is the nigrostriatal pathway a part of?
Basal ganglia motor loop system.
Common side effects of antipsychotics?
E-PACCHA
EPS Psychic side effects Anticholinergic Cardiovascular Cardio-metabolic Hormonal Allergic reactions
EPS side effects commonly associated with Antipsychotics?
Muscle Stiffness
Shakiness
Anticholinergic side effects associated with Antipsychotics?
Dry mouth
Blurred Vision
Psychic side effects associated with antipsychotics?
Tiredness
Sedation
Cardiovascular side effects associated with antipsychotics?
Fast pulse
Q-T elongation
Allergic reaction side effects associated with antipsychotics?
Rashes
Unusual skin pigmentation
Cardio-metabolic side effects associated with antipsychotics?
Weight gain
Insulin resistance
Metabolic syndrome
Why do FGAs cause so many side effects?
They are not selective for any of the four dopamine pathways
According to the BNF what are the names of the different derrivatives of FGAs?
Phenothiazines Butyrophenones Thioxanthenes Diphenylbutylpiperidines Substituted benzamides
How many sub-groups of Phenothiazines are there according to the BNF?
Three
What are the main drugs in Group 1 Phenothiazines?
Chlorpromazine hydrochloride
levomepromazine
Promazine hydrochloride
What are the effects/side effects associated with Group 1 Phenothiazines?
Pronounced sedative effect
Moderate anti-muscarinic effects
EPS
What are the main drugs in Group 2 Phenothiazines?
Pericyazine
Mesoridazine
What are the effects/side effects associated with Group 2 Phenothiazines?
moderate side effects
Fewer EPS than Group 1 & 3
What are the main drugs in Group 3 Phenothiazines?
Fluphenazine
Perphenazine
Trifluoperazine
What are the effects/side effects associated with Group 3 Phenothiazines?
Fewer sedative and anti-muscarinic effects
More pronounced EPS than Group 1 & 2
What are the main drugs in the Butylphenones derrivatives?
Haloperidol
Benperidol
What are the effects/side effects of the Butylphenones ?
Resemble Group 3 of Phenothiazines
What are the main drugs in the Thioxanthenes
derrivatives?
Flupentixol
Zuclopenthixol
What are the effects/side effects of the Thioxanthenes?
Moderate sedative effects
Moderate anti-muscarinic effects
Moderate EPS
