L6 Anti-psychotic

Question 1

Drugs that increase dopamine activity?

Answer 1

levodopa, cocaine

((worsen schizophrenia or produce psychosis))

Question 2

Most antipsychotic drugs block?

Answer 2

Dopamine D2 receptors in brain
Some drugs block also : H 1 , 5HT 2 , alpha 1 & muscarinic receptors

(all these receptors are blocked more by typical antipsychotic drugs having their respective side effects & have less effect against negative symptoms)

Question 3

Anti-psychotics:

Answer 3

1. Typical anti-psychotic (1st generation) drugs

a. Pheno-thiazines:
Chlorpromazine ,Flu-phe-nazine, Tri-fluo pe-razine
b. Thioxanthines: Thio-thexene
C. But yro phenone: Halo-peridol, dro-peridol

2. Atypical antipsychotics( 2nd generation)
Res-peridone
Olan-zapine
Clo-zapine
loxa-pine
aripeprazole

Question 4

Anti-psychotics Used for treatment of hiccoughs?

Answer 4

Chlorpromazine

+ ((Cause marked sedation & have moderate antimuscarinic & extrapyramidal side-effects))

Question 5

Anti-psychotics Used in drug induced nausea?

Answer 5

Prochlorperazine

Question 6

Typical anti-psychotic Cause less sedation & antimuscarinic effects, but marked extrapyramidal side-effects?

Answer 6

Fluphenazine, Trifluoperazine

Question 7

Typical anti-psychotic has no anti-histaminic activity, so not used as anti-emetic?

Answer 7

Thio-rida-zine

Question 8

anti-psychotic with High extrapyramidal effects

Answer 8

Haloperidol

Question 9

anti-psychotic ( Used in neurolept anesthesia )?

Answer 9

Droperidol

( It’s typical )

Question 10

Effective for both positive & negative symptoms?

Answer 10

Atypical antipsychotics

Question 11

Negative symptoms. Not getting pleasure from normally
pleasurable stimuli. We use?

Answer 11

Atypical antipsychotics

Question 12

Adverse effects of Typical anti-psychotics

Answer 12

Autonomic nervous system:

-↑ IOP, dry mouth ( x M3)

-tachycardia, impotence & failure to ejaculate ( x a1 )

-Parkinsonism akathesia & dystonia & dyskinesia ( extrapyramidal )

-Amenorrhea (hyperprolactinemia)

-Weight gain increase in appetite. Hyperglycemia

-Neuroleptic malignant syndrome

Question 13

cause agrainulocytosis?

Answer 13

Clozapine

Question 14

Neuroleptic malignant syndrome treated with?

Answer 14

dantrolene & stop the drug

Question 15

Other indications of antipsychotics?

Answer 15

1.Anti emetic use except Thioridazine (No anti- emetic activity)
2.Pruritis
3.Neurolept anesthesia (Droperidol+ fentanyl)
4. Hiccups : Chlorpromazine is more effective

Note
Not used in Parkinsonism

Question 16

Commonly prescribed as first line in schizophrenia
• Blocks both dopamine D2 and 5-HT 2 receptors

Answer 16

Risperidone

Question 17

Atypical anti-psychotics Causes lesser extrapyramidal, anti-muscarinic & prolactin related side effects & weight gain. But Cause anxiety, insomnia, dizziness & hypotension

Answer 17

Risperidone

Question 18

Olanzapine may cause ?

Answer 18

hyperglycemia

Question 19

used in patients refractory to other antipsychotic drugs & has shown to be an effective antipsychotic drug with a minimal risk of extrapyramidal effects.

Answer 19

Clozapine

Question 20

Can cause bone marrow depression ?

Answer 20

Clozapine

Question 21

Dopamine D2 receptor blocked by anti-psychotic drugs
will decrease activity of?

Answer 21

anti-Parkinsonism drugs that are dopamine agonists

Question 22

anti-psychotics can Potentiate?

Answer 22

sedative effects of benzodiazepines & antihistamines

Question 23

antipsychotic used in bipolar depression

Answer 23

aripeprazole