Major Tranquilizers

Question 1

What are tranquilizers also known as?

Answer 1

• antipsychotic medications
• neuroleptic drugs (older term)

Question 2

What are tranquilizers used to treat?

Answer 2

• Psychotic disorders - schizophrenia, paranoia
• Dementia
• Movement disorders
• Intractable hiccups
• Severe nausea and vomiting (chemotherapy)

Question 3

What kind of drugs are tranquilizers?

Answer 3

Blocker drugs - they block all kinds of receptors and act as antagonists

Primarily with dopamine receptors (reward neurotransmitter & movement)

Question 4

What is responsible for the major effects of tranquilizers?

Answer 4

Blockade of dopaminergic transmission

Question 5

What does blockage in the prefrontal cortex and limbic areas cause with tranquilizers?

Answer 5

Antipsychotic action

Question 6

What does blockade in basal ganglia with tranquilizers do?

Answer 6

Extrapyramidal side effects - like parkinson’s

Question 7

What does blockade in chemoreceptor trigger zone of the medulla cause with tranquilizers?

Answer 7

Antiemetic effects - stop vomiting

Question 8

How does tranquilizers help with schizophrenia?

Answer 8

Schizophrenia = overactivity of dopaminergic system –> antipsychotic meds reduce dopaminergic activity by blocking D2 receptors

Question 9

All tranquilizers are strong _________ receptor antagonist?

Answer 9

D2 receptor

Question 10

What are some problems with dopaminergic hypothesis of schizophrenia?

Answer 10

Receptors are blocked within 2-4 hours, but therapeutic activity requires several weeks of treatment to achieve full effect

Therapeutic effect is related to slow-developing depolarization block of dopaminergic neurons

Question 11

Since tranquilizers help to recover normal cell morphology - what happens after drugs are discontinued?

Answer 11

Morphological abnormalities come back and symptoms of disease return

Question 12

All tranquilizers have similar ________?

Answer 12

Efficacy

Question 13

What are some side effects of tranquilizers?

Answer 13

• Extrapyramidal side effects: movement disorders
  
  • Parkinsonism - akinesia (difficulty initiating movement) tremor
  • Caused by blockade of D2 receptors in basal ganglia
• Akathisia - restless leg syndrome
• Dystonia - sustained muscle contraction
• Tradive Dyskinesia - abnormal movements (face and tongue but may be trunk and limbs)
• Sedation and Autonomic side effects

Question 14

Antipyschotics potentiate CNS effects of what kind of drugs?

Answer 14

• Sedatives
• Analgesics
• Antihistamines
• Respiratory depression caused by Opioids
• Antacids - decrease absorption of antipyschotics
• Anticonvulsants - decrease plasma levels of antipsychotics
• Antipyschotics may alter efficacy of antihypertensive meds

Question 15

What are some of the typical antipyschotics?

Answer 15

• chlorpromazine (Thorazine) - original
• haloperidol (Haldol) - end of life drug
• prochlorperazine (Compazine) - nausea/vomiting

Question 16

What are the atypical antipsychotics?

Answer 16

• aripiprazole (Abilify) - bipolar
• clozapine (Clozaril)
• risperdone (Risperdal)

Question 17

What are the things a dentist should watch out for with patients taking antipsychotics?

Answer 17

• Hematologic disturbances - wbc counts
• Alter QT interval of heart - caution with epinephrine, risk for arrhythmias
• Extrapyramidal effects (movement disorders)
  
  • Bruxism, tardive dyskinesia