NEURO: ANTIPSYCHOTICS, 1ST GENERATION ATYPICAL - CLOZAPINE Flashcards
1
Q
ANPAT CLOZAPINE: INDICATIONS
A
- Urgent tx for psychomotor agitation
- Schizophrenia
- Bipolar Disorder
2
Q
ANPAT CLOZAPINE: MOA
A
- Block post synaptic dopamine-D2 receptors
- Features that distinguish 2nd gen AntiPsych from 1st Gen, improved efficacy in tx resistant schizophrenia and a lower risk of extrapyramidal side effects
- Possible mechanisms for these differences = higher affinity for other receptors (particularly 5-HT2A) and a character of looser binding to the D2 receptors
3
Q
ANPAT CLOZAPINE: ADVERSE EFFECTS
A
- Some degree of sedation
- Extrapyramidal effects = more common with 1st gen AntiPsych
- Metabolic disturbance = weight gain, DM, lipid changes
- Prolong QT interval = arrhythmias
- Risperidone = particular effects on dopaminergic transmission in the TUBEROHYPOPHYSEAL PATHWAY - regulates the secretion of Prolactin
- Breast Symptoms and sexual dysfxn
- Agranulocytosis
- Myocarditis
4
Q
ANPAT CLOZAPINE: WARNINGS
A
- Cardiovascular Dx patients
- Not used in patients with severe heart disease and neutropenia
5
Q
ANPAT CLOZAPINE: INTERACTIONS
A
- Sedation may be more pronounced when used with other sedating drugs
- Should not be combined with other dopamine blocking antiemetics and drugs that prolong the QT interval ( amiodarone, quinines, macroclides, SSRIs)
6
Q
ANPAT CLOZAPINE: OTHER EXAMPLES
A
- Quetiapine
- Olanzapine
- Risperidone
- CLOZAPINE