NEURO: ANTIPSYCHOTICS, 1ST GENERATION ATYPICAL - CLOZAPINE Flashcards

1
Q

ANPAT CLOZAPINE: INDICATIONS

A
  • Urgent tx for psychomotor agitation
  • Schizophrenia
  • Bipolar Disorder
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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
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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
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4
Q

ANPAT CLOZAPINE: WARNINGS

A
  • Cardiovascular Dx patients

- Not used in patients with severe heart disease and neutropenia

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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)
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6
Q

ANPAT CLOZAPINE: OTHER EXAMPLES

A
  • Quetiapine
  • Olanzapine
  • Risperidone
  • CLOZAPINE
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