Neuroleptics & Anti- Psychotics

Question 1

What mechanism of action do anti- Schizophrenia drugs take?

Answer 1

• Dopamine D2 receptor antagonists

- Reduce the positive symptoms of Schizophrenia

Question 2

Haloperidol:

Answer 2

-High Potency (2mg)
-Typical Drug
-D1 and D2 antagonist
AE’s include EPS symptoms, hyperprolactinemia, anti-emetic (anti-vomiting), tardive dyskinesia

Question 3

Zuclopenthixol:

Answer 3

Moderate Potency (4mg)
-Typical Drug
-D1 and D2 antagonist
-Used for long term treatment
3 forms:
1. Zuclopenthixol dihydrochloride- taken orally
2. Zuclopenthixol acetate- used as a sedative
3. Zuclopenthixol decanoate- weekly injections
AE’s: DA side effects only
–>EPS Symptoms, hyperprolactiema, anti-emetic & tardive dyskinesia

Question 4

Chlorpromazine:

Answer 4

Low Potency (100 mg)

• Typical Drug
• Dopamine antagonist least likely to cause toxicity
• Targets the EPS, pituitary and chemoreceptor zone
• Can cause tardive dyskinesia

Question 5

Clozapine (Clorazil):

Answer 5

D1, D2 and 5-HT antagonist
-Effective for both pos and neg symptoms
-AE’s: Few EPS symptoms; weight gain
–>Requires mandatory weekly blood testing
(Can cause Bone Marrow Suppression, leading to agranulocytosis and death)

Question 6

Risperidone (Risperal):

Answer 6

High Potency Drug

• D2, 5-HT2 & adrenergic antagonist
• At optimal doses, reduces (+/-) symptoms with no EPS AE’s

Question 7

Olanzapine (Zyprexa):

Answer 7

D2 and 5HT-2 antagonist

• Reduces (+/-) side effects with no EPS symptoms- other than weight gain, dry mouth & dizziness
• -Seems to halt schizophrenia progression

Question 8

Quetiapine (Seroquel):

Answer 8

Low Potency

• D1, D2, 5-HT & 5-HT1a antagonist
• Actions similar to Risperidone & Olanzapine but CHEAPER

Question 9

Neuroleptic Malignant Syndrome:

Answer 9

-Can be caused by a sufficient enough DA block

Treatment:

1. Stop taking drug
2. Hydrate & Cool
3. Dantrolene (Ca2+ release inhibitor)
4. Bromociptine (DA Antagonist)