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Psychiatric Drug Classes > Neuroleptics/Antipsychotics > Flashcards

Neuroleptics/Antipsychotics Flashcards

0
Q

What is another name for antipsychotics?

A

Neuroleptics

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1
Q

What are antipsychotics used to treat? What are three examples?

A

They are used primarily to treat psychosis

i.e., hallucinations, delusions, and thought disorder

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2
Q

The word neuroleptic is derived from which two Greek words?

A

The Greek words for “nerve” and “affecting” (lentikos, which means seizing)

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3
Q

Neuroleptics were originally understood to do what?

A

Reduce the intensity of nerve function

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4
Q

Neuroleptics used to be called what?

A

Major tranquilizers

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5
Q

Thorazine

First Generation

A

Chlorpromazine

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6
Q

Prolixin

First Generation

A

Fluphenazine

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7
Q

Haldol

First Generation

A

Haloperidol

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8
Q

Loxitane

First Generation

A

Loxapine

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9
Q

Trilafon

First Generation

A

Perphenazine

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10
Q

Orap

First Generation

A

Pimozide

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11
Q

Mellaril

First Generation

A

Thioridazine

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12
Q

Navane

First Generation

A

Thiothixene

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13
Q

Stelazine

First Generation

A

Trifluoperazine

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14
Q

Abilify

Second Generation

A

Aripiprazole

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15
Q

Saphris

Second Generation

A

Asenapine

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16
Q

Clozaril

Second Generation

A

Clozapine

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17
Q

Fanapt

Second Generation

A

Iloperidone

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18
Q

Latuda

Second Generation

A

Lurasidone

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19
Q

Zyprexa

Second Generation

A

Olanzapine

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20
Q

Invega

Second Generation

A

Paliperidone

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21
Q

Seroquel

Second Generation

A

Quetiapine

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22
Q

Risperdal

Second Generation

A

Risperidone

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23
Q

Geodon

Second Generation

A

Ziprasidone

24
Q

Both first and second generation antipsychotics block what type of receptors? In which specific system?

A

They block post-synaptic dopamine receptors in the mesolimbic system

25
Q

How do you first and second generation antipsychotics each impact serotonin receptors?

A

First generation antipsychotics have minimal antagonism of serotonin receptors

Second-generation antipsychotics have greater antagonism of serotonin receptors

26
Q

The side effects associated with both first and second generation antipsychotics are due to antagonism at which three types of receptors?

A

Histaminic, muscarinic, and Alpha adrenergic receptors

27
Q

Antipsychotic medications are FDA approved for which 5 conditions?

A

Schizophrenia

bipolar disorder

major depressive disorder (adjunctive therapy)

autism

Tourette’s disorder

28
Q

In dementia, what is the non-FDA approved use of antipsychotic medications?

A

For behavioral disturbances

29
Q

What is the non-FDA approved use of antipsychotic medications in substance use disorder?

A

To promote reduction in use

30
Q

What is the non-FDA approved use of antipsychotic medications in patients with anorexia nervosa?

A

To increase body weight

31
Q

Antipsychotic medications are used as non-FDA approved adjunctive therapy in which 2 conditions?

A

Obsessive-compulsive disorder

post-traumatic stress disorder

32
Q

True or false: antipsychotic medication is used as a non-FDA approved therapy for generalizing anxiety disorder?

A

True

33
Q

Antipsychotic medications are also not FDA approved for the treatment of which three symptoms?

A

Hiccups, nausea/vomiting, and delirium

34
Q

What are 4 examples of extrapyramidal side effects?

A

Dystonia, akathisia, parkinsonism, tardive dyskinesia, Etc.

35
Q

What type of syndrome can antipsychotic medication use trigger?

What 4 aspects of this syndrome characterize the condition?

A

Metabolic syndrome

Elevated lipids, hypertension, hyperglycemia, and obesity

36
Q

What are 6 anti-cholinergic effects caused by antipsychotic medication use?

A

Confusion, agitation, constipation, xerostomia, blurred vision, and urinary retention

37
Q

What kind of does-related effect can some antipsychotic medications have?

A

Does-related sedation

38
Q

Use of antipsychotic medication may exhibit what type of EKG change in some patients?

A

Prolongation of QTC interval

39
Q

Antipsychotic medications can cause what type of endocrinopathy?

A

Hyperprolactinemia (Inhibition of dopamine)

40
Q

What effect can some antipsychotic medications have on blood pressure?

A

orthostatic hypotension

41
Q

What impact can antipsychotic medications have on relationships and sexual health?

A

It can cause sexual dysfunction

42
Q

Do some antipsychotic medications impact liver functioning?

A

Yes, they can lead to LFT elevations and hepatitis

43
Q

A patient currently taking antipsychotic medications who presents with confusion, hyperthermia, tachycardia, muscle rigidity, and labile blood-pressure is more than likely suffering from what condition?

A

Neuroleptic malignant syndrome

44
Q

Inducers or inhibitors of CYP450 have the potential to influence antipsychotics serum concentrations in what ways?

A

They have the ability to either decrease or increase serum concentrations of antipsychotic medications

45
Q

Inducers or inhibitors of which 3 specific genotypes of CYP450 have the potential to influence antipsychotic serum concentrations?

A

1A2
3A4
2D6

46
Q

Using antipsychotic medications in combination with antihypertensive agents may increase the risk of what complication?

A

Orthostatic hypotension

47
Q

The use of antipsychotic medications in combination with benzodiazepines may increase the risk for what complication?

A

Over sedation

48
Q

Using antipsychotic medications in combination with agents known to increase the QTC interval may increase the risk of what complication?

A

Torsades

49
Q

Why are the second-generation antipsychotics now considered first-line therapy?

What three side effects are they associated with?

A

They are considered first-line due to their lower risk of extrapyramidal symptoms

Weight gain, lipid abnormalities, and incident diabetes

50
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics showed what general finding?

A

It showed that there are few differences of clinical importance with regard to the use of first vs. second-generation antipsychotics for treating the core symptoms of schizophrenia

51
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics, showed what type of clinical relationship between haloperidol and olanzapine?

A

There was some evidence for benefit of haloperidol over olanzapine for improving POSITIVE symptoms of schizophrenia

52
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics, showed what second type of clinical relationship between olanzapine and haloperidol?

A

There was also some evidence of olanzapine over haloperidol for improving NEGATIVE symptoms of schizophrenia

53
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics, showed an increased incidence of what syndrome with olanzapine?

A

Metabolic syndrome

54
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics, showed low-strength evidence of a higher incidence of what adverse effect for chlorpromazine versus clozapine?

A

Tardive dyskinesia

55
Q

A 2012 journal article in the Annals of Internal Medicine, by Hartling, et al., which was a review of first vs. second generation antipsychotics, showed what regarding diabetes mellitus?

A

Evidence was insufficient to draw conclusions regarding diabetes mellitus

56
Q

The CATIE trial, Which was a 2005 journal article published in the New England Journal of Medicine by Lieberman et al. Compared perphenazine (a first-generation antipsychotic) with several second-generation antipsychotics in a double-blind study. The majority of patients in each group ended up doing what?

A

The majority of patients in each group discontinued their assigned treatment due to a lack of efficacy or intolerable side effects (74% by 18 months)

57
Q

The CATIE trial, Which was a 2005 journal article published in the New England Journal of Medicine by Lieberman et al. Compared perphenazine (a first-generation antipsychotic) with several second-generation antipsychotics in a double-blind study. Which medication showed the greatest weight gain and increases in glucose and lipids?

A

Olanzapine

58
Q

The CATIE trial, Which was a 2005 journal article published in the New England Journal of Medicine by Lieberman et al. Compared perphenazine (a first-generation antipsychotic) with several second-generation antipsychotics in a double-blind study. Which medication showed the greatest risk of extrapyramidal side effects?

A

Perphenazine

Psychiatric Drug Classes (10 decks)

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