Neuroleptics (decrease DA) - for Schizophrenia

Question 1

1st generation (typical or atypical?)

Answer 1

“Typical”

Question 2

Chlorpromazine

Answer 2

1st gen antipsychotic, antagonize D2 receptors. Low potency, also H1 antagonist (dry mouth, constipation)

Question 3

Fluphenazine

Answer 3

1st gen antipsychotic, D2 antagonist - high potency (Schizophrenia)

Question 4

Trifluoperazine

Answer 4

1st gen antipsychotic, D2 antagonist - high potency (Schizophrenia)

Question 5

Perphenazine

Answer 5

1st gen antipsychotic, D2 antagonist - high potency (Schizophrenia)

Question 6

Thiothixene

Answer 6

1st gen antipsychotic, D2 antagonist - high potency (Schizophrenia)

Question 7

Haloperidol

Answer 7

1st gen antipsychotic, D2 antagonist - high potency (Schizophrenia)

Question 8

Tetrabenazine

Answer 8

VMAT2 inhibitor = Domamine-depleting in synapse (for huntington’s and tardive dyskinesia. occasionally used for schizophrenia)

Question 9

Dantrolene

Answer 9

Direct muscle relaxant (for malignant hyperthermia associated with NMS) - NMS (neuroleptic malignant syndrome is side effect of neuroleptics)

Question 10

2nd generation neuroleptics (typical or atypical?)

Answer 10

“Atypicals”. Pines, Dones, and Rips
Pines: more sedating b/c more antihistamine activity and more metabolic syndrome inducing
Drones: more EPS
Rips: only one (Aripiprazole), less weight side effects

Question 11

Clozapine

Answer 11

D2 (& D1 & D4) receptor antagonist, and 5-HT receptor antagonist, and NMDA antagonist. For schizophrenia when other drugs don’t work, must monitor WBC. 2nd gen neuroleptic

Question 12

Olanzapine

Answer 12

D2 antagonist, 5-HT antagonist (lessens EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 13

Quetiapine

Answer 13

D2 antagonist, 5-HT antagonist (lessens EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 14

EPS

Answer 14

Extrapyramidal syndrome: when DA forced too low => Akathesia, Dystonia, Parkinsonism, NMS (neuroleptic malignant syndrome = hyperthermia, muscle rigidity, vital sign instability, and Rhabdomyolysis)

Question 15

NMS

Answer 15

Neuroleptic Malignant Syndrome: When DA forced too low => hyperthermia, muscle rigidity, vital sign instability, and Rhabdomyolysis (also EPS)

Question 16

Asenapine

Answer 16

D2 antagonist, 5-HT antagonist (lessens EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 17

Risperidone

Answer 17

D2 antagonist, 5-HT antagonist (more EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 18

Ziprazidone

Answer 18

D2 antagonist, 5-HT antagonist (more EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 19

Paliperidone

Answer 19

D2 antagonist, 5-HT antagonist (more EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic. Active metabolite of risperidone

Question 20

Iloperidone

Answer 20

D2 antagonist, 5-HT antagonist (more EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic

Question 21

Lurasidone

Answer 21

D2 antagonist, 5-HT antagonist (more EPS risks). For schizophrenia. halts mania. 2nd gen neuroleptic. least weight side effects of all SGAs

Question 22

Aripiprazole

Answer 22

Partial D2 and D3 agonist, partial 5-HT 1a agonist, 5-HT 2a antagonist. for schizophrenia, stops mania, treats depression. less weight side effects

Question 23

Reserpine

Answer 23

Blocks VMAT => decreased release of monoamines = for hypertension and psychosis (decrease NE and DA)