Neuropharmacology: Antipsyhcotics II Flashcards
What are the targets of atypical psychotics?
DA blockade esp against D4 (and D2)
5HT2A/C block
What are the side effects of DA receptor blocsk?
dyskinesias, parkinsonisms, galactorrhea, anti-emesis
What are some advantages of serotonin receptor blocks? Disadvantages?
may be antipsychotic
also, it suppresses many extrapyramidal side effects
disadvantage: depression
What drugs have cholinergic blocks, and which ones don’t?
do: chlopromazine, clozapine
do NOT: haloperidol, risperidone
What are the side effects of drugs with anti-cholinergic properties?
confusion, tachycardia, constipation, urinary retention, blurred vision
What are some disadvantages of an alpha-adrenergic 1 block?
hypotension.
What are the disadvantages of an alpha-adrenergic 2 block?
weight gain. esp. wti clozapine and olanzapine
What are some side effects of a histaminic block?
sedation, drowsiness, weight gain. seen with many drugs but NOT haloperidol
How do the pharmacokinetcis contribute to drug-drug interactions with anti-psychotics?
these are highly protein bound. so if you have another drug that is highly protein bound, you may increse the effective concentration i nthe brain since there are fewer proteins for it to hang out with in the periphery.
What is the drug and side effect I need to know about with anti-psychotics?
clozapine produces angranulocytsis. thus, pts must have regular blood testing for as long as they are on the drug at lease every 2 wks.
What are the neurotoxic side effects?
acute dystonia, akathisia (fidgety), parkinsonism, perioral tremo, and tardive dyskinesia
How do we manage acute dystonia and when does it occur?
occurs early and is treated with anti-PD drugs– though this is tough becasue these drugs increase DA concentrations. may try anti-PD drugs that work by blocking ACh
How do we manage acute akathisia and when does it occur?
first 1-2 mo after start of treatment
treat with beta-blockers primarily (propanlol, anticholinergics)
How do we manage tardive dyskinesia and when does it occur? Which drugs/patients most likely? Other symtpoms?
see after months-yrs of therapy. sometimes also see choreaform movements due to DA nuerons who are overly sensitive to DA. less frequently seen with newer gen drugs. these symptoms often get worse after withdrawal of the offending agent but symptoms may eventually subside (or not). prevention is keye.
