Pharm Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

How is antipsychotic-induced EPS toxicity treated?

A

benztropine or diphenhydramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is NMS treated?

A

dantrolene, D2 agonist: bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the EPS side effects? how long are they expected to last?

A
  • Acute dystonia (4 hr)
  • Akathisia (restlessness) (4 d)
  • bradykinesia (4 wk)
  • tardive dyskinesia (4 mo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens when D2 receptors are inhibited?

A

the normal block of adenylate cyclase is lifted leading to an increase in cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What risk is increased with low potency drugs?

A

autonomic (hypoTN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What risk is increased with high potency drugs?

A

EPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is prolactin increased with D2 antagonists

A

Presence of dopamine in the hypothalamus inhibits the release of prolactin. When it’s blocked, prolactin release is less regulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference in effectiveness based on potency?

A

No difference!! They have the same efficacy, but potency determines side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is acute dystonia? How do you treat it?

A

Muscle Spasms: facial grimacing, torticollis (stiff neck), oculogyeric crisis
Tx: anticholinergic antiparkinsonian agent (benztropine) – block increase in DA turnover in BG–> reduce EPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is akathesia? How is it treated?

A

-Strong, subjective feelings of distress or discomfort: “ants in the pants”
Tx: decrease dose (most effective), can add antiparkinsonian or propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of parkinsonian syndrome? How is it treated?

A

akineasia, mask facies, decreased arm movement, rigidity, tremor
Tx: anticholinergic, amantadine
**don’t increase DA levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is NMS? How is it treated?

A

neuroleptic malignant syndrome
-RARE: fever, severe parkinsonian with catatonia
-fluctuations in coarse tremor intensity
-autonomic instability
-elevated CK, myoglobinemia
HIGH MORTALITY
Tx: immediate antipsych cessation, support, dantrolene or bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is perioral tremor?

A
  • RARE
  • rabbit syndrome
  • treat with anticholinergics, stop neuroleptic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is tardive dyskinesia? How is it treated?

A

stereotyped, repetitive, quick choeriform movements of face (eyelids), mouth, tonuge, extremities, trunk
NO adequate treatment, discontinue drug
–symptoms fade with time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some symptoms of metabolic syndrome?

A

abdominal obesity, dyslipidemia, high BP, insulin resistance, glucose intolerance, prothrombotic state (high fibrinogen), pro-inflam state (high CRP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What receptor blockade causes EPS?

A

D2

17
Q

What receptor blockade causes hyperprolatinemia?

A

D2

18
Q

What receptor blockade causes hypotension?

A

alpha adrenergic

19
Q

What receptor blockade causes sedation?

A

histamine

20
Q

What receptor blockade causes weight gain?

A

histamine and 5-HT

21
Q

What receptor blockade causes anticholinergic symptoms?

A

muscarinic

22
Q

What receptor blockade causes sexual side effects?

A

5-HT, muscarinic, noradrenergic, D2

23
Q

How are most antipsychotics given? why not oral?

A

IM

oral absorption is erratic

24
Q

Do antipsychotic cross the placenta? Enter breast milk?

A

yes

25
Q

How long until the peak plasma conc for antupsychotic (about)?

A

2-4 hr

26
Q

How does plasma concentration of antipsychotic correlate to effect?

A

it doesnt

27
Q

How long does the biologic effect of antipsychotic normally last?

A

about 24 hr– once daily dosing

28
Q

What type of tolerance is generally seen with antipsychotics?

A

tolerance to sedation over days to weeks

29
Q

Which type of antipsychotics is associated with CYP interactions?

A

atypicals

30
Q

What 3 antipsychotics are available as long acting depots?

A

haloperidol, risperidone, fluphenazine