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NMSP Exam III > [PHARM] Anti-psychotics [Segars] > Flashcards

[PHARM] Anti-psychotics [Segars] Flashcards

1
Q

What antipsychotic is used for suicidal behavior?

A

Clozapine

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2
Q

What antipsychotic drug is used for hallucinations/delusions associated with parkinson disease psychosis?

A

Pimavanserin

(remember, P with Parkinson)

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3
Q

What are examples of positive symptoms of schizophrenia?

A

Hallucinations

Delusions

Disorganized speech/thinking

Agitation

Abnormal motor behavior

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4
Q

What are examples of negative symptoms of schizophrenia?

A

Apathy

Avolition

Alogia

Cognitive deficits (working memory)

Social withdrawal

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5
Q

What are the implications with D2 antagonism?

A

1) Induces extrapyramidal symptoms (pseudoparkinsonism)
2) Hyperprolactinemia

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6
Q

What is suffix is -azine associated with?

A

First generation agents

-azine

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7
Q

What suffix is -idone associated with?

A

Second generation agents

-idone

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8
Q

What suffix is -piprazole associated with?

A

Second generation agents

-piprazole

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9
Q

What suffix is -apine associated with?

A

Second generation agents

-apine

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10
Q

What is the primary difference b/w 1st generation agents and 2nd generation agents?

A

Second generation have reduced movement disorder side effects than first gen

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11
Q

MOA of first generation antipsychotics?

A

Primarily block dopamine type 2 (D2) post synaptic receptors

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12
Q

Where are other sites of action of 1st generation antipsychotics?

A

In addition to primarily blocking D2 receptors…

  • Muscarinic (M)
  • Histamine (H1)
  • Alpha adrenergic (Alpha1)
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13
Q

What are the SE associated with blocking muscarinic receptors?

A

Dry mouth

Constipation

Urinary retention

Blurred vision

Sedation

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14
Q

What are the SE associated with blocking alpha adrenergic receptors?

A

Orthostatic hypotension

Dizziness/syncope

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15
Q

What are the SE associated with blocking histamine receptors?

A

Sedation

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16
Q

Describe the dopamine associated side effects:

A

Hyperprolactinemia

Extrapyramidal symptoms (EPS) (acute or tardive dyskinesia)

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17
Q

When is the D2 occupancy dangerous for getting extrapyramidal symptoms?

A

Greater than approx 80%

18
Q

What are the (2) low potency 1st gen agents?

A

Chlorpromazine

Thioridazine

19
Q

What are the low potency agents more well known for?

A

more sedation, hypotension, tachycardia, ECG-changes

20
Q

What are the (2) high potency 1st gen agents?

A

Haloperidol

Fluphenazine

21
Q

What are the high potency agents more associated with?

A

more movement (EPS) and endocrine effects (prolactin)

22
Q

How do you treat a patient with dystonia (EPS)?

A
  1. Anticholinergics (benztropine, Diphenhydramine, and Trihexyphenidyl)
23
Q

What can you use to treat a patient with akathisia?

A

3 Bs:

  1. Beta-blocker (propranolol)
  2. Benzodiazepine (lorazepam)
  3. Anticholinergic (Benztropine)
24
Q

How can you treat a patient with EPS of parkinsonism?

A
  1. Anticholinergic (benztropine)
  2. Dopamine enhancer (release/reuptake) (amantadine)
25
Q

what is tardive dyskinesia and how can you treat it?

A

repetitive, uncontrollable movements, >6 months

selective vesicular monoamine transporter 2 (VMAT2) (valbenazine and deutetrabenzine)

26
Q

What is the class of drugs used to treat tardive dyskinesia (TD)?

What are those drugs?

A

Selective vesicular monoamine transporter 2 inhibitors

Valbenazine

Deutetrabenazine

27
Q

What is the MOA of second generation antipsychotics?

A

Block dopamine (D2) receptors

AND

5HT2A

28
Q

What is the -suffix for the second generation antipsychotics that are 5HT-2A/DA receptor antagonists?

Name the (3) drugs

A
  • idone
  • Lurasidone
  • Risperidone
  • Ziprasidone
29
Q

What is the -suffix for the second generation antipsychotics that are PARTIAL 5HT-1A/DA receptor AGONISTS?

Name the (1) drugs

A

-piprazole

Aripiprazole

30
Q

What is the -suffix for the second generation antipsychotics that are multi-acting receptor-target agents?

Name the (3) drugs

A

-apine

Clozapine

Olanzapine

Quetiapine

31
Q

What is the ONE inverse serotonin agonist/antagonist?

A

Pimavanserin

(Parkinson’s psychosis)

32
Q

What are the common side effects with second generation anti-psychotics?

A

Weight gain

Metabolic effects

QTc prolongation/ECG changes

33
Q

Which second generation antipsychotic med should be your go-to?

(fewest side effects)

A

Aripiprazole

34
Q

What is one of the RARE side effects of clozapine?

A

Agranulocytosis

35
Q

What is the ONE rare side effect of olanzapine that is noteworthy?

A

Drug reaction w/ eosinophilia and systemic symptoms (DRESS)

36
Q

What is neuroleptic malignant syndrome (NMS)?

A

Rare but potentially fatal, severe Parkinson’s like movement disorder w/ wide spread muscle contraction

37
Q

What is the antidote for neuroleptic malignant syndrome?

A

Dantrolene

38
Q

What sort of labs should you aquire before prescribing second gen antipsychotics?

A

Serum glucose

Lipids

Weight

BP

Waist circumference

Personal/FH of metabolic and CV disease

39
Q

What are the (4) Long acting injectable agents?

A

“ROAP”

R= Risperidone

O= Olanzapine

A= Aripiprazole lauroxil

P= (will not be on exam) just remember top 3

40
Q

What are the (4) first generation agents that segars wants you to know?

A

Chlorpromazine

Fluphenazine

Haloperidol

Thioridazine

41
Q

What are the (8) second generation agents that segars wants you to know?

A

Aripiprazole

Cariprazine

Clozapine

Lurasidone

Olanzapine

Quetapine

Risperidone

Ziprasidone

NMSP Exam III (5 decks)

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