PHARM - antipsychotic pharmacology Flashcards
(28 cards)
typical antipsychotics are also known as
neuroleptics
name four typical antipsychotics (DA inhibitors)
chlorpromazine - low potency
perphenazine - medium potency
haloperidol - high
fluphenazine - high
dopamine theory of schizophrenia
- hypoactivity in the mesocortical pathway causing negative symptoms
- hyperactivity in the mesolimbic pathway causing positive symptoms
side effects of low potency typical antipsychotics
- Dry mouth, blurred vision, constipation, urinary retention, hypotension, sedation, weight gain
- Less acute dystonia, NMS
- Parkinsonism, akathesia, tardive dyskinesia
- Prolactin elevation
side effects of high potency typical antipsychotics
- More acute dystonia, NMS
- Parkinsonism, akathesia, tardive dyskinesia
- Prolactin elevation
period of maximum risk for acute dystonia
1-5 days
period of maximum risk for Parkinsonism
5-30 days
period of maximum risk for akathisia (motor restlessness)
5-60 days
period of maximum risk for tardive dyskinesia (oral-facial)
months to a year
period of maximum risk for rabbit syndrome (perioral tremor)
months to year
what percent of tardive dyskinesia in psych patients is due to neuroleptics?
about half
major manifestations of NMS
fever, rigidity, increased CPK level
minor manifestations of NMS
tachycardia tachypnea abnormal BP altered consciousness diaphoresis
NMS diagnostic criteria
3 major or 2 major and 4 minor
clozapine type, indication, and mechanism
- novel antipsychotic
- taken off market and reintroduced for treatment resistant schizophrenia
- potent serotonin and NE a2 antagonist, weak DA D2 antagonist
clozapine benefits
benefits - dramatically effective for positive and some negative symptoms
- minimal EPS effects
- minimal prolactin elevation
clozapine side effects
Agranulocytosis (reason for blood tests consistently) Seizures Myocarditis Weight gain, glucose and lipid dysregulation Tachycardia, hypotension Drooling Sedation Liver function changes
clozapine is especially effective for….
- comorbid substance abuse with schizophrenia
- decreasing required hospitalization time to prevent suicide
risperidone type, indication, mechanism
- novel antipsychotic (first one introduced post-clozapine)
- 5HT2/D2 ratio similar to clozapine
risperidone side effects
- EPS at higher doses
- prolactin elevation
risperidone benefit
- fewer relapses than haloperidol
olanzapine type, indication, mechanism
- novel antipsychotic (second post-clozapine)
- 5HT/D2 ratio like clozapine/risperidone
olanzapine SEs
- low EPS
- low prolactin elevation
- weight gain, sedation, glucose/lipid dysreg?
quetiapine type, indications, mechanism
- novel antipsychotic
- 5HT/D2 ratio similar to clozapine
