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pharmacology II > Pharm II, neuroleptics > Flashcards

Pharm II, neuroleptics Flashcards

1
Q

who should never be given antipsycotic medications

A

dementia patients or older population

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2
Q

what are antipsycotics used for?

A

schizophrenia, delirium, mania, sever aggitation

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3
Q

psycosis

A

distorted reality, disorganized thinking hallucinations

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4
Q

hallucinations

A

sensory perception in absence of external stimuli - any of the sences

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5
Q

what is secondary psychosis

A

psychosis from non psychological cnditons like neurological disorders, electrolyte disorders, multiple medical conditons and drugs

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6
Q

neuro disorders than can cause psycosis

A

frontal lobe tumors, syphilis

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7
Q

what is more deadly, hypo or hyperglycemia

A

hypoglycemia

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8
Q

medical conditnos that cause psycosis

A

Lyme, AIDS lupis etc

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9
Q

what OTC drugs can cause psycosis

A

dextromethorphan and antihistamines

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10
Q

what do neuroleptic drugs do

A

they do not cure, they permit patient to function more effectively

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11
Q

two categories of neuroleptic

A

Typical/first generation or Atypical/second generation

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12
Q

what is neuroleptic another word for

A

antipsycotic

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13
Q

what is the MOA of both the typical and atypical neuroleptic drugs

A

both block of dopamine receptors in the brain and have some effect on receptor subtypes NE, ACH and serotonin receptors

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14
Q

what does the atypical neuroleptic dodifferent than typical

A

atypical are antagonist or partial antagonist of serotonin receptors

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15
Q

what receptor seems to be the one that neuroleptic uses

A

Dopamine receptor D2 - blocking receptor

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16
Q

what pathway does excess dopamine cause psycosis

A

mesolimbic pathway

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17
Q

what may cause many of the unwanted side effects of neuroleptics

A

the non selective dopamine receptor blockaid in pathways other than mesolimbic

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18
Q

common side effects of neuroleptics

A

Parkinsonian like sx, weight gain, tadive, blurred vision, benedryl , increased prolactin

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19
Q

dyskinesia

A

involuntary movement ie grimacing, pill rollling

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20
Q

tardive

A

dyskinesia contiues after drugs have been discontinued

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21
Q

extrapyramidal signs

A

akinesia/cant initiate movement - akathisia/cant remain motionless

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22
Q

what is neuroleptic malignant syndrome

A

Rare side effect of neuroleptics - fatal if drug isn’t discontinued and antidoted with dopamine agonist

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23
Q

sx of neuroleptic malignant syndrome

A

catatonia, fluxuatiing BP dysarthria and fever

24
Q

antidote for neuroleptic malignant syndrome

A

dopamine agonist - bromocriptine

25
Q

what causes most neuroleptic drugs to be antiemetic

A

Blockage of D2 dopaminergic receptors in the chemoreceptor triggerzone

26
Q

why are some neuroleptic drugs used in chemo

A

antiemetic effects reducing nausea of chemo

27
Q

typical neuroleptic /block dopamine receptor D2

A

Chlorpromazine/thorazine

28
Q

chlorpromazine /thorazine MOA

A

typical neuroleptic - Primary a D2, alpah and HI blockaide

29
Q

side effects of chlorpromazine/thorazine

A

typical neuroleptic- increased prolactin from dopamine blockate causing galactorrhea amenorrhea and infertility

30
Q

indication for chlorpromazine/thorazine

A

typical neuroleptic- mania - schizophrenia - hiccoughs

31
Q

moa for prochlorperazine/compazine

A

typical neuroleptic - primary HI receptor antagonist, D2 receptor agonist

32
Q

indication for prochlorperazine/compazine

A

typical neuroleptic- verdigo - nausea vomiting from migraines

33
Q

what is the difference in the moa or thorazine and compazine

A

Thorazine primary D2 receptor antagonist/ Compazine primary and H1 receptor antagonist

34
Q

what is the safer typical neuroleptic

A

Compazine has the greatest anti-emetic effect and is concidered safer than thorazine

35
Q

side effects of prochlorperazine/compazine

A

benedryl like sx with lower of seizure threshold*

36
Q

what is haloperidol/haldol

A

typical neuroleptic that chiefly blocks D2 receptor

37
Q

why must you be careful with haloperidol/halodol administration

A

to prevent excessive setation and tardive dyskinesia

38
Q

side effects of haloperidol/haldol

A

typical neuroleptic: extrapyramidal/parkinsonian and neuroleptic malignant syndrome is possible

39
Q

indication for haloperidol/haldol

A

typical neuroleptic huntingtons dz, tourettes, acute agitate behavior

40
Q

typical neuroleptics

A

chlorpromazine/thorazine (D2) - Prochlorperazine/compazine (H1) - Haloperidol/Haldol (D2 blocker)

41
Q

atypical neuroleptics

A

Clozapine/clozaril (D2-5HT20 - Respiradone/risperdal (dop ser block)

42
Q

atypical neuroleptic for schizo when other meds have failed

A

Clozapine/clozaril(D2-5HT2) - Olanzapine/zyprex (D2-5HT2)

43
Q

Why is atypical neuroleptic clozapine/clozaril (D2-5HT) not first line treatment for schizo

A

because of the side effects:

44
Q

side effects of clozapin/clozaril(D2-5HT2)

A

agranulocytosis 1-2% and myocarditis and weight fain and diabetes

45
Q

what is a problem with all atypical neuroleptics

A

weight gain and increased diabetes

46
Q

atypical neuroleptic just for psychosis with unknown MOA

A

Respiradon/risperdal : dopamine serotonin receptor blockade

47
Q

what atypical neuroleptic must you adjust dose if patient has liver dysfunction

A

Respiradone/risperadal: metabolized by CYP 450

48
Q

when would you specifically not use respiradone/risperadal side effects

A

those with dementia and combative behavior: risks of wt gain, high sugar and increased risk of stroke in elderly

49
Q

side effects of olanzapine/zyprexa

A

atypical neuroleptic: extream weight gain, diabetes,stroke

50
Q

what neuroleptic has diminished extrapyramidal effects compaire to the others

A

atypical neuroleptic - Olanzapine/zyprex (D2-5HT2)

51
Q

what is mania

A

elevated or irritable mood with increased activity, speech thought etc

52
Q

what are lithium salts used for

A

prophylactically in bipolar and manic episode treatment

53
Q

MOA or lithium

A

unknown - dampen transmission NE and diminish glutamate respones

54
Q

what is signifigant about Lithium carbonate/eskalith

A

very small therapeudic index effective dose is close to toxic dose - must monitor blood

55
Q

side effects of lithium

A

weight gaoin, cognitive impairment- memory deficits, renal impairment

56
Q

What is the most common renal effect of lithium

A

diabetes insipidus due to reduce renal response to ADH 20%

57
Q

what is the thyroid problem with Lithium carbonate Eskalith

A

hypothyroidism that is not autoimmune in 5-35% its not reversable

pharmacology II (31 decks)

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