Pharmacology - Antipsychotics Flashcards
(+) symptoms are due to what chemical inbalance?
Increased Dopamine
(-) symptoms are due to what chemical inbalance?
Increased Serotonin
Typical Antipsychotics (1st Gen) have what MOA?
Dopamine Antagonists
What are the 2 HIGH potency Typical Antipsychotics?
Haloperidol
Fluphenazine
What are the 2 HIGH potency Typical Antipsychotics?
Haloperidol
Fluphenazine
What are the 2 LOW potency Typical Antipsychotics?
Thioridazine
Chlorpromazine
What are the 2 LOW potency Typical Antipsychotics?
Thioridazine
Chlorpromazine
If EPS (extrapyramidal symptoms) arise with use of Typical Antipsychotics, what pathway is altered?
Nigrostriatal
If EPS arise with use of Typical Antipsychotics, what is the treatment?
Anti-cholinergic medications
Akathisia
Feeling restless - urge to move
If a patient is on a Dopamine Antagonist and develops extreme restlessness, what do they have?
Akathisia
Acute Dystonia
Muscle contraction
If a patient is on a Dopamine Antagonist and develops a sustained muscle contraction, what do they have?
Acute Dystonia
Dyskinesia is a possible EPS with Typical Antipsychotics. What will it mimic?
Parkinson’s like features
What is the most severe and permanent EPS with use of Typical Antipsychotics?
Tardive Dyskinesia
Describe Tardive Dyskinesia
Facial movements
- Grimacing
- Lip/tongue smacking
Typical Antipsychotics (1st Gen) can also affect what endocrine related pathway?
Tubuloinfundibular
What are the possible endocrine related side effects of Dopamine Antagonists?
Galactorrhea
Amenorrhea
Gynecomastia
How do Dopamine Antagonists cause Galactorrhea/Amenorrhea/Gynecomastia?
Dopamine normally inhibits the release of Prolactin
–> If Dopamine is blocked, then there will be an increase in Prolactin release
Atypical Antipsychotics (2nd Gen) have what MOA?
Dopamine AND Serotonin Antagonists
List 4 common Atypical Antipsychotics
Quetiapine
Olanzapine
Risperidone
Clozapine
List 3 side effects of Quetiapine
Somnolence
Weight gain
QTC prolongation
List 3 side effects of Olanzapine
Weight gain
Diabetes Mellitus
QTC prolongation
What is the very LAST option when treating with Atypical Antipsychotics?
Clozapine
What is the major side effect of Clozapine?
Agranulocytosis
In a normal patient, what drug class should be chosen?
Atypical Antipsychotics
= Dopamine and Serotonin Antagonists
In an Agitated patient, what 2 drugs should be used?
Haloperidol
Olanzapine
What 2 drugs have oral dissolving forms for those that won’t take pills?
Olanzapine
Risperidone
For noncompliant patients, what is a good route of administration?
Depot
If all else fails, what drug should you choose?
Clozapine
