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Pharmacology > Psych: Antipsychotics > Flashcards

Psych: Antipsychotics Flashcards

1
Q

Which antipsychotic is useful for suicidal behavior?

A

Clozapine

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2
Q

Which antipsychotic is useful for the hallucinations/delusions associated with Parkinson’s Disease?

A

Pimavanserin

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3
Q

How long does it take for antipsychotics to work?

A

Minimum of 2-3 weeks

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4
Q

MOA of Chlorpromazine, fluphenazine, perphenazine, thioridazine, trifluoperazine?

A

D2 receptor antagonists
-also block muscarinic, H1

First generation (Typical) antipsychotics

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5
Q

MOA of haloperidol?

A

D2 receptor antagonists
-also block muscarinic, H1

First generation (Typical) antipsychotics

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6
Q

MOA of loxapine, molindone, pimozide, and thiothixene?

A

D2 receptor antagonists (D2>5HT)
-also block muscarinic, H1

First generation (Typical) antipsychotics

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7
Q

MOA of iloperidone, lurasidone, paliperidone, risperidone, ziprasidone?

A

5HT2A and D2 blockers (5HT>DA)

Second generation (Atypical) antipsychotics

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8
Q

MOA of apripiprazole and brexipiprazole?

A

Partial DA/5HT1 receptor agonists

Second generation (Atypical) antipsychotics

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9
Q

MOA of cariprazine ?

A

5HT2/D2 antagonist and partial DA/5HT1 agonist

Second generation (Atypical) antipsychotics

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10
Q

MOA of asenapine, clozapine, olanzapine, quetiapine and lumateperone?

A

Multi-acting Receptor target agents

Second generation (Atypical) antipsychotics

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11
Q

MOA of pimavanserin?

A

Inverse 5HT agonist

Second generation (Atypical) antipsychotics

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12
Q

What are some of the adverse effects associated with the first-generation antipsychotics?

A

Muscarinic
-dry mouth, constipation, urinary retention, blurred vision

Alpha-adrenergic
-orthostatic hypotension, dizziness/syncope

Other
-risk of QTc

Hyperprolactinemia

Extrapyramidal symptoms

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13
Q

What are the acute extrapyramidal symptoms associated with first generation antipsychotics?

A

Acute akathisia, dystonia, parkonsonian like

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14
Q

What are the late symptoms of first generation antipsychotics?

A

Tardive dyskinesia

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15
Q

How do you treat the extrapyramamidal symptoms?

A

Benztropine and Trihexyphenidyl

Also diphenhydramine

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16
Q

How do you treat tardive dyskinesia associated with first gen antipsychotics?

A

Selective VMAT2 inhibitors

Valbenazine and deutetrabenazine

17
Q

What are common side effects among all the second generation antipsychotics?

A

Weight gain and metabolic effects

QT prolongation

Stroke

18
Q

What do you have to test for before starting a patient on second gen antipsychotics?

A

serum glucose, lipids, BMI, BP, waist circumference, personal/family history of CV disease

Mainly establishing baseline of metabolic issues due to the risk**

19
Q

Which second gen antipsychotic is associated with agranulocytosis?

A

Clozapine

-monitor WBC

20
Q

Which second gen antipsychotic is associated with DRESS syndrome?

A

Olanzapine

21
Q

What is a severe adverse reaction that includes severe fever and muscle rigidity that is associated with all antipsychotics?

A

Neuroleptic Malignant Syndrome (NMS)

-Tx: dantrolene

22
Q

How do you treat Neuroleptic Malignant Syndrome (NMS)?

A

Dantrolene

-Ca++ channel blocker (RYR channel)

23
Q

Which drugs should be used for non-adherence to meds?

A

Haloperidol decanoate
Fluphenazine decanoate

Risperidone
Olanzapine
Ariprazole lauroxil
Paliperidone palmitate

24
Q

Which second-generation antipsychotics are LEAST associated with weight gain? (3)

A

Aripiprazole
Lurasidone
Ziprasidone

25
Q

which subclass of first-generation antipsychotics is LEAST associated with sedation, anticholinergic, and orthostatics? (H1, M1, and a1 blockage in other terms)

A

Haloperidol, Thiothixene, and Fluphenazine
-High potency

Hal Tries Flying High

26
Q

which subclass of first-generation antipsychotics is MOST associated with sedation, anticholinergic, and orthostatics? (H1, M1, and a1 blockage in other terms)

A

Chlorpromazine and thioridazine
-low potentcy

Cheating Thieves are Low

27
Q

Which class, 1st or 2nd, is more associated with extrapyramidal symptoms?

A

1st

28
Q

Which class, 1st or 2nd, is more associated with metabolic symptoms?

A

2nd

29
Q

Antagonism of what receptor causes amenorrhea and galactorrhea? What could you prescribe to prevent this?

A

D2 antagonists (Resperidone is worst of this)

To prevent, prescribe a D2 partial agonist (ie Ariprazole)

Pharmacology (50 decks)

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