Psych Drugs Flashcards
Name the typical antipsychotics
Haloperidol and the -azines (trifluoperazine, fluphenazine, thioridazine, chlorpromazine)e
Mechanism of typical antipsychotics
block dopamine D2 receptors to increased cAMP
High potency typical antipsychotics
Try to Fly High
Trifluoperazine, fluphenazine, haloperidol
Side effects of high potency antipsychotics
extrapyramidal symptoms
Clinical use of typical antipsychotics
schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome, Huntington’s
Toxicity of typical antipsychotics
lipid soluble and stored in fat thus slowly removed from body
Extrapyramidal side effects
Endocrine side effects - hyperprolactinemia
Side effects from blocking:
muscarinic - dry mouth, constipation
alpha 1 - hypotension
histamine - sedation
can cause QT prolongation
Extrapyramidal symptom treatment
Benztropine or diphenhydramine
Low potency typical antipsychotics
Cheating THieves are low
chlorpromazine, thioridazine
Side effects of low potency antipsychotics
non-neurologic side effects
anticholinergic, antihistamine and alpha1-blockade effects
Side effect of chlorpromazine
Corneal deposits
Side effect of Thioridazine
reTinal deposits
Side effect of haloperidol
EPS
Evolution of EPS side effects
4 hr dystonia (muscle spasm, stiffness, oculogyric crisis)
4 day akathisia (restlessness)
4 wk bradykinesia (parkinsonism)
4 mo tardive dyskinesia
Neuroleptic malignant syndrome
FEVER
fever, encephalopathy, vitals unstable, increased enzymes, rigidity of muscles
Treatment of NMS
dantrolene or D2 agonists (bromocriptine)
Tardive dyskinesia
stereotypic oral-facial movements as a result of long-term antipsychotic use
Name the atypical antipsychotics
clozapine, risperidone, olanzapine, quietapine, aripiprazole, ziprasidone
Mechanism of atypical antipsychotics
not completely understood
varied effects on 5-HT2, dopamine and alpha and H1 receptors
Clinical use of atypical antipsychotics
Schizophrenia (positive and negative symptoms
Bipolar, OCD, anxiety, depression, mania, Tourette syndrome
What are negative symptoms?
Alogia = loss of speech
Affective flattening = loss of affect/emotion
Avolition = loss of motivation to do anything
Toxicity of atypical antipsychotics
fewer EPS and anticholinergic side effects
prolong QT interval
Toxicity of olanzapine and clozapine
Can cause significant weight gain
Toxicity of clozapine
agranulocytosis and seizure
monitor WBC weekly
Toxicity of risperidone
increase prolactin –> lactation and gynecomastia
increased prolactin –> decreased GnRH which leads to decreased FSH and LH and infertility/amenorrhea
Mechanism of lithium
possibly related to inhibition of phosphoinositol cascade
Use of lithium
mood stabilizer for bipolar disorder; blocks relapse of acute and manic events
also used for SIADH