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PR - CNS > PSYCHOSIS + SCHIZOPHRENIA: 1ST GEN > Flashcards

PSYCHOSIS + SCHIZOPHRENIA: 1ST GEN Flashcards

1
Q

MoA

A

Blocks post-synaptic dopamine D2 receptors in the brain

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2
Q

What are the 1st gen antipsychotics?

A

Phenothiazines and butyrophenone
Others: thioxanthenes
pimozide, sulpride

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3
Q

Why are typical antipsychotics not preferred?

A
  • More extrapyramidal symptoms (EPS)
  • More hyperprolactinaemia
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4
Q

Phenothiazines

A

Hepatotoxic & acute dystonic reactions
Split into groups (1, 2 & 3)

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5
Q

Group 1 phenothiazines

A

chlorpromazine, levomepromazine
promazine

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6
Q

Group 1 phenothiazines properties

A
  • Most sedation
  • Moderate antimuscarinic and EPSEs
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7
Q

Group 2 phenothiazines

A

periciazine

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8
Q

Group 2 phenothiazines properties

A
  • Moderate sedation
  • Least EPSEs
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9
Q

Group 3 phenothiazines

A
  • fluphenazine
  • prochloperazine
  • trifluoperazine
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10
Q

Group 3 phenothiazines properties

A
  • Moderate sedation
  • High EPSEs (e.g. someone with parkinson’s, we must avoid these)
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11
Q

Butyrophenones

A

benperidol, haloperidol

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12
Q

Thioxanthenes

A

flupentixol
zuclopentixol

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13
Q

Butyrophenones properties

A

Moderate sedation
High EPSEs (similar to group 3 phenothiazines)

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14
Q

Thioxanthenes properties

A

Moderate sedation
Antimuscarinic effects
EPSEs

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14
Q

Pimozide and sulpride

A
  • Reduced sedation
  • Antimuscarinic effects
  • EPSEs
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15
Q

Which phenothiazine has the most sedative but moderate antimuscarinic and
EPSE side-effect?

A

Group 1
- Chlorpromazine
- Levomepromazine
- Promazine
CLPY (SLEEPY)!

16
Q

Which phenothiazine has fewer sedative effects but the MOST WORSE antimuscarinic and EPSE side-effect?

A

Group 3
- Fluphenazine
- Perphenazine
- Prochlorperazine
- Trifluoperazine

17
Q

Which phenothiazine has moderate sedative effects but the LEAST worse antimuscarinic and EPSE side-effect?

A

Group 2 Phenothiazines
- Pericyazine

18
Q

What are the other indications for
Phenothiazines other than schizophrenia?

A
  1. Prochlorperazine e.g.
    Buccastem M
    - Nausea and vomiting
    - Vertigo
    - N&V associated with migraines
  2. Chlorpromazine
    - For relief of persistent hiccups
  3. Levomepromazine
    - Antiemetic in palliative care
    - Restlessness and confusion

PR - CNS (61 decks)

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