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Pharmacology 2 > Psychotropic Medications > Flashcards

Psychotropic Medications Flashcards

1
Q

Classifications

A 
Antipsychotics 
Antidepressants
Mood Stabilizers (Bipolar Drugs)
Sedative-Hypnotics
Anxiolytics (Antianxiety Meds)
CNS Stimulants
ADHD Meds
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2
Q

Schizophrenia

A

A chronic psychotic disorder which has a positive, negative & cognitive symptoms. Disordered thinking and reduced ability to comprehend reality.

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3
Q

Schizophrenia Symptoms

A

Delusions
Hallucinations
Difficulty Processing Information
Incoherence

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4
Q

Positive Symptoms (add to)

A

Characterized by exaggeration (increase) or distortion of normal function

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5
Q

Positive Symptoms Examples

A

Delusions
Hallucinations
Paranoia
Agitation

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6
Q

Hallucination

A

Experiencing things with your 5 senses that aren’t there.

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7
Q

Delusion

A

False thought

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8
Q

Negative Symptoms

A

Characterized by a decrease or lessening of function and motivation

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9
Q

Negative Symptom Examples

A 
Poverty of speech 
Poor Self Care 
Social Withdrawal 
Flat Affect 
Avolition (lack of movement)
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10
Q

Cognitive Symptoms

A

Thinking difficulties

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11
Q

Cognitive Symptom Examples

A

Disordered thinking
Inability to focus attention
Prominent learning
Memory Difficulties

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12
Q

Antipsychotic Medications INDICATIONS

A 
Schizophrenia 
Bipolar Disorder 
Tourette's Syndrome 
Prevention of emesis 
Delusional disorders 
Dementia 
Organic Mental Disorder
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13
Q

Categories of Antipsychotic Meds

A

First Generation/Conventional/Traditional
(PHENOTHIAZINES & NONPHENOTHIAZINES)

Second Generation/Atypical

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14
Q

Antipsychotic MOA

A

Block Actions of Dopamine
5 Receptors: D1-D5
ALL block D2 (dopaminergic) receptor - promotes EPS resulting in pseudoparkinsonism
Atypicals have weak affinity to D2 receptors - cause fewer EPS

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15
Q

What would happen if you gave an Antipsychotic to someone with Parkison’s?

A

Would worsen Parkinson’s because of the lack of dopamine

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16
Q

Antipsychotic A/E

A

Extrapyramidal Side Effects
Anticholinergic Effects - can’t see, can’t pee, can’t spit, can’t sh*t
CV Effects
Rare & Toxic Effects (Neuroleptic Malignant Syndrome)

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17
Q

Extrapyramidal Side Effect (EPS)

A

Pseudoparkinsonism
Acute Dystonic Reactions
Akathisia
Tardive Dyskinesia

18
Q

Pseudoparkinsonism

A 
Rigidity
Masklike faces
Stooped posture
Drooling
Shuffling gait 
"Pill-rolling"
Tremor
19
Q

What do you treat Pseudoparkinsonism with?

A

Trihexyphenidyl

Benztropine

20
Q

Acute Dystonic Reactions

A

Opisthotonos
Oculogyric Crisis
Torticollis

21
Q

What do you treat Dystonic Reactions with?

A 
Diphenhydramine hydrochloride (Benadryl) 25-50 mg IM/IV 
Congentin 1-2 mg IM/IV may be SECOND choice
22
Q

Opisthotonos

A

Tetanic spasm of the back muscles causing the trunk to arch forward while the head and lower limb thrust backward

23
Q

Akathisia

A 
Motor inner driven restlessness 
Motor: 
- Pacing 
- Tapping
- Squirming 
- Crossing/uncrossing legs
24
Q

What do you treat Akathisia with?

A

Propanolol

Benzodiazepines

25
Q

Tardive Dyskinesia

A 
Facial: 
- Protruding tongue 
- Smacking 
- Licking spastic facial distortion 
- Smacking movements 
Limbs: 
- Choreic 
- Athetoid 
Trunk: 
- Pelvic thrusts
- Neck & Shoulder movements
26
Q

Anticholinergic S/E

A 
Dry Mouth 
Urinary Retention 
Constipation 
Blurred Vision 
Photosensitivity 
Dry Eyes 
Impotence
27
Q

CV Effects

A

Hypotention & Postural hypotention

Tachycardia - QT prolongation

28
Q

Rare and Toxic Effects

A 
Agranulocytosis 
Low # WBCs 
Jaundice 
Neuroleptic Malignant Syndrome: 
- Hyperpyrexia 
- Severe muscle rigidty 
- Elevated BP 
- Tachycardia 
- Diaphoresis 
- Incontinence: can be fatal if temp goes high enough
- Cognitive alterations
29
Q

First Generation Agents

A 
Haloperidol 
Fluphenazine 
Trifluoperazine 
Thiothixene 
Pimozide 
Loxapine 
Perphenzazine 
Chlorpromazine 
Thioridazine
30
Q

Haloperidol Indications

A

Schizo
Acute psychosis
Tourettes severe behavioral problems in children

31
Q

Haloperidol A/E

A 
EPS
QT-interval 
Neuroendocrine S/E
- Galactorrhea 
- Gynecomastia 
- Menstrual Irregularities
32
Q

Chlorpromazine Indications

A 
Schizo 
Psychotic D/O 
Vomiting
Intractable hiccups 
Severe childhood behavioral problems
33
Q

Chlorpromazine A/E

A 
Sedation
Ortho hypotention 
Anticholinergic 
Neuroendocrine 
Photosensitivity 
EPS (low risk) 
Lowers seizure threshold 
QT Interval
34
Q

Second Generation (Atypical) Agents

A

Clozapine - MOST EFFECTIVE

35
Q

Clozapine

A

Schizophrenia
Bipolar D/O
Levodopa-induced psychosis

36
Q

Clozapine A/E

A 
Serious agranulocytosis 
Reserved for other drug failures 
Common: 
- Sedation 
- Weight gain 
- Ortho hypotention 
- Anticholinergic effects 
- Tachycardia 
Minimal: 
- Neuroendocrine (gynecomastia) effects
- Sexual dysfunction 
METABOLIC EFFECTS 
- Weight gain in excess of 30 pounds, DM, increase lipids
- Seizures 
- EPS (relatively low) 
- Myocarditis 
- Double death rate in elderly with dementia
37
Q

Second Generation Agents

A 
Risperidone 
Paliperidone 
Olanzapine 
Ziprasidone 
Quetiapine 
Aripiprazole 
Iloperidone 
Lurasidone
38
Q

Risperidone Indications

A 
Schizo 
Bipolar 
Autism 
Improves (+) symptoms 
SE generally infrequent and mild
39
Q

Olanzapine

A 
Schizo 
Bipolar 
Bipolar mania 
Agitation with schizo 
Major depression (not 1st line)
40
Q

Quetiapine

A 
Schizo 
Depression 
Acute mania 
Depression in bipolar 
SEDATION!
41
Q

Aripiprazole

A 
Schizo 
Acute bipolar mania 
Depression 
Agitation 
Autism
42
Q

Antipsychotic Information

A
  • 1st & 2nd generation are equally effective except for CLOZAPINE
  • 1st = more EPS
  • 2nd = metabolic effects
  • Symptoms start resolving in 1-2 days, significant improvement 1-2 weeks
  • Continue therapy x12 months, then 25% can stop

Pharmacology 2 (1 decks)

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