schizophrenia drugs Flashcards
(38 cards)
what are some first generation anti-psychotics
-chlorpromazine
-haloperidol
-zuclopenthixol
-flupentixol
-trifluperazine
-prochlorperazine
-perphenazine
-sulpiride
what are some second generation anti-psychotics
-clozapine
-olanzapine
-quetiapine
-risperidone
-paliperidone
-lurasidone
what is the third generation anti-psychotic
aripirazole
which anti-psychotics for acute treatment
second gen
dopaminergic side effects
-extra pyramidal side effects
-neuroleptic malignant syndrome
-hyperprolactinaemia
-akathesia/restless legs
different types of extra pyramidal side effects
-acute dystonia
-Parkinsonism
-tardive dyskinesia
symptoms of acute dystonia
-onset in minutes
-increasing muscle tone
-energetic
-torticolis
-oculogyric crisis
-tongue protrusion
symptoms of parkinsonism
-bradykinesia
-cogwheeling rigidity
-resting tremor
-shuffling gait
-dead-pan facial expression
symptoms of tardive dyskinesia
-long-term often permanent
-involuntary repetitive oro-facial movements
-blinking, grimacing, pouting, lip smacking common
-may involve limbs and or trunk
how do you treat EPSE
-procyclidine 5mg
-trihexyphenidyl
-orphenadrine
what are the three main features of neuroleptic malignant syndrome
-autonomic instability
-malignant hyperpyrexia
-increasing muscle tone
progression of neuroleptic malignant syndrome
increasing muscle tone, pyrexia, changing pulse/BP > rhabdo > ARF >coma > death
investigation for neuroleptic malignant syndrome
creatinine kinase
treatment for neuroleptic malignant syndrome
-stop antipsychotic
-rapid cooling, renal support
-skeletal muscle relaxants e.g. dantroline
-dopamine agonists e.g. bromocriptine
how can antipsychotics cause high prolactin
affects the tuberoinfundibular pathway
-prolactin release inhibited by dopamine
-blockade of dopamine leads to increased prolactin release
high prolactin features in women
-galactorrhoea
-decreased libido, decreased arousal, anorgasmia
-amenorrhoea, anovulation
high prolactin features in men
-gynaecomastia
-erectile dysfunction, oligospermia
-decreased libido
high prolactin features in men and women
-decreased bone mineralisation
-decreased bone density > osteoporosis
-falls > fractures
presentation of akathisia
-manifests within days-weeks of treatment
-pacing
-rocking from foot to foot
-unable to sit or stand still
-poor sleep as a result
-links to increased suicide risk
treatment of akathisia
1st) beta blocker - propranolol
2nd) benzodiazepines - clonazepam
anticholinergic side effects
-dry mouth
-blurred vision
-constipation
5HT2 receptor blockade side effects
-weight gain
-metabolic syndrome
-type 2 DM
anti-adrenergic side effects
postural hypotension
other important side effects
-hepatotoxicity
-prolonged QT interval
-photosensitivity
