SECOND GEN ANTIPSYCHOTICS Flashcards
-ending in?
- apnie
- adone
MOA?
antagonizes 5-HT and D2 receptors
first line for schizophrenia?
less EPS and hyperprolactinemia than first generations
–b/c less affinity for DA receptors
greater negative symptom improvements than 1st gen
MOST cardiometabolic side effects
Olanzapine
LOW cardiometabolic side effects
QT prolongation risk
***oral and muscular IM injection not IV
name this other one?
- QT prolongation risk
- orthostatic hypotension
Ziprasidone
Iloperidone
Higher EPS and Hyperprolactinemia potential
Risperidone
No hepatic metabolism so if patient has liver disease it may be useful
similar to risperidone
9-OH metabolite ot risperidone
Paliperidone
MORE sedation
LOW EPS potential
Quetiapine
Low cardiometabolic effects
partial D2 agonism, lower EPS potential
Aripiprazole
CYP3A4 substrate
low cardio metabolic side effects
preferred in pregancy
Lurasidone
Only drug that can treat treatment resistant schizophrenia (TRS)
the bad boy of 2nd gens
Low D2 receptor antagonism
Pros
- Superior efficacy
- Very low EPS symptoms and Tardive Dyskinesia
- -Low D2 effects
Clozapine
what are the cons of clozapine?
agranulocytosis
- makes it a REMS drug for risk efficacy management system
- -absolute neutrophil count must be monitored system
- –0-6 month on drug=monitor once/week
- –if over 1 year on the drug=monitor every 4 weeks
- –if ANC<500 discontinue treatment
what are the pros of long acting formulations?
longer 1/2 life, lower relapse rates, consistent bioavailability, avoid intentional overdose
what are the cons of long acting formulations?
longer time to steady state, less flexible dose adjustment, injection site pain
name this syndrome?
due to extensive and severe dopaminergic blockade
treated with dantrolene (skeletal muscle relaxant)
neuroleptic malignant syndrome
