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Psych and Behavior > Segars Anti Psychotics chart high yield > Flashcards

Segars Anti Psychotics chart high yield Flashcards

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1
Q

What generation is most likely to case Weight gain and Diabetes?
examples?

A
  • Second Generation (SGAs)
  • the “prazoles”, “apines” and “idones”
  • Most likely Clozapine and Olanzapine
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2
Q

SGAs Least likely to cause weight gain and Diabetes?

A
  • Aripiprazole

- Ziprasidone

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3
Q

Which Generation is most likely to cause hypercholesterolemia?
examples?

A
  • SGAs
  • Clozapine
  • Olanzapine
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4
Q

Generation most like to cause EPS/Tardive Dyskenesia?

Most likely drug?

which drug in that generation is least likely?

A
  • FGAs
  • “idol”, “azine”, “ixene”
  • MOST LIKELY is haloperidol
  • LEAST LIKELY Chlorpromazine and Thiordazine
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5
Q

Which FGA is most likely to cause hypercholesterolemia?

least likely?

A
  • most likely = chlorpromazine

- least likely Fluphenazine and Haloperidol

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6
Q

Which SGA is the worst for causing EPS/Tardive dyskenisia?

A

-Risperidone is the most likely

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7
Q

Generation most likely to cause prolactin elevation?

examples?

A
  • FGAs

- HALOPERIDOL, Fluphenazine, and thioridazine

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8
Q

Generation most likely to cause sedation?

examples?

A
  • FGAs most but also some SGAs
  • FGAs ie Chlorpromazine, Thioridazine
  • SGAs ie Quetiapine, Olanzapine, and Clozapine

Quetiapine sounds like quiet as in sedation

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9
Q

Generation most likely to cause anticholinergic side effects?

examples?

A
  • FGAs and SGAs
  • FGAs ie Thioridazine
  • SGAs Clozapine
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10
Q

Least likely to cause anticholinergic effects?

A
  • SGAs ie Aripiprazole and Ziprasidone
  • these two drugs have VERY LOW risk of side effects. they are the best atypical antipsychotics
  • only rarely do weight gain/diabetes, eps, sedation
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11
Q

Generation most likely to cause orthostatic hypotension?

what receptor?

examples?

A
  • SGAs has more examples Clozapine
  • alpha receptor
  • FGAs ie Thiroidazine (most stars) or Chlorpromazine
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12
Q

Generation most likely to cause QT prolongation?

examples?

A
  • FGAs
  • ie Thioridazine
  • if on a SGA, Ziprasidone is most likely
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13
Q

Why is Clozapine used last?

A
  • it causes agranulocytosis, so you must monitor WBC
  • very rare hypersensitivity reaction called……. Drug reaction w/ Eosinophillia and Systemic Symptoms (DRESS)
  • you’ll see skin eruptions and other allergic signs
  • doctors must be trained before using this drug
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14
Q

Besides DRESS what else does Clozapine cause?

Treatment? How does it work?

Olanzapine or Clozapine will be in the question stem

A
  • Neuroleptic Malignant Syndrome (NMS)
  • rare, severe parkinsons like mvt disorder w/ wide spread muscle contraction
  • patients develop rhabdomyolysis

Treatment = Dantrolene, which stops malignant hyperthermia by closing the rhyanodine receptor so that calcium cant get out which limits the profound muscle contractions

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15
Q

If you put a patient on a FGA and especially a SGA what must you do?

A
  • serum glucose
  • lipid profile
  • weight (BMI)
  • blood pressure
  • waist circumference
  • FH of heart/metabolic issues
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16
Q

What do most clinician start with?

A

-SGAs

17
Q

how do we defeat nonadherent patients, jobless, homeless patients?

A

-long acting injectable agents (LAIAs)

  • ie ‘ROAP”
  • Risperidone
  • Olanzapine
  • Aripiprazole
  • Paliperidone
18
Q

How long until we see changes of therapy?

A

-weeks w/ maximum benefit taking several months

19
Q

is multimodal or unimodal therapy better?

A

-multimodal therapy

ie drugs along with support and emotional help

20
Q

What do we use for treatment resistant disease?

A

-Clozapine

21
Q

issues in the Mesolimbic pathway from VTA to NA deals with?

A

positive symptoms of schizophrenia

22
Q

issues in the Mesocortical pathway from VTA to Cortex deals with?

A

negative symptoms of schizophrenia

23
Q

issues in the Nigrostriatal pathway from substantia nigra to basal ganglia deals with?

A

associated with the side effects

ie. psuedoparkinson symptoms

24
Q

issues in the Tuberoinfundubular pathway from Hypophysis to infundibular region deals with?

A

increases in prolactin levels

25
Q

What three drugs are antidotes to dopamine OD

DBT
“D.opamine B.eating T.reatments”

A

Diphenhydramine (Benadryl)

Benztropine ( Congentin)

Trihexyphenidyl

26
Q

FGAs in general cause what categories of side effects?

A

EPS/Tardive dyskinesia

prolactin elevation

27
Q

SGAs in general cause what categories of side effects?

A

Weight gain/hyperglycemia

hypercholesterolemia

28
Q

These cause weight gain/Diabete Mellitus

A

SGAs&raquo_space; FGAs
Olanzapine**
Clozapine**
Arip* and Zipra*

FGA
Chlorpromazine***

29
Q

These cause hypercholesterolemia

A

SGAs&raquo_space; FGAs
Olanzapine**
Clozapine**
Aripprazole* and Ziprasidone*

FGA
Chlorpromazine*

30
Q

These cause EPS/Tardive Dyskinesia

A

FGAs&raquo_space; SGAs
Haloperidol**
Chlorpromazine and Thioridazine*

SGAs
Risperidone***

31
Q

These cause prolactin elevation, breast growth, glacctorreah, amenorrhea

A

FGAs&raquo_space; SGAs
Fluphenazine*
Haloperidol*

32
Q

What are the high potency FGAs?

A

Fluphenazine
Haloperidol
Thiothixene

33
Q

These cause sedation

A

FGAs = SGAs

FGAs
Chlorpromazine*
Thioridazine*

SGAs
Clozapine* BUT this will only be the correct answer on the test for treatment resistant disease and suicide prone
Olanzapine and Quetiapine**

34
Q

These cause anticholinergic side effects

A

FGAs > SGAs

FGAs
Thioridazine**
Chlorpromazine*

SGAs
Clozapine***

35
Q

What SGAs cause little to no side effects?

A

Aripiprazole and Ziprasidone

Ziprasidone** for QTc prolongation

36
Q

These cause orthostatic hypotension

A

FGAs > SGAs
Thioridazine**
Chlorpromazine*

SGAs
Clozapine***

37
Q

Receptor involved in orthostatic hypotension?

A

blockade of the alpha adrenergic

38
Q

These cause QTc prolngation

A

FGAs > SGAs
Thioridazine***

SGAs
Ziprasidone**

Psych and Behavior (10 decks)

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