side effects of antip

Question 1

Antipsychotics can cause hyperprolactinaemia.

Prolactin production can be stimulated by dopamine receptor antagonists such as Risperidone and many other antipsychotic medications.

Hyperprolactinaemia in men can present with gynaecomastia, galactorrhoea, reduced libido and erectile dysfunction. Hyperprolactinaemia in women can present with galactorrhoea and menstrual dysfunction.

what antipsychotic does not cause high prolactin

Answer 1

Aripiprazole is one of the antipsychotics that does not raise prolactin as much as others, so is often a good alternative or adjunct.

Question 2

side effect of clozapine

Answer 2

impaired intestinal peristalsis - causing constipation

Question 3

what can secondary to the second-generation antipsyhcotic such as risperidone cause

staring into space an feels hot and sweaty to touch and high BP and HR , flcutuating consciouness

how long delay before starting another anti-p

Answer 3

neuroleptic maligant sydnrome

check CK due to muscle ridgity - early presentation
muscle necrosis and rhabdo

NMS is a medical emergency. Treatment consists of immediate cessation of the dopamine antagonist (or restarting or continuing of the dopamine agonist) and supportive measures (rehydration, cooling, and treatment of rhabdomyolysis if present)

A delay of at least 2 weeks in restarting antipsychotic treatment is advised following full resolution of NMS.

Question 4

what haloperidol when do you do an ECG

Answer 4

after changes in dose and annually

Question 5

akathisia

what drug auses it

Answer 5

feeling of inner restlessness and tension and urge to constanly move parts of the body espcially the legs and difficulty maintian ga posture for a few minutes.
heloperiodol

Question 6

sx of hyperprolactinoma

Answer 6

gynaecomastia
galactorrhoea
reduced libido
erectile dysfunction
menstrual dysfunction
infertility
osteoporosis

Question 7

clozapine toxicity is precipated by infection what should you look out for

Answer 7

raised clozpine level - measure in infection to anticipate toxiciy
confusion
drowsiness
ataxia
tachy c

Question 8

most antipsychotics are assoiated with

Answer 8

weight gain abnormal lipid profiles and therefore carry an increased risk of stroke

Question 9

antip are mostly - moa

Answer 9

dopamine antagonists - act on post pituitary leading to galactorrhea

agonists can treat high prolacitn such as cabergoline

Question 10

Low levels of which neurotransmitter are associated with the development of anxiety?

Answer 10

GABA - has inhibitory effect on brain and reduced neuronal excitability- this means there is a reduced inhibitory effect in the brain allowing neurone to activate at an increased rate

also serotonin