Sketchy Pharm: Second Generation Antipsychotics

Question 1

What are the second-generation (atypical) antipsychotics?

Answer 1

Quetiapine, olanzapine, risperidone, and aripiprazole (“QUiET, OnLy whISPERIng AllOwed”)

Ziprasidone, clozapine ( ZIPper on the woman’s dress; CLOset)

Question 2

What is the mechanism by which second-generation antipsychotics work?

Answer 2

They, like the first-generation antipsychotics, block D2 receptors in the mesolimbic system. Additionally, however, they also block 5-HT 2A receptors.

(Think of Dalí with the double dope-rope and the smiley face with the slice taken.)

Question 3

SGAs, unlike FGAs, can treat the __________ symptoms of schizophrenia.

Answer 3

positive and negative

Question 4

What disorders other than schizophrenia can be treated with SGAs?

Answer 4

OCD (the guy obsessively adjusting the painting), treatment resistant depression (the guy struggling with the wine bottle), Tourette’s (elephant marionette)

Question 5

Other than blocking 5-HT 2A receptors and D2 receptors, many SGAs also block _________.

Answer 5

H1 histamine receptors and alpha-1 (the guy swatting the bee painting and the extinguished alpha candle)

Question 6

Which SGA has the greatest antimuscarinic ability?

Answer 6

Clozapine (the clozapine closet blocking the Alice in Wonderland painting)

Question 7

One of the big side effects of SGAs that is not associated with FGAs is ____________.

Answer 7

weight gain (the bloated Dalí painting) and metabolic syndrome (diabetes – candy –and dyslipidemia –butter); ziprasidone has the lowest risk (“just think of that sleek black dress”)

Question 8

What are the side effects specific to clozapine?

Answer 8

Agranulocytosis
Myocarditis
Lowered seizure threshold

(failing grains of sand, heart on the beach, and shaking alarm clock)

Question 9

Most of the SGAs cause fewer extrapyramidal side effects than the FGAs. Which, however, still causes some?

Answer 9

Risperidone (the guy whispering to the extrapyramidal-hat-wearing patron getting kicked out of the gallery); risperidone can also cause prolactinemia and neuroleptic malignant syndrome

Question 10

All of the SGAs can cause ____________.

Answer 10

torsades

Question 11

The first-generation antipsychotics are called ____________, while the second-generation antipsychotics are called __________.

Answer 11

typical; atypical