T41e Antipsychotics

Question 1

aripiprazole

Answer 1

atypical antipsychotic (abilify) blocks D2c (mesolimbic/cortical) with 5-HT2 antagonism.

TX.

AVD. (no agranulocytosis) quinidine like sedative, less dyskinesias, (due to selectivity not affecting D2a in nigrostriatal), significant weight gain, increased salivation (wet pillow) due to serotonin pharmacology overriding antimuscarinic effect, seizures.

Question 2

chlorpromazine

Answer 2

conventional antipsychotic (phenothiazine - prototype)

ADV. corneal deposits. thia - meaning sulfonamide may lead to dose independant allergic HSR.

Question 2

clozapine

Answer 2

atypical antipsychotic - prototype (clozaril) blocks D2c (mesolimbic/cortical) with 5-HT2 antagonism.

TX.

AVD. agranulocytosis thru HSR requires weekly WBC counts, quinidine like sedative, less dyskinesias, NO tardif dyskinesia (due to selectivity not affecting D2a in nigrostriatal), significant weight gain, increased salivation (wet pillow) due to serotonin pharmacology overriding antimuscarinic effect, seizures.

Question 3

fluphenazine

Answer 3

conventional antipsychotic (piperazine - prolixin)

ADV. Severe extrapyrimidal (EPS) due to low antoi-muscarinic/ antialpha effects

Question 5

Haloperidol

Answer 5

conventional antipsychotic. (butyrophenone - haldol)

ADV. Severe extrapyrimidal (EPS) due to low antoi-muscarinic/ antialpha effects .Malignant neuroleptic hyperthermia [tx with bromocriptine, pergolide, dantroline] and tardif dyskynesia. [tx switch to atypilca]

Question 6

loxapine

Answer 6

conventional antipsychotic

Question 7

olanzapine

Answer 7

atypical antipsychotic (zyprexa) blocks D2c (mesolimbic/cortical) with 5-HT2 antagonism.

TX.

AVD. (no agranulocytosis) quinidine like sedative, less dyskinesias (due to selectivity not affecting D2a in nigrostriatal), significant weight gain, increased salivation (wet pillow) due to serotonin pharmacology overriding antimuscarinic effect, seizures.

Question 8

pimozide

Answer 8

conventional antipsychotic

DOA. oral

TX. Tourrets, strong antiemetic.

Question 9

piperazines

Answer 9

conventional antipsychotic

Question 10

piperidines

Answer 10

conventional antipsychotic

Question 11

quetiapine

Answer 11

atypical antipsychotic (seroquel) blocks D2c (mesolimbic/cortical) with 5-HT2 antagonism.

TX.

AVD. (no agranulocytosis) quinidine like sedative, less dyskinesias (due to selectivity not affecting D2a in nigrostriatal), significant weight gain, increased salivation (wet pillow) due to serotonin pharmacology overriding antimuscarinic effect, seizures.

Question 12

risperidone

Answer 12

atypical antipsychotic (risperdal) partial agonist D2c (mesolimbic/cortical) with 5-HT2 antagonism.

TX.

AVD. (no agranulocytosis) quinidine like sedative, less dyskinesias (due to selectivity not affecting D2a in nigrostriatal), significant weight gain, increased salivation (wet pillow) due to serotonin pharmacology overriding antimuscarinic effect, seizures.

Question 13

thioridazine

Answer 13

conventional antipsychotic (piperidines)

ADV. Quinidine like (strong antimuscarinic and anti-alpha) causing torsades/convulsions/coma. Causes retinal deposits. EPS-extrapyrimidal not severe due to autotreated anit-muscarinic.

Question 14

thiothixene

Answer 14

conventional antipsychotic

Question 15

ziprasidone

Answer 15

atypical antipsychotic (geodon)