Typical and Atypical

Question 1

Chlorpromazine (Thorazine)

Answer 1

Typical
PO, IV, IM, moderate sedation
MOA: D2 antagonist, strong affinity = longer receptor binding time.
Indications: Schizophrenia, treats positive symptoms
Side effects: Sedative, Extrapyramidal symptoms ( involuntary movement (tardive dyskinesia), tremors and rigidity, body restlessness (akathisia), muscle contractions (acute dystonia)), antimuscarinic effects, hyper prolactemia, weight gain, cardiovascular (orthostatic hypotension, prolonged QT interval)

Question 2

Haloperidol (Haldol)

Answer 2

Typical
PO, IV, IM, IM depot
Higher D2 affinity and potency than Chlorpromazine.
MOA: D2 antagonist, strong affinity = longer receptor binding time.
Indications: Schizophrenia, treats positive symptoms
Side effects: Sedative, Extrapyramidal symptoms ( involuntary movement (tardive dyskinesia), tremors and rigidity, body restlessness (akathisia), muscle contractions (acute dystonia)), antimuscarinic effects, hyper prolactemia, weight gain, cardiovascular (orthostatic hypotension, prolonged QT interval)

Question 3

Aripiprazole (Abilify)

Answer 3

Atypical
D2 partial agonist.
PO, IM
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 4

Olanzapine (Zyprexa)

Answer 4

Atypical
best patient compliance
PO, IM, IM depot
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 5

Risperidone (Risperdal)

Answer 5

Atypical
PO, IM
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 6

Paliperidone (Invega)

Answer 6

Atypical
PO, IM, IM depot
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 7

Quetiapine (Seroquel)

Answer 7

Atypical
different profile (acts on other receptors)
PO
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 8

Ziprasidone (Geodon)

Answer 8

Atypical
lengthens QT interval
PO, IM
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 9

Clozapine (Clozaril)

Answer 9

Atypical
most efficacious so most side effects
second line - dont use until after all others
PO
high sedation, high weight gain
MOA: D2 antagonist, weaker affinity = shorter receptor binding time. 5HT2A antagonist = increases PFC DA release.
Indications: Schizophrenia treats positive and negative symptoms
Side Effects: sedative, less EPS, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabetes II), cardiovascular (orthostatic hypotension, prolonged QT interval).

Question 10

Memantine (Namenda)

Answer 10

NMDA antagonist
MOA: blocks glutamate receptor to stop the over stimulation by glutamate.
Indications: moderate to sever AD
Administered with donepazil or rivastigmine
side effects: tiredness, dizziness, confusion, HA, constipation, vomiting, pain all over, coughing, SOB, and hallucinations.