Anti Psychotics Flashcards
:
• midbrain to limbic system.
• emotional behaviours.
• Hyperactivity may cause positive psychotic symptoms.
• Blockade of D2 receptors decreases positive symptoms
Mesolimbic
Midbrain to prefrontal cortex
Hypo-activity causes negative symptoms
Blocking D2 receptors may worsen negative symptoms
Mesocortical pathway
Hypothalamus to anterior pituitary
Dopamine released from these pathways inhibit prolactin secretion
Blockade of these receptors cause increased prolactin levels
Tuberoinfundibular pathway
Substantia nigra to basal ganglia
Controls motor movement
Blockade of D2 receptors lead to disorders of movement and extrapyramidal reactions
Nigrostriatal Pathway
1st generation- block D2 receptors in mesolimbic pathway
Chlorpromazine
Fluphenazine
Haloperidol
Thioridazine
Block d2 receptors
2nd Gen - better for treating negative symptoms
Clozapine
Risperidone
Olanzapine
Quetiapine
Aripiprazole
Block other receptors
High potency first gen cause EPR. Who are these?
Fluphenazine
Haloperidol
- high affinity for D2
Low potency first gen cause sedation and postural hypotension
Chlorpromazine and thioridazine
- less affinity for D2
How to treat Parkinsonism ?
antimuscarinics like benzotropine, trihexyphenidyl, diphenhydramine with Amantadine
How to treat akathisia
Clonazepam or propranolol
How to treat dystonia
Benztropine
Trihexyphenidyl
Diphenhydramine
How to treat tardive dyskinesia
Tetrabenazine
Valbenazine
Clozapine if they have psychotic effects
What symptoms are seen in neuroleptic malignant syndrome
Rigidity
Tremors
Hyperthermia
Altered mental status
How to treat neuroleptic malignant syndrome
Dantroline or bromocriptine
Adverse effects of antipsychotics
Anticholinergic effects
H1 blockade—> orthostatic hypotension and impaired ejaculation
