16- Antipsychotics Flashcards Preview

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Flashcards in 16- Antipsychotics Deck (15)
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1
Q

chlorpromazine (Thorazine)

A

typical antipsychotic- D2 antagonist

  • returns DA balance in nucleus accumbens (positive symptoms)
  • higher clinical potency than atypicals
  • multiple side effects d/t activity at muscarinic, adrenergic, DA, serotonin and histamine receptors
  • can induce/inhibit CYP metabolism
  • metabolized by CYP2D6 and CYP3A4
2
Q

fluphenazine (Permitil, Prolixin)

A

typical antipsychotic- D2 antagonist

  • returns DA balance in nucleus accumbens (positive symptoms)
  • higher clinical potency than atypicals
  • multiple side effects d/t activity at muscarinic, adrenergic, DA, serotonin and histamine receptors
  • can induce/inhibit CYP metabolism
  • metabolized by CYP2D6 and CYP3A4
3
Q

thiothixene (Navane)

A

typical antipsychotic- D2 antagonist

  • returns DA balance in nucleus accumbens (positive symptoms)
  • higher clinical potency than atypicals
  • multiple side effects d/t activity at muscarinic, adrenergic, DA, serotonin and histamine receptors
  • can induce/inhibit CYP metabolism
  • metabolized by CYP2D6 and CYP3A4
4
Q

haloperidol (Haldol)

A

typical antipsychotic- D2 antagonist

  • returns DA balance in nucleus accumbens (positive symptoms)
  • higher clinical potency than atypicals
  • multiple side effects d/t activity at muscarinic, adrenergic, DA, serotonin and histamine receptors
  • can induce/inhibit CYP metabolism
  • metabolized by CYP2D6 and CYP3A4
5
Q

aripiprazole (Abilify)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release and inc. DA release in the cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
6
Q

clozapine (Clozaril)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release and inc. DA release in the cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
  • increased risk of metabolic syndrome, ganulocytosis, leukopenia
7
Q

olanzapine (Zyprexa)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release and inc. DA release in cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
  • increased risk of metabolic syndrome
8
Q

paliperidone (Invenga)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release and inc. DA release in cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
9
Q

quetiapine (Seroquel)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release inc. DA release in cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
10
Q

risperidone (Risperdal)

A

atypical antipsychotic

  • inhibit serotonin receptors (2A & 2C)
  • lower affinity for DA receptors than typical drugs
  • blocking serotonin receptors leads to both a decrease in glutamate release and inc. DA release in cortex
  • Less EPS and NMS
  • many side effects because of off-target effects
  • metabolized by CYP1A2, 3A4, 2D6
  • induce/inhibit CYPs
11
Q

Neuroleptic Malignant Syndrome (NMS)

A

rare, but life threatening
occurs shortly after beginning typical drug
-Hyperthermia
-Mental Status Changes
-Rigidity
-Autonomic Instability
treatment: d/c neuroletpic use, life support, Bromocriptine, Dantrolene

12
Q

Mesolimbic Pathway

A

ventral tegmental area to NUCLEUS ACCUMBENS
-role- motivation, reward, emotional behaviors
hallucinations, delusions & thought disorder
-HYPERACTIVITY in pathway causes POSITIVE symptoms of schizophrenia

13
Q

Mesocortical Pathway

A

ventral tegmental area to CORTEX

  • role- cognition, executive function, emotions
  • HYPOACTIVITY leads to NEGATIVE symptoms of schizophrenia
14
Q

Nigrostriatal Pathway

A

substantia nigra to striatum

  • role- motor planning and purposeful movement
  • isn’t believed to be involved in schizophrenia, but antipsychotics can interfere with this pathway leading to movement disorder side effects
15
Q

Tuberoinfundibular Pathway

A

hypothalamus to pituitary gland

  • role- inhibition of prolactin release
  • normal in schizophrenia, but hypoactivity can lead to galactorrhea, amenorrhea, sexual dysfunction