38: Antipsychotic Drugs Flashcards Preview

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Flashcards in 38: Antipsychotic Drugs Deck (33):
1

describe schizophrenia

severe type of psychosis

- considered neurodevelopmental disorder
- develops during childhood and adolescence
- genetic disorder with high heritability

2

positive v. negative symptom of schizophrenia

positive = manifestation of abnormal behavior
negative = absence of normal behavior

3

delusions, hallucinations, paranoia, agitation =

positive symptoms of schizophrenia

4

emotional apathy, inattentiveness, socially withdrawn =

negative symptoms of schizophrenia

5

dopamine hypothesis

hyperactivity of the mesolimbic/mesocortical DA system

excessive limbic DA activty --> psychosis

6

serotonin hypothesis

blockade of 5HT2A receptor is key MOA of the main class of atypical antipsychotic drugs

7

glutamate hypothesis

hypofunction of NMDA receptors located on GABAergic interneurons can lead to hyperstimulation of cortical neurons

8

subtype of antipsychotic drugs that produce high incidence of extrapyramidal side effects EPS

neuroleptics

9

therapeutic indications for antipsychotic agents

-schizophrenia
-psychotic behavior
-severe mania
-antiemetic (prochlorperazine, phenergan)

10

best treatment =

drug and social therapy

11

chlorpromazine

typical

12

thioridazine

typical

13

clozapine

atypical

14

olanzapine

atypical

15

fluphenazine

typical

16

risperidone

atypical

17

aripiprazole

atypical

18

haloperidol

typical

19

quetiapine

atypical

20

ziprasidone

atypical

21

describe the pharmokinetics of antipsychotics

- large Vd (lipophilic)
- metabolized by liver

22

MOA of typical antipsychotic agents

antagonist of post-synaptic D2 receptors

23

MOA atypical antipsychotic agents

antagonist at 5HT2a receptors AND D2 receptors

24

blockade of _____ is responsible for EPS

D2 receptor

25

describe EPS extrapyramidal syndrome

- parkinson like syndrome
-akathesia
-dystonia
-tardive dyskinesia

26

what are the endocrine side effects of antipsychotics?

hyperprolactinemia

-gynecomastia
-infertility
- galactorrhea
- menstrual irregularities

27

side effect more common of atypicals than typicals

weight gain

28

besides 5HT and D receptors - what can antipsychotics bind to and what are the effects?

anticholinergic
- urinary retention, dry mouth, blurred vision, constipation, mental confusion

antihistaminic
- sedation, weight gain

anti-adrenergic (a1)
- postural hypotension, reflex tachycardia, erectile dysfunction

29

what is neuroleptic malignant syndrome?

hypertension and hyperthermia

adverse effect of antipsychotics

30

which atypical agent is most strongly associated with EPS?

risperidone

clozapine and quetiapine are least strongly associated with EPS

31

_____ age increases risk for tardive dyskinesia

increasing

cumulative years of treatment also increases risk

32

risk of development of parkinsonism with antipsychotics increases with _____

potency and dosage

33

which atypical antipsychotics pose diabetes risks due to weight gain side effects?

clozapine and olanzapine