Antispychotic Agents Lecture PDF

Question 1

Antipsychotic drugs uses (5)

Answer 1

• Schizophrenia
• schizoaffective disorder
• delusional disorder
• manic phase of bipolar disorder
• major depression in combo with other antidepressants

Question 2

Psychosis

Answer 2

Condition of mental disorder characterized by marked thought disturbance and perception of reality, loss of contact from reality

Question 3

Theory of schizophrenia cause

Answer 3

Theorized to be due to overactive dopaminergic pathways in brain areas such as the limbic system

Question 4

Atypical antipsychotics are…

Answer 4

…2nd generation agents

Question 5

First vs second gen antipsychotics

Answer 5

1st gen cause strong blockade of dopamine in CNS causing extrapyramidial movement symptoms, 2nd gen have moderate dopamine receptor blockade and serotonergic blockade as well and have lower risk of extrapyramidal symptoms but greater risk of metabolic effects, but both are ultimately are very efficient at treatment of psychosis

Question 6

Examples of 1st gen antipsychotics (3)

Answer 6

• chorpromazine (thorazine)
• haloperidol (haldol)
• thiothixene (navane)

Question 7

1st gen antipsychoics ADR’s (6)

Answer 7

• Extrapyramidal reactions
• Hyperprolactinemia
• Weight gain
• Dry mouth
• Sedation
• Orthostatic hypotension

Question 8

Extrapyramidal reactions and treatment (and one treatment to avoid

Answer 8

• Movement disorders caused by dopamine blockade presenting very similar to parkinsons with late stage presenting as tardive dyskinesia
• Only way to temporarily stave off tardive dyskinesia is to increase dose of antipsychotic but this will long term worsen condition, it is irreversible even upon cessation of drug, can give anticholinergic drugs
• Avoid levadopa

Question 9

Clozapine (clozaril)

Answer 9

Powerful 2nd gen antipsychotic indicated only for patients with schizophrenia who have not responded to traditional agents or who cannot tolerate extra pyramidal side effects, large ADR is agranulocytosis that can be fatal requiring mandatory weekly monitoring of blood counts and highest incidence of weight gain

Question 10

Receptor blockade and side effects of antipsychotic agents (D2, H1, muscarinic cholinergic, and a1 adrenergic)

Answer 10

D2 - extrapyramidal reaction
H1 - weight gain and sedation
muscarinic cholinergic - dry mouth and urinary retention
a1 adrenergic - orthostatic hypotension

Question 11

Long acting injectible antipsychotics function and one problem

Answer 11

• Prevent relapse and maintain highest possible level of functioning for patients and promote adherance for those who need long term treatment
• Effects are long term and cannot be reversed if toxicity or pregnancy occurs

Question 12

OBRA ‘87 regulations

Answer 12

Require that an individual on an antipsychotic must be necessary and should be discontinued if not needed and given at the lowest effective dose, particularly important in elderly care facilities up to governmental regulation

Question 13

Tardive dyskinesia

Answer 13

Side effect of antipsychotic medications causing facial behavior such as tongue protrusion or puffing out of cheeks