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NMSP Exam 3 > Antipsychotic drugs > Flashcards

Antipsychotic drugs Flashcards

1
Q

What antipsychotic would you prescribe for a patient who has been treatment resistive and is a suicide risk?

A

Clozapine (2nd gen)

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2
Q

What would you prescribe for a patient with parkinson’s who is in the late stages showing signs of psychosis?

A

Pimavanserin (5HT inverse agonist)

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3
Q

What are the 2 Dopamine pathways most involved in the symptoms of Schizophrenia?

A

Mesolimbic

Mesocortical

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4
Q

What are positive symptoms?

A

Symptoms that are additional to a person/overactive.

Hallucinations, delusions, disorganized speech, agitation

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5
Q

What are negative symptoms?

A

“Hypoactive” symptoms

Apathy, Alogia, Cognitive deficits, social withdrawal

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6
Q

Which pathway is responsible for the EPS/TD side effects of antipsychotics?

A

Nigrostriatal Pathway

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7
Q

What suffix do Typical (1st gen) agents share?

A
  • azine

* not all of them, but about half

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8
Q

What suffix to Atypical (2nd gen) agents share?

A
  • idone
  • piprazole
  • apine
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9
Q

What is the main difference between typical and atypical antipsychotics?

A

atypical (2nd gen) have decreased EPS/TD side effects

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10
Q

What neurotransmitter does first gen’s primarily block?

A

D2

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11
Q

What neurotransmitter does second gen’s primarily block?

A

5HT2

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12
Q

What are 3 other neurotransmitter receptors that typical agents block (and accounts for side effects)?

A

Muscarinic
Histaminic
a1 adrenergic

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13
Q

What side effects are associated with a1-adrenergic blockage by typicals?

A

Orthostatic Hypotension
Dizziness/Syncope

Remember: a1= 1 Heart= blood pressure issues

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14
Q

What are some presenting symptoms for hyperprolactinemia caused by typical antipsychotics?

A

Amenorrhea
Galactorrhea
Gynecomastia
Decreased Libido

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15
Q

What are the 1st line treatments for EPS symptoms?

A

Benztropine (anticholinergic)

Trihexyphenidyl

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16
Q

What are the side effects associated with histamine blockade by typical?

A

Sedation

17
Q

What can be given to offset the histamine-mediated EPS symptoms?

A

Diphenhydramine

18
Q

Treatments for Tardive Dyskinesia

A

VMAT2 inhibitors- “-benazines”
Valbenazine
Deutetrabenazine

19
Q

“-idone” mechanism of action

A

5HT-2A/DA Antagonists

20
Q

Which 2nd gen’s work by being partial agonists at DA/5HT1A receptors?

A

-piprazoles

21
Q

Which 2nd gen’s are considered multi-acting agents?

A

-apines

22
Q

What side effects are more common in 2nd gen compared to 1st gen?

A

Metabolic problems: Weight gain, Hyperlipidemia, Hyperglycemia

QTc prolongation

23
Q

Which 1st gen’s have the highest risk for EPS and TD?

A

High Potency:
Fluphenazine
Haloperidol

“HAL FLIES HIGH”

24
Q

Which 1st gen’s have the highest risk for anti-histamine/cholinergic/a1 side effects?

A

Chlorpromazine
Thioridazine

“Cheating Thieves are LOW”- These have low potential for EPS/TD side effects

25
Q

Which 2nd gens have the highest risk for metabolic side effects?

A

ClOzapine
Olanzapnie

O’s for Obesity

26
Q

Overall, which 2nd gen’s has the lowest risk of side effects?

A

Ziprasidone

Risperidone

27
Q

What is the GASS used for?

A

Generalized survey to evaluate side effects of antipsychotics

28
Q

What is the AIMS used for?

A

Evaluates Movement side effects

29
Q

What is a side effect specifically related to Clozapine?

A

Agranulocytosis

30
Q

A patient who is taking antipsychotics presents with muscle rigidity, rhabdomyolysis, hyperthermia, and dehydration. What could they be suffering from?

A

Neuroleptic Malignant Syndrome (NMS)

31
Q

What is the antidote to NMS?

A

Dantrolene

32
Q

What are the Long-Acting Injectable Agents?

A 
ROAP
Risperidone
Olanzapine
Aripiprazole 
Paliperidone (don't need to know this one)

NMSP Exam 3 (18 decks)

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