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NMSP Week 6/7 > Antipsychotic Drugs (Segars) > Flashcards

Antipsychotic Drugs (Segars) Flashcards

1
Q

The following list of drugs makes up what class?

Chlorpromazine
Fluphenazine
Perphenazine
Thioridazine
Trifluoperazine
Haloperidol 
Loxapine
Molindone
Pimozide
Thiothixene
A

First generation antipsychotic agents

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2
Q

The following list of drugs makes up what class?

Iloperidone
Lurasidone
Paliperidone
Risperidone
Ziprasidone
Aripiprazole
Brexpiprazole
Cariprazine
Lumateperone
Asenapine
Clozapine
Olanzapine
Quetiapine
Pimavanserin
A

Second generation antipsychotic agents

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3
Q

What is the primary difference between first generation agents and second generation agents?

A

Second generation agents have reduced movement disorder symptoms

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4
Q

First generation agents are also called?

Second generation agents are also called?

A

1) Typical

2) Atypical

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5
Q

What is the MOA for the FGA’s?

A

Block D2 post synaptic receptors

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6
Q

FGA’s can cause dry mouth, constipation, urinary retention, blurred vision, and sedation due to?

A

Also blocking muscarinic receptors

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7
Q

FGA’s can cause orthostatic hypotension and dizziness/syncope due to?

A

Also blocking α1-adregneric receptors

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8
Q

FGA’s can cause sedation due to?

A

Also blocking H1 receptors

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9
Q

Amenorrhea/Galactorrhea/Gynecomastia/Decreased libido are dopamine associated side effects due to?

What pathway is involved?

A

1) Hyperprolactinemia

2) Tuberoinfundibular pathway

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10
Q

Acute akathisia/dystonia/parkinsonism-like and tardive dyskinesia are what type of dopamine associated side effects?

What pathway is involved?

A

1) Extrapyramidal symptoms

2) Nigrostriatal pathway

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11
Q

Anticholinergic agents such as Benztropine & Trihexyphenidyl are used to treat what side effects?

A

Extrapyramidal symptoms

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12
Q

Selective vesicular monoamine transporter 2 (VMAT2) inhibitors such as Valbenazine and Deutetrabenazine are used to treat what side effects?

A

Tardive Dyskinesia

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13
Q

What drugs make up the FGAs?

A

(-azine make up a bunch)

1) Chlorpromazine
2) Fluphenazine
3) Perphenazine
4) Thioridazine
5) Trifluoperazine
6) Haloperidol
7) Loxapine
8) Molindone
9) Pimozide
10) Thiothixene

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14
Q

What is the MOA of SGA’s?

A

Blocks D2 post synaptic receptors and blocks 5HT2A receptors

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15
Q

Are SGAs stronger at blocking D2 or 5HT2A receptors?

A

5HT2A

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16
Q

The following list of drugs make up what category of SGAs?

Iloperidone
Lurasidone (also partial 5HT-1A agonist)
Paliperidone (metabolite of Risperidone)
Risperidone
Ziprasidone
A

5HT-2A/DA Receptor Antagonists

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17
Q

The following list of drugs make up what category of SGAs?

Aripiprazole
Brexpiprazole

A

Partial DA/5HT-1A Receptor Agonists

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18
Q

The following list of drugs make up what category of SGAs?

Asenapine
Clozapine
Olanzapine
Quetiapine
Lumateperone
A

Multi-Acting Receptor-Target Agents

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19
Q

Pimavanserin makes up what category of SGAs?

A

Inverse Serotonin Agonist/Antagonist

20
Q

What are common side effects of SGAs?

A

1) Weight gain

2) Metabolic effects (hyperglycemia/insulin resistance, hyperlipidemia)

21
Q

What are rare side effects of SGAs?

What populations are at greater risk for these side effects?

A

1) QTc prolongation (women, elderly, and those on antiarrhythmics)
2) Stroke (Elderly with dementia)

22
Q

When monitoring antipsychotics, guidelines recommend determining in all patients, what baseline items?

A

1) Serum glucose
2) Lipids
3) BMI
4) BP
5) Waist circumference
6) Family history of CV and metabolic disease

23
Q

Which SGA is associated with agranulocytosis as a side effect?

A

Clozapine

24
Q

Which SGA is associated with Drug Reaction w/ Eosinophilia & Systemic Symptoms (DRESS) as a side effect?

A

Olanzapine

25
Q

What drugs make up the SGAs?

A 
(-idone):
Iloperidone
Lurasidone
Paliperidone
Risperidone
Ziprasidone

(-piprazole):
Aripiprazole
Brexpiprazole

(-apine)
Asenapine
Clozapine
Olanzapine
Quetiapine

Pimavanserin
Cariprazine
Lumateperone

26
Q

Neuroleptic Malignant Syndrome (NMS) is a rare but potentially-fatal antipsychotic side effect that causes severe Parkinson’s-like movement disorder with wide-spread muscle contraction that can be treated with?

A

Dantrolene

27
Q

Non-adherence of antipsychotics can be managed with?

What are these agents?

A

1) Long-Acting Injectable Agents (LAIA’s)

2) OAR: Olanzapine, Aripiprazole, Risperidone

28
Q

Which SGA is used for recurrent suicidal behavior?

A

Clozapine

29
Q

Which SGA is used for Parkinson Disease psychosis?

A

Pimavanserin

30
Q

What adverse side effects are more commonly seen with the FGA chlorpromazine?

A

1) Tardive dyskinesia
2) Sedation
3) Anticholinergic side effects
4) Orthostatic hypotension
5) QTc prolonging

31
Q

What adverse side effects are more commonly seen with the FGA fluphenazine?

A

1) EPS
2) Tardive dyskinesia
3) Prolactin elevation

32
Q

What adverse side effects are more commonly seen with the FGA haloperidol?

A

1) EPS
2) Tardive dyskinesia
3) Prolactin elevation
4) QTc prolonging

33
Q

What adverse side effects are more commonly seen with the FGA thioridazine?

A

1) Sedation
2) Anticholinergic side effects
3) Orthostatic hypotension

34
Q

What adverse side effects are more commonly seen with the SGA cariprazine?

A

1) Sedation
2) Anticholinergic side effects
3) Orthostatic hypotension

35
Q

What adverse side effects are more commonly seen with the SGA clozapine?

A

1) Weight gain
2) Hyperglycemia
3) Hyperlipidemia
4) Sedation
5) Anticholinergic side effects
6) Orthostatic hypotension

36
Q

What adverse side effects are more commonly seen with the SGA olanzapine?

A

1) Weight gain
2) Hyperglycemia
3) Hyperlipidemia
4) Sedation

37
Q

What adverse side effects are more commonly seen with the SGA quetiapine?

A

1) Hyperlipidemia

2) Sedation

38
Q

What adverse side effects are more commonly seen with the SGA risperidone?

A

Prolactin elevation

39
Q

What adverse side effects are more commonly seen with the SGA ziprasidone?

A

QTc prolonging

40
Q

A 42-year-old patient is treated with an antipsychotic medication to manage his schizophrenia. Which of the following agents would more likely have been prescribed if the patient experienced skeletal muscle rigidity, tremor at rest, flat facies, uncontrollable restlessness, and spastic torticollis?

A. Haloperidol
B. Clozapine
C. Olanzapine
D. Chlorpromazine
E. Quetiapine
A

A. Haloperidol

41
Q

A 36-year-old woman has had schizophrenia for several years, during which time she has received various different medications. Her current treatment is fluphenazine, and she is experiencing amenorrhea and galactorrhea. Which antipsychotic agent would be more appropriate for this patient and would have the lowest risk of her current adverse effects?

A. Aripiprazole
B. Haloperidol
C. Chlorpromazine
D. Risperidone
E. Clozapine
A

A. Aripiprazole

42
Q

A 36-year-old woman has had schizophrenia for several years, during which time she has received various different medications. Her current treatment is fluphenazine, and she is experiencing amenorrhea and galactorrhea. Which second generation agent would be least appropriate for this patient and would have a near-equal risk of her current adverse effects?

A. Aripiprazole
B. Haloperidol
C. Chlorpromazine
D. Risperidone
E. Clozapine
A

D. Risperidone

43
Q

A 35-year-old homeless man has been taking chlorpromazine for many years to control his schizophrenia. He has experienced numerous adverse effects typical of this treatment, including blurred vision, dry mouth, mydriasis, nausea, urinary retention, and constipation. These effects are caused by blockade of which receptor?

A. Alpha adrenergic
B. Dopamine
C. Nicotinic
D. Serotonin
E. Muscarinic
A

E. Muscarinic

44
Q

A patient with a history of schizophrenia is transported to the emergency department by ambulance after repeated episodes of fainting. The cause is speculated to possibly be attributed to severe drug-induced orthostatic hypotension associated with one of her medications and thought to be due to alpha-adrenergic blockade. Which antipsychotic medication that the patient could have been receiving would be the most likely cause of this side effect?

A. Risperidone
B. Thioridazine
C. Aripiprazole
D. Haloperidol
E. Fluphenazine
A

B. Thioridazine

45
Q

A patient with a history of schizophrenia is transported to the emergency department by ambulance after repeated episodes of fainting. The cause is speculated to possibly be attributed to severe drug-induced orthostatic hypotension associated new therapy with thioridazine. This side effect is caused by blockade of which receptor?

A. Alpha adrenergic
B. Dopamine
C. Nicotinic
D. Serotonin
E. Muscarinic
A

A. Alpha adrenergic

46
Q

A 22-year-old male college student with a BMI of 49 is diagnosed with schizophrenia. Which medication is a second-generation antipsychotic that would be most appropriate as first-line therapy for this patient and have the lowest impact on his BMI?

A. Quetiapine
B. Olanzapine
C. Clozapine
D. Chlorpromazine
E. Ziprasidone
A

E. Ziprasidone

NMSP Week 6/7 (18 decks)

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