Anti-Psychotics Flashcards Preview

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Flashcards in Anti-Psychotics Deck (17):
1

Chlorpromazine

First antipsych, was tested as antihistamine

2

Affinity to D2 Binding

NOT correlated w/ efficacy

3

Conventional/First Generation (3)

Phenothiazines
Thioxanthenes
Butyrophenones: haloperidol

4

Atypica/2nd Gen (3)

Clozapine
5HT-DA Blockers (SDAs): Risperidone, olanzipine, etc
Partial Agonists: aripiprazole

5

Convential Antipsych Mech/3 additional properties

Full D2 antags
Also M1, alpha1, and H1 antagos so you get drowsiness, decreased BP, etc

6

4 DA Pathways/levels untreated Schiz/effects

Mesolimbic Pathway - high DA/positive symptoms
Mesocortical - low DA/cognitive and affective/negative symptoms
Nigrostriatal and Tuberoinfundibular Pathways have normal DA

7

Good Results After D2 Antagonist

Normal in mesolimbic so reduced positive symptoms

8

Bad Results After D2 Antag (4)

Decreased pleasure/reward from mesolimbic
Neg symptoms still bad bc low in mesocortical
Now low in nigrostriatal and tuberoinfundibular, so maybe parkinsonism and elevated prolactin

9

Atypica Antipsych Mech

Indirectly augment DA via 5HT antagonism (high 5HT2/D2 ratio) and prevents total long/binding and actually has some partial D2 agonism. So may reduce DA activity in some ways while preserving a lot of functioning

10

3 Mech Qualities of Atypical Antipsychs (similar to last card)

5HT DA R antagonist
D2 R antagonism w/ rapid dissociation
D2R partial agonist

11

Results After 5HT DA Antagonist

Get lower in mesolimbic pathway (maybe still decrease pleasure/reward), but everything else normal. Remove negatives and positives, no prolactin or parkinson problems

12

3 Antipsych Side Effects

Prolactin Elevation
Metabolic Side Effects (more common w/ newer)
Extrapyramidal Syndrome (more common w/ older psychs) like Tardive Syndrome

13

Consequences of PRL elevation

Just everything sexual fucked up

14

Acute Dystonia

Sustained abnormal postures/muscle spasms that develop w/ neuroleptic medication

15

Akathasia

Inner driven restlessness from meds

16

Tardive Dyskinesia

Abnormal, involuntary movements of tongue, jaw, trunk, or extremeties. Facial-lingual-orals most common. Often appear unconcerned w/ syptoms

17

Blood Dyscrasias

Most dangerous w/ clozapine - can get leukopenia or agranulocytosis (much more dangerous)