Anti-Psychotics Flashcards
(12 cards)
Typical (first generation) antipsychotics
Mechanism of Action:
Use:
Typical antipsychotics
dopamine (D2) receptor antagonists
treat the positive symptoms of psychosis
vary in potency
- Side Effects:
- EPS
- Parkinsonism
- Akathesia
- Dystonia
- Hyperprolactinemia- decreased libido, gynecomastia, impotence, amenorrhea
- Antimuscarinic
- Tardive Dyskinesia
- Neuroleptic Malignant Syndrome
- EPS
Chlorpromazine (Thorazine)
What makes it special?
Chlorpromazine
photosensitivity, blue-grey skin discoloration, orthostatic hypotension
Thioridazine (Mellaril)
What makes it special?
Thioridadine
retinitis pigmentosa
Thiothixene
What makes it special?
Thiothixene
ocular pigment changes
Haloperidol (Haldol)
What makes it special?
Haloperidol
can be given PO/IM/IV
*higher potency means you can give less of the drug but you are more likely to have EPS*
Tardive dyskinesia
Tardive dyskinesia occurs after >6 months of use of neuroleptics. Commonly presents as a contraction or a small muscle (mouth, tongue, hand)
Treatment: discontinue medication
Neuroleptic Malignant Syndrome
NMS
high potency antipsychotics (haloperidol)
Fever, rigidity (lead pipe), autonomic instability, leukocytosis, tremor, elevated CPK, sweating, delirium
Treatment: dantrolene, bromocriptine, or amantadine and discontinue the current medication
Atypical Antipsychotics
What makes them special?
Atypical Antipsychotics
block both dopamine and serotonin receptors and are effective for both positive and negative symptoms of psychosis.
can also be used to treat acute mania and bipolar disorder. Can also be used to treat borderline personality disorder, PTSD, and certain psychiatric disorders in childhood.
- Side Effects:
- Metabolic Syndrome
- Weight gain
- hyperlipidemia
- hyperglycemia- DKA
Clozapine (Clozaril)
What makes it special?
Clozapine
most effective- but use only as a last resort for refractory schizophrenia
can cause myocarditis, agranulocytosis (always do a CBC with diff before starting the medicaiton)
Only antipsychotic shown to decrease the risk of suicide
Will not exacerbate prolactinomas because its a weak D2R antagonist
Quetiapine (seroquel)
What makes it special?
Quetiapine
sedation- can be used to treat psychosis with sleep disorders
Ziprasidone (Geodon)
What makes it special?
Ziprasidone
less likely to cause weight gain
assoc w/ QTc prolongation
must be taken with a meal
Aripiprazole (Abilify)
What makes it special?
Aripiprazole
partial D2 agonism
more activating (less sedating)
less potential for weight gain
good for treating tic disorders
**aripiprazole has a strong affinity for D2 receptors- it may make other antipsychotics less effective because it will displace them from the receptor.
