Anti-Psychotics Flashcards
(30 cards)
what is the main receptor blockage that their therapeutic action is linked to
dopamine 2 - - antipsychotic potency runs parallel to activity here
why do APs target other receptors then too
to reduce the EPSE and make them more tolerabel
do APs benefit all aspects of the schizophrenia symtpoms?
no, they are better for the positive ones the negative ones are really hard to treat
are certain APs more efficacious than others?
not really, apart from clozapine. But this is reserved for those unresponsive to 2 other drugs as it can cause agranulocytosis
how do you start someone on an APs
- discuss side effect profile
- start at low dose and slowly increase
- trial for 4 weeks at optimum dose
- only use one APs at a time
- review prescription regularly
how long does it take for APs to work
varies between drug but usually there is some effect int eh first few days adn then this builds up over a few weeks
if someone has poor oral adherence, what are the options
depot IM injections available for some drugs - long acting infusion
which APs are available as depot injection
rispierdone
paliperidone
olannapine
aripiprazole
which AP is used for the management of acute psychosis in PD and why
quietipaine - least D2 receptor activity
are there any risks of using atypical APs in the elderly?? (START STOPP)
yes, there is an increasd risk of stroke and VTE with atypical APs
are there cardiac problems assoicated with APs
yes, they can prolong the QT interval and cause torsade de pointes
Which receptor does clozapine act on?
big mix
what is the main AE in the mouth caused by clozapine
hypersalivation
what is the main AE of clozapine which limits its use
agranulocytosis - particularly low levels of neutrophils = high risk of serious infections due to immunosuppression
outline the monitoring required for clozapine
FBC
- weekly for first 6 months
- then 2 weekly for next 6 months
- then every 4 weeks
what should you watch out for in pt on clozapine
gets ill - sore throat or cough etc
do a FBC
outline the interaction between clozapine and smoking
if someone smokes and then stops - clozapine will now be metabolized faster
which has the most tolerable side effect profile
Aripiprazole -
which are the worst for weight gain
olanzapine
clozapine
what effect does clozapine have on seizues
lowers threshold for them
acute dystonic reaction
this is a painful, involuntary muscle spasm that typically involves the neck, eye and back muscles
give 3 examples of an acute dystonic reaction
torticollis, protruding tongue, fixed upward gaze
parkinsonism
the pharmacological induction of Parkinsonism due to blockage of the D receptors
how is the onset of drug induced Parkinson’s different
rapid osnet and symmetrical
