anti-psychotics (neuroleptics) Flashcards
(19 cards)
1st gen antipsychotics - ________
2nd gen antipsychotics - _________
1st gen - typical
2nd gen - atypical
what are the two groups 1st gen antipsychotics can be divided into?
low-potency and high-potency
what does potency of a drug refer to?
how much of a drug must be taken for it to reach optimal efficacy (its strength)
what is the MOA of 1st gen antipsychotics
dopamine (d2) receptor antagonists
what is an example of a first generation drug?
eg. chlorprozamine
(haloperidol, trifluoperazine, IM piportil, IM clopixol, IM modecate, IM fluanxol)
side effects of 1st gen antipsychotics
- highly sedating (esp initially)
- postural hypotension
- dizziness, dry mouth
- difficulty urinating
example of a low potency 1st gen antipsychotic
chlorprozamine - good to sedate
high potency 1st gen antipsychotics
least sedative and anticholinergic effects, needed in small amount, BUT most EPSE
EPSE - Extrapyrimidal Side Effects
examples of high potency 1st gen antispychotics
trifluoperazine, haloperidol, modecate, fluphenazine
general side effects of antipsychotics
- anti-cholinergic (blurred vision, constipation, dry mouth,urinary retention, increased ocular pressure)
- cardiovascular (orthostatic hypo, arrhythmias, tachycardia)
- sedation
anti-cholinergic BCDUI
what are the different EPSE?
- acute dystonia - one eye rolled back
- akathisia - inability to sit still
- akinesia - drooling
- dystonia - toy soldier
- tardive dyskinesia - rapid chewing movement
- parkinsonism
- neuroleptic malignant syndrome - most dangerous one!!!
treatment of EPSE
IM congentin (benztropine) - fast acting! for dystonia
oral artane (trihexyphenidyl) - parkinsonism
diphenhydramine (benadryl)
what is the MOA of 2nd gen antipsychotic
blocks dopamine (d2) and serotonin (5ht2) receptors, improves positive symptoms but more effective for negative symptoms
what are examples of negative symptoms
- amotivation
- attention deificit
- anhedonia (inability to experience pleasure)
- avolitional attitude (decrease in motivation)
what are examples of 2nd gen antipsychotics
clozapine, risperidone, olanzapine, aripiprazole, quetiapine fumarate
why are atypical antipsychotics preferred?
1st gen (typical) anti psychotics have higher risk of neuroleptic malignant syndrome and EPSE
what are specific side effects of clozapine
agranulocytosis! have to monitor wbc every 6/12, and check seizure chart
what are monitoring measures for clozapine
dose related seizure risk!
what are specific side effects of olanzapine
weight gain! or type 2 dm
