Flashcards in Anti-Psychotics Sang Deck (25):
What are the 2 classes of anti-psychotics?
What are the ATYPICAL anti-psychotics?
What are the Typical Antipsychotics? (3)
"T for typical, HC"
SIDE EFFECTS: Which drug has the greatest ,and least Extra Pyramidal Symptoms (EPS)
Greatest: Haloperidol (High affinity for D2 in Nigrostriatal tract)
Least: Clozapine (Low affinity for D2)
Which are REVERSIBLE neurologic toxic effects of Anti-Psychotics? (3)
1) EPS2) Akathisia3) Dystonia
What is Akathisia?
A state of agitation, distress, and restlessness. "Unable to sit still"
What is dystonia?
Neurological movement disorder: - sustained muscle contractions -> twisting and repetitive movements or abnormal postures.
What is the most likely mechanism of Antipsychotic drugs?
Block Postsynaptic D2 receptors in the CNS. - Particularly the mesolimbic-frontal system
Which of the REVERSIBLE neurologic toxic effects should be treated IMMEDIATELY and why?
1) Dystonia2) Very painful
What drugs are given to treat Dystonia? (2)
1) Diphenhydramine (Sedative Antihistamine with anticholinergic) 2) Benztropine (Anti-Muscarinic)
What is the MOST IMPORTANT unwanted effect of antipsychotic drugs?
What is Tardive dyskinesias?
Choreoathetoid movements of the muscles of the lips and buccal cavity and may be IRREVERSIBLE.
What is Choreoathetosis?
Occurence of involuntary movements in a combination of 1) Chorea: Irregular migrating contractions2) Athetosis: Twisting and Writhing
How does one develop Tardive Dyskinesia?
After several years of antipsychotic drug use. - Some have it as early as 6 months.
How do you treat Tardive Dyskinesia? (3)
1) Discontinue or reduce dose of current antipsychotic2) Eliminate all drugs with central anticholinergic action3) Add diazepam (high dose if necessary) to enhance GABAergic activity
SIDE EFFECTS: Which drug has the greatest and least AUTONOMIC symptoms
Greatest: ThioridazineWeaktest: Haloperidol
What causes AUTONOMIC side effects? (2)
Due to blockade of 1) Peripheral ALPHA-ADRENERGIC receptors2) MUSCARINIC receptors
AUTONOMIC Side Effects of Alpha-Adrenergic receptor blockade: (2)
1) Postural Hypotension2) Failure to ejaculate
AUTONOMIC Side Effects of Muscarinic Blockade. (3)
1) Atropine-like effects2) Antimuscarinic CNS effects3) Urinary retention
SIDE EFFECTS: Which drugs have an INTERMEDIATE autonomic effect? Exception?
Most AytpicalsException: Ariprprazole, Ziprasidone
SIDE EFFECTS: Which drug has the greatest and least METABOLIC effects?
Greatest: Clozapine, OlanzapineWeakest: Ziprasidone, Aripiprazole
What are the METABOLIC side effects: (4)
1) Significant weight gain2) Hyperglycemia3) Hyperlipidemia may occur4) Some my develop DM
What are specific side effects of ENDOCRINE toxicity:
D2 receptor blockade in pituitary: 1) Hyperprolactinemia2) Gynecomastic3) Amenorrhea-galactorrhea syndrome4) Infertility
Which drugs cause Atropine-like effects (Antimuscarinic Autonomic Side effect)
1) Thioridazine2) Clozapine3) Most atypicals except - Ziprasidone - Aripiprazole