Antipsychotic Agents and Lithium Flashcards Preview

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Flashcards in Antipsychotic Agents and Lithium Deck (17):
1

Typical (Classical) Antipsychotics

D2 receptor affinity
Phenothiazines (chlorpromazine, thioridazine, fluphenazine)
Thioxanthenes (thiothixene)
Butyrophenones (haloperidol)

2

Atypical antipsychotics

Serotonin receptor affinity
Heterocyclics (clozapine, loxapine, olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole)

3

Low Potency
-fewer extrapyramidal effects but more H1, Alpha1 & M blocking effects

Chlorpromazine, thioridazine, mesoridazine

4

High Potency
- more extrapyramidal effects but less H1, Alpha1 & M blocking effects

Haloperidol, Fluphenazine, Droperidol

5

Dopaminergic tracts
1. Mesocortical-mesolimbic
2. Nigrostriatal
3. Tuberoinfundibular
4. Medullary-periventricular
5. Incertohypothalamic

1. Mesocortical-mesolimbic
- mentation and mood
2. Nigrostriatal
- Extrapyramidal function
3. Tuberoinfundibular
- Prolactin release
4. Medullary-periventricular
- eating behavior
5. Incertohypothalamic
- anticipatory motivational phase of copulatory behavior

6

Class: Typical antipsychotic
Use: Schizophrenia & other psychotic disorders
SE: EPS, Tardive dyskinesia, Failure of ejaculation, Marked sedation, corneal & lens deposits

Chlorpromazine

7

Class: Typical antipsychotic
Use: Schizophrenia & other psychotic disorders, antiemesis
SE: EPS, tardive dyskinesia, failure of ejaculaion, retinal deposits, Cardiotoxicity
Notes: Strongest autonomic effects
Only antipsychotic w/ fatal dose

Thioridazine

8

Class: Typical antipsychotic
Use: Schizophrenia & other psychotic disorders, Huntington's disease, tourette's syndrome
SE: EPS (major), Hyperprolactinemia, Neuroleptic malignant syndrome
Note: Weakest autonomic effects
Least sedating among typical antipsychotics

Haloperidol

9

Class Atypical antipsychotic
Uses: Schizophrenia (refractory, suicidal)
SE: Weight gain, hyperglycemia (DM), Hyperlipidemia, Myocarditis,
Notes: ONly antipsychotic that reduces risk of suicide

Clozapine

10

Class: Atypical antipsychotic
Uses: Schizophrenia, other psychotic disorder, bipolar disorder (manic episodes)
SE: Somnolence, fatigue, sleep paralysis, hypnagogic hallucination, cataracts, priapism

Quetiapine

11

Class: Atypical antipsychotic
Uses: Schizophrenia, other psychotic disorder, bipolar disorder
SE: Insomnia, Hyperprolactinemia (marked), photosensitivity
Note: Only antipsychotic approved for schizophrenia in the youth

Risperidone

12

Features of Neuroleptic Malignant Syndrome

Fever,
Encephalopathy,
Vitals unstable,
Elevated CPK,
Rigidity

13

Class: Mood stabilizer
MOA: uncertain. Decreases cAMP. Inhibits inositol-1-phosphatase, causing depletion of inositol and inositol triphosphate
Uses: Bipolar disorder, recurrent depression, schizoaffective disorder
SE: Thyroid enlargement, Nephrogenic diabetes insipidus, edema, Bradycadia

Lithium

14

Mood stabilizer CI in sick sinus syndrome

Lithium

15

Disease caused by Lithium in fetus

Ebstein anomaly

16

Lithium threshold

2 mEq/L

17

Lithium overdose treatment

Hemodialysis