Antipsychotic Agents and Lithium Flashcards Preview

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Flashcards in Antipsychotic Agents and Lithium Deck (40):
1

Typical (Classical) Antipsychotics

Phenothiazines (Chlorpromazine, Thioridazine, Fluphenazine)
Thioxanthenes (Thiothixene)
Butyrophenones (Haloperidol)

2

Atypical Antipsychotics

Heterocyclics (Clozapine, Loxapine, Olanzapine, Risperidone, Quetiapine, Ziprazidone, Aripiprazole)

LAHAT NG MAY -PINE at -DONE

3

_____ Potency:
fewer extrapyramidal effects, more H1, Alpha1 and muscarinic blocking effects

Low
(i.e. Chlorpromazine, Thioridazine, Mesoridazine)

4

_____ Potency:
more extrapyramidal effects, less H1, Alpha1 and muscarinic blocking effects

High
(i.e. Haloperidol, Fluphenazine, Droperidol)

5

These Dopamine ___ receptors are the target of older antipsychotics

D2 receptors in the caudate putamen, nucleus accumbens, cerebral cortex and hypothalamus

6

Identify the Dopaminergic Tract:
Regulates mentation and mood

Mesocorticcal - Mesolimbic

7

Identify the Dopaminergic Tract:
Extrapyramidal function

Nigrostriatal

8

Identify the Dopaminergic Tract:
Control of PRL release

Tuberoinfundibular

9

Identify the Dopaminergic Tract:
Eating behavior

Medullary-Periventricular

10

Identify the Dopaminergic Tract:
Anticipatory motivational phase of copulatory behavior

Incertohypothalamic

11

Antipsychotic that decreases incidence of suicide

Clozapine

12

Antipsychotic Toxicities

Constipation, dry mouth, loss of accomodation
Orthostatic hypotension, impotence
Toxic-confusional state
Weight gain
Hyperprolactinemia

13

Hallucinogenic Receptors

5HT2A/2C

14

Antipsychotics that can improve + symptoms but not - symptoms

Typical/Classical

15

Antipsychotics that can improve both + and - symptoms

Atypical

PERO SOBRANG MAHAL

16

Tx for Acute Dystonia

Diphenhydramine

17

Tx for Parkinsonism

Benztropine

18

Tx for Rabbit Syndrome

Benztropine

19

Tx for Tardive Dyskinesia

None

20

Tx for Akathisia

Diphenhydramine

21

Tx for Neuroleptic Malignant Syndrome

Withdraw drug, Dantrolene

22

Typical Antipsychotics
Blocks D2 receptors>>5HT2

Chlorpromazine
Thioridazine
Haloperidol

LAHAT NG -ZINE

23

Atypical Antipsychotics
Blocks 5HT2>>D2

Clozapine
Olanzapine
Quetiapine
Risperidone
Ziprazidone
Aripiprazole

LAHAT NG -PINE at -DONE

24

Sx of Neurleptic Malignant Syndrome
FEVER

Fever
Encephalopathy
Vitals Unstable
Elevated CPK
Rigidity

25

Prototype typical antipsychotic
SE: CORNEAL AND LENS Deposits, failure of ejaculation, marked sedation, neuroleptic malignant syndrome, contact dermatitis

Chlorpromazine
(Phenothiazine)

26

Typical antipsychotic for anti-emesis
SE: RETINAL deposits, failure of ejaculation, cardiotoxicity (arrhythmia)
Strongest AUTONOMIC EFFECTS

Thioridazine
(Phenothiazine)

27

Only antipsychotic with Fatal Overdose

Thioridazine
(Phenothiazine)

28

Typical antipsychotic
Drug for Huntington, Tourette's
SE: EPS (major), Neuroleptic Malignant Syndrome
Weakest AUTONOMIC EFFECTS
Least sedating

Haloperidol
(Butyrophenone)

29

Prototype atypical antipsychotic
Drug for refractory schizophrenia, suicidal
SE: AGRANULOCYTOSIS, weight gain, hyperglycemia, hyperlipidemia, myocarditis, seizures, ileus, hypersalivation

Clozapine

30

Atypical antipsychotic for Bipolar disorder, anorexia nervosa, depression
SE: weight gain, hyperglycemia, hyperlipidemia

Olanzapine

31

Atypical antipsychotic
SE: Somnolence, Fatigue, Sleep paralysis, Hypnagogic hallucinations, cataracts, priapism

Quetiapine

32

Atypical antipsychotic for intractable hiccups, Tourette's syndrome
SE: Hyperprolactinemia, Photosensitivity
Only antipsychotic approved for schizophrenia in the youth

Risperidone

33

Atypical antipsychotic
SE: Postural hypotension, QT prolongation (Torsades)
Little or not tendency to cause hyperglycemia, hyperprolactinemia or weight gain
Increased mortality in elderly patients with dementia-related psychosis

Ziprasidone

PUSO

34

Atypical antipsychotic
Least sedating atypical antipsychotic
no atropine like effects
Little or not tendency to cause hyperglycemia, hyperprolactinemia or weight gain
Very good safety profile

Aripiprazole

35

Sx of Neuroleptic Malignant Syndrome

Fever
Encephalopathy
Vitals Unstable
Elevated CPK
Rigidity

36

Tx of Bipolar disorder
Used with antidepressants during maintenance therapy
Slow onset of action
Protective versus suicide and self-harm

Lithium

37

Mood stabilizer that decreases cAMP, Inhibits Inositol1phosphate
SE: Thyroid enlargement, Nephrogenic DI, Edema, Leukocytosis, Teratogen, Ebstein's Anomaly, Bradycardia
Contraindicated in Sick Sinus Syndrome

Lithium

38

Tx of Lithium overdose

Hemodialysis

39

Threshold for Lithium Toxicity

2 mEq/L

40

Sx of Lithium Overdose

Neuromuscular excitability, tremors, twitching, agitation, weakness, ataxia, leukocytosis, bradycardia, hypotension