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Dental Pharmacology > Antipsychotic Drugs > Flashcards

Antipsychotic Drugs Flashcards

(53 cards)

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1
Q

typical: first generation antipsychotics (FGAs)

A

phenothiazenes; thioxanthenes; dibenzoxazapines; butyrophenones and diphenylbutylpiperidines; dihydroindolone

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2
Q

phenothiazenes

A

chlropromazine; thioridazine; mesoridazine; fluphenazine; trifluoperazine; perphenazine

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3
Q

thioxanthenes

A

chlorprothixene; thiothixene

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4
Q

dibenzoxazapines

A

loxapine

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5
Q

butyrophenones and diphenylbutylpiperidines

A

haloperidol and pimozide

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6
Q

dihydroindolone

A

molindone

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7
Q

atypical: second generation antipsychotics (SGAs)

A

clozapine; risperidone; olanzapine; quetiapine; aripiprazole

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8
Q

delusions (false beliefs); hallucinations; disorganized thoughts and speech; restlessness

A

positive/active symptoms of schizophrenia

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9
Q

flat affect; social withdrawal; loss of drive; paucity of speech; impaired process planning and memory and personal hygiene

A

negative/passive symptoms of schizophrenia

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10
Q

most anti psychotic drugs block …

A

dopamine receptors

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11
Q

schizophrenia patients have increased density of …

A

dopamine receptors

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12
Q

newer neuroleptic drugs bind preferentially to … and …

A

serotonin 5-HT2 and dopamine D4 receptors

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13
Q

typical (FGAs) do not alleviate …

A

negative symptoms

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14
Q

atypical (SGAs) alleviate …

A

both positive and negative symptoms

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15
Q

hypo-frontality hypothesis of schizophrenia: 3 components

A

positive symptoms; negative symptoms; impaired cognition

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16
Q

meso cortical pathway

A

negative symptoms

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17
Q

meso limbic pathway

A

positive symptoms

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18
Q

instead of just affecting dopamine, now the idea is to balance the 3 neurotransmitters thought to be involved … … and …

A

dopamine, serotonin, glutamate

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19
Q

clinical potency of FGAs is generally correlated with degree of …

A

dopamine D2 antagonism

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20
Q

high liability for metabolic syndrome, weight gain, blood disorders

A

SGAs

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21
Q

phenothiazine; aliphatic chain at R1; low potency; high sedating potential

A

chlorpromazine

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22
Q

phenothiazine; aliphatic chain at R1; hight potency

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A

trifluoperazine

23
Q

phenothiazine; piperidine ring at R1; low potency; higher sedating potential; hypotensive

24
Q

phenothiazine; piperazine ring at R1; hight potency; strong EPS; least sedating of the three groups

25
thioxanthene; N replaced by C at position 10; high potency; EPS
thiothixene
26
thioxanthene; N replaced by C at position 10; high potency; high EPS
chlorprothixene
27
buterophenone; unrelated in structure to other 2 classes; hight potency; less sedating; strong EPS
haloperidol
28
dihydroindolone; structurally not related to other classes; pharmacologic profile resembles that of piperazine group of phenothiazine
molindole
29
dibenzoxapine; resembles TCA in structure; pharmacologic and clinical profile is similar to piperazine group of phenothiazine
loxapine
30
diphenylbutylpiperidine; approved for Tourettes syndrome; alleviates pos. symptoms of schizophrenia; selective D2 antagonism with anti psychotic and parkinson like side effects
pimozide
31
4 major pathways to dopaminergic system:
mesolimbic pathway; mesocortical pathway; nigrostriatal pathway; tuberoinfundibular pathway
32
Dopamine D2 blockade in ... and ... may be responsible for antipsychotic effects of FGAs
meso limbic and meso cortical
33
D2 blockade by FGA in ... may cause EPS
basal ganglia (nigrostriatal)
34
D2 super sensitivity in ... may cause tardive dyskinesia
nigrostriatal
35
involuntary muscle contraction, torticollis; Rx: anticholinergic (bentropine)
acute dystonia
36
inner restlessness and constant urge to move, restless leg syndrome; Rx: BZDs, propanolol
akathisia
37
bradykinesia, tremor, rigidity, postural instability; Rx: levo-dopa, bromocriptine
pseudoparkinsonism
38
repetitive, involuntary, purposeless movements; Rx: up the dose of neuroleptic; switch to an atypical neuroleptic drug (clozapine)
tardive dyskinesia
39
F of FEVER of neuroleptic malignant syndrome
fever (hypothalamic dopamine blockade)
40
1st E of FEVER of neuroleptic malignant syndrome
encephalopathy (delirium; coma)
41
V of FEVER of neuroleptic malignant syndrome
vital signs (autonomic instability; tachycardia; sweating; urinary and fecal incontinence)
42
2nd E of FEVER of neuroleptic malignant syndrome
Enzymes (muscle breakdown; myoglobinuria w/o RBC in urine; high creatine phosphokinase
43
R of FEVER of neuroleptic malignant syndrome
rigidity of muscles (dopamine blockade in the basal ganglia)
44
SGA dibenzodiazepines
clozapine and quetiapine
45
SGA benzisoxazole and most frequently prescribed in US
risperidone
46
SGA thienobenzodiazepine
olanzapine
47
SGA dihydrocarbostyril
aripiprazole
48
2 main side effects of clozapine
weight gain and agranulocytosis
49
used with lithium for treatment of bipolar disorder
risperidone
50
high potential for abuse with effects similar to barbiturates and other hypnotics
quetiapine
51
first of 3rd gen antipsychotic drug; also used for bipolar and autism spectrum disorders; lower liability for weight gain
aripiprazol
52
most frequently prescribed FGAs
haloperidol; chlorpromazine; thioridazine
53
most commonly prescribed SGAs
risperidone; olanzapine; aripiprazole

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