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Flashcards in Antipsychotic Drugs Deck (53):
1

typical: first generation antipsychotics (FGAs)

phenothiazenes; thioxanthenes; dibenzoxazapines; butyrophenones and diphenylbutylpiperidines; dihydroindolone

2

phenothiazenes

chlropromazine; thioridazine; mesoridazine; fluphenazine; trifluoperazine; perphenazine

3

thioxanthenes

chlorprothixene; thiothixene

4

dibenzoxazapines

loxapine

5

butyrophenones and diphenylbutylpiperidines

haloperidol and pimozide

6

dihydroindolone

molindone

7

atypical: second generation antipsychotics (SGAs)

clozapine; risperidone; olanzapine; quetiapine; aripiprazole

8

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

positive/active symptoms of schizophrenia

9

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

negative/passive symptoms of schizophrenia

10

most anti psychotic drugs block ...

dopamine receptors

11

schizophrenia patients have increased density of ...

dopamine receptors

12

newer neuroleptic drugs bind preferentially to ... and ...

serotonin 5-HT2 and dopamine D4 receptors

13

typical (FGAs) do not alleviate ...

negative symptoms

14

atypical (SGAs) alleviate ...

both positive and negative symptoms

15

hypo-frontality hypothesis of schizophrenia: 3 components

positive symptoms; negative symptoms; impaired cognition

16

meso cortical pathway

negative symptoms

17

meso limbic pathway

positive symptoms

18

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

dopamine, serotonin, glutamate

19

clinical potency of FGAs is generally correlated with degree of ...

dopamine D2 antagonism

20

high liability for metabolic syndrome, weight gain, blood disorders

SGAs

21

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

chlorpromazine

22

phenothiazine; aliphatic chain at R1; hight potency

trifluoperazine

23

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

thioridazine

24

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

fluphenazine

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

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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