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Antipsychotic Drugs Flashcards

(48 cards)

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1
Q

name the typical antipsychotics

A

CHLORPROMAZINE, FLUPHENAZINE, perphenazine (phenothiazine)

Haloperidol: diphenybutylpiperidine
& butyrophenones

also thiothixine: thioxanthenes

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2
Q

name the atyopical antipsychotic agents

A 
CLOZAPINE
RISPERIDONE
OLANZEPINE
quietapine
ziprasidone
ARIPIPRAZOLE
paliperidone
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3
Q

ANTIPSYCHOTIC ACTION COMES ABOUT BY WHAT OVERASLL MECHANISM

A

DOPAMINE RECEPTOR ANTAGONISM

ALL DRUGS CAPABLE OF REDUCING PSYCHOSIS ARE ALSO D2 RECEPTO ANTAGONIST

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4
Q

D2RECEPTOR WHEN ACTED ON BY DOPAMINE

A

ADENYLATE CYCLASE IS INHIBITED

DECREASED CAMP LEVELS

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5
Q

DOPA 1 WHEN ACTED ON BY DOPAMINE

A

ADENYLATE CYCLASE IS ACTIVATED

RISING CAMP LEVELS

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6
Q

receptor specificity of atypical antipsychotics

A

low d2 affinity

high 5HT2 affinity

*less extrapyramidal parkinsonism features seen with atypicals-lower affinity for D2

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7
Q

other receptors antipsychotics block

A

serotonin, histamine, alpha i AR, muscarinic

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8
Q

blockade of D2 receptors blocks

A

positive symptoms

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9
Q

blockade of 5HT2 releives

A

negative symptoms

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10
Q

blockade of alpha 1 receptors produces

A

orthostatic hypotension and tachycardia

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11
Q

blockade of H1 receptors induces

A

sedation

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12
Q

blockade of mACH receptors causes

A

confusion and memory impairment

also provides protection against extrapyramidal side effects

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13
Q

typical antipsychotic side effects

*inhibit dopamine 2

A

produce eps
elevate prolactine levels
equally effective but vary in potency side effect profile
(more potent greater EPS/less potent more sedations and OHTN)

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14
Q

largely effective for positive symptoms
dellusions
hallucinations
disorganized thought and behavior

A

typical antipsychotics

chlo
flu
halo

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15
Q

greater eficacy for relieving negative symptoms
-flat affect, withdrawl, paucity of thought, avolition,
reduced EPS
5ht2 blockade and D2 blockade

A

atypical antipsychotics

CLozapine
Risperidone
Olanzepine
Aripiprazole

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16
Q

low potency typicals all have

A

aliphatic of piperiDINE side chaine

lower EPS effects but greater antimuscarinic effects

higher rate of OHTN and sedation

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17
Q

potent typicals have

A

piperaZINE side chain

greater EPS, weak anticholinergic

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18
Q

potent typicals…name them

A

haloperidol and fluphenazine

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19
Q

only approved antipsychotic agent in children and teens

A

risperidone

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20
Q

atyopical at low doses and typical at high doses

21
Q

active metabolite of risperidone

22
Q

higher doses of risperidone shows greater risk of

23
Q

atypicals-low potency- with additonal 5HT2 antagonism that may be good for treating negative symptoms

Study These Flashcards
A

CLozapine

olanzapine

quetiapine

24
Q

MOA for aripiprazole (abilify)

lower incedence of side effects

Study These Flashcards
A

d2 partial agonist
5HT2A antagonist
5HT1A partial agonist

25
D1, D2, 5HT1, 5HT2, alpha adrenergic antagonist no antimuscranic receptors
asenapine
26
all antipsychotics produce a series of behavioral effects termed NEUROLEPTIC SYNDROME--WHA ARE THEY
supression of spontaneous movements and complex behaviours reduced initiate and interest in environment decreased manifestations of emotion over time psychotic symptoms dissappear over time
27
dopa blockade by antipsychotics works in the
limbic system where anticholinergics do not block ther therapeutic effect anticholinergics do not affect DA turnover in limbic system
28
anticholinergics in the basal ganglia
block antipsychotic induced increases in DA turnover (metabolism)-consequently block many of the symptoms of EPS *restore balance between cholinergic and dopamine system in basal ganglia
29
extrapyramidal side effects of high potency typical antipsychotics (Haloperidol and Fluphenazine)
Acute Dystonia Akathesia Parkinsonian Syndrome Neuroleptic Malignant SYndrome later: perioral tremor tardive dyskinesia
30
key features of neuroleptic malignant syndrome within weeks of therapy
fever, rigidity, parkinsonism with catatonia, mental status changes, coarse tremor, and autonomic instabilityelevated creatinine kinase, myoglobinemia, fever in the 38 degree range
31
useful in releiving acute dystonia *spasms to face and neck within first 5 days
benztropine-anticholinergic antiparkinsonian agent
32
Akathesia-ants in the pants-subjective feelings of distress treatment? 5-60 days
decrease dose antiparkinsonian agent- benztropine antianxiety agent or propranolol
33
parkinsonian syndrome in psychosis due to treatmen with haloperidol--- rigid, tremor, masked face, akinesia, dec arm movement, gait dist
anticholinergic antiparkinsonian agent-benztropine amantadine giving dopa or bromocriptine-will make the psychosis worse
34
tx of neuroleptic malignant syndrome
dantrolene and bromocriptine after stopping the offending agent and supportive care
35
tardive dyskinesia is caused by months to years after beginning treatment
use of a dopa blocker results from compensatory increases in basabl ganglia dopamine function
36
antipsychotics and epilepsy
low potency -clozapine- can lower threshold for seizures dopa metabolism remains unchanged in the cortex with long term antipsychotic use
37
antipyschotics and the CTZ
ACTUALL PROTECT AGAINST N/V BY INHIBITING DOPA ACTIVATION OF EMESIS CENTER
38
INCREASE PROLACTIN SECRETION AND SHOULD NOT BE USED IN THOSE WITH BREAST CANCERS
ALL TYPICALS AND RISPERIDONE
39
DOES NOT INCREASE PROLACTIN
QEUTIAPINE ARIPIRPRAZOLE MIGHT DECREASE
40
MAY INCREASE RISK FOR TIIDM
ATYPICALS | CLOZAPINE AND OLANZAPINE
41
IMPAIRS GLUCOSE TOLERANCE | DECREASES INSULIN RELEASE
CHLORPROMAZINE
42
TYPE OF ANTIPSYCHOTIC IMPACTING CV SYSTEM
LOW POTENCY TYPICALS CHLORPROMAZINE, THIORDAZINE MAYBE EVE VENTRICULAR ARRHYTMIAS
43
JAUNDICE IN THE 2-4 WEEKS
CHLORPROMAZINE
44
LIMITED USE DUE TO A, AND LEUKOPENIA GRANULOCYTOSIS
CLOZAPINE
45
SCHIZOPHRENIA TREATED WITH
ANTIPSYCHOTICS
46
BIPOLAR DISORDER WITH PSYCHOTIC FEATURES TREATED WITH
MOOD STABLIZERS AND OR ANTIPSYCHOTICS
47
SCHIZOAFFECTIVE DISORDER
ANTIPSYCHOTICS, MOOD STABILIZERS, AND OR ANTIDEPRESSANT
48
MAJOR DEPRESSIVE DISORDER WITH PSYCHOTIC FEATURES TREAT WITH
ECT AND OR ANTIDEPRESSANTS MEDICATION AND OR ANTIPSYCHOTIC MEDICATION

Psychology (6 decks)

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