Antipsychotic drugs Flashcards Preview

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Flashcards in Antipsychotic drugs Deck (31):
1

characteristics of typicals

older
more extrapyramidal side effects
treat positive symptoms

2

effects of typicals

induce state of apathy, lack of initiation, limited range of emotion
reduce confusion and agitation in psychotic patients

3

characteristics of atypicals

newer
less extrapyramidal side effects
first line for out patient
treat positive and negative symptoms

4

major receptor target for typicals

D2 dopamine receptor

5

off target receptors for typicals and their effects

alpha and muscarinic- anticholinergic side effects
H1- weight gain, sedation
serotonin 2c- weight gain

6

what makes one atypical

5HT2a receptor

7

relationship between receptor and dose

higher D2 affinity= lower dose recquried

8

nigrostriatal pathway

substantia nigra to basal ganglia
movement
hyperactive in schizophrenia
degeneration in parkinson's

9

mesolimbic pathway

VTA to nucleus accumbent
hyperactive in schizophrenia- positive symptoms

10

mesocortical pathway

tegmental area to cortex
hypoactive in schizophrenia- negative symptoms

11

tubuloinfundibular pathwya

tegmental area to hypothalamus
controls prolactin release

12

typical antipsychotics

haloperidol
trifluoperazine
fluphenazine
thioridazine
chlorpromazine

13

high affinity for D2 typical

trifluoperazine
fluphenazine
haloperidol

14

low affinity for D2 typical

thioridazine
chlorpromazine

15

atypicals

aripiprazole
clozapine
olanzapine
quetiapine
risperadone
ziprasidone

16

clinical indications for typicals

schizophrenia- positive symptoms
acute mania- temporarily for slow onset of Li
psychosis
tourette's syndrome
parities
intractable hiccups
nausea and vomiting
movement disorders

17

treatment concerns with typicals

non adherance- cause of relapse
inadequate dosing- treatment failure
look for organic cause if no improvement

18

major effects of high potency typicals

can't pee can't see can't spit can't poop
EPS

19

EPS of high potency typicals

acute dystonia
parkinsonism
akathisia
tardive dyskinesia

20

acute dystonia

4 h onset
spasm of head/neck/face muscles

21

parkinsonism

days/weeks onset
muscle rigidity, bradykinesia, tremor, shuffling gait

22

akthisia

days/weeks onset
urge to move

23

treatment of acute dystonia, parkinsonism, akthisia

benztropine
trihexyphenidyl
diphenydramine

24

treatment for tardive dyskinesia

switch to lower dose or an atypical

25

tardive dyskinesisa

4 month onset
involuntary repetitive men tents of face/neck
worse with directed movement
irreversible

26

major side effect low potency typical

increased non specific effects
sedation- histamin antagonist
orthostatic hypotension, sexual dysfunction- alpha
dry mouth, constipation, vision problems- muscarinic

27

specific ADR with chlorpromazine

corneal deposits

28

specify ADR with thirodazine

retinitis pigments
retrograde ejaculation

29

side effects of all typicals

hyperprolactinemia
neuroleptic malignant syndrome

30

neuroleptic malignant syndrome

stiff
hot
altered consciousness
elevated CK
autonomic instability

31

treatment of neuroleptic malignant syndrome

dantrolene
bromocriptine
amatadine
benzodiazepines