antipsychotics Flashcards
(19 cards)
haloperidol, pimozide, -azines (trifluoperazine, chlorpromazine, fluphenazine, thioridazine)
typical antipsychotics, block D2 receptors
typical antipsychotics usage
for schizophrenia (primarily for + symptoms), OCD, Tourette syndrome, delirium, psychosis, Huntington disease, BPD.
“Hal tries to fly high” and effects
haloperidol, trifluoperazine, fluphenazine are high potency antipsychotics with more extrapyramidal side effects
“cheating thieves are low” and effects
chlorpromazine, thioridazine are low potency antipsychotics with more anticholinergic, antihistaminergic, and alpha 1 blockage effects
range of side effects of typical antipsychotic drugs (organ systems)
endocrine, metabolic, cardiac, ophthalmologic and extrapyramidal symptoms
endocrine side effects of typical antipsychotics
acts on dopamine receptors leading to hyperprolactinemia causing galactorrhea, oligomenorrhea and gynecomastia
cardiac side effects of typical antipsychotics
QT prolongation
ophthalmologic side effects of typical antipsychotics
chlorpromazine causes corneal deposits and thioridazine cause retinal deposits
Metabolic side effects of typical antipsychotics
Hyperlipidemia, weight gain and hyperglycemia
Other side effects (antihistamine, antimuscarine, alpha1 blockade, extrapyramidal symptoms…)
Antihistamine: sedation
Antimuscarine: dry mouth, constipation
Alpha1 blockade: orthostatic hypotension
Extrapyramidal symptoms: ADAPT- Acute Dystonia( hours to days) treated with benztropine or diphenhydramine, Akathisia or restlessness (days to months) treated by beta blockers, benztropine and benzodiazepines, Parkisonism or bradykinesia (days to months) treated with benztropine and amantadine, Tardive dyskinesia (months to years) causing chorea orofacially treated with atypical antipsychotics like clozapine, valbenazine and deutetrabenazine.
OTHERS: neuroleptic malignant syndrome
Names of atypical antipsychotics and usage
Aripiprazole, -apines (asenapine,clozapine,olanazapine,quetiapine), -peridone (iloperidone,paliperidone,risperidone), -sidones (lurasidones, ziprasidone)
Used for schizophrenia, OCD, BPD, anxiety disorders, depression, mania, Tourette syndrome,
Clozapine used for treatment resistant schizophrenia or schizoaffective disorder and for suicidality in schizophrenia
Side effects of atypical antipsychotics
All->prolong QT, fewer extrapyramidal and anticholinergic side effects than typical
-apines cause same metabolic as typicals +clOpazine and Olanzapine cause Obesity
Clozapine cause agranulocytosis and seizures
Risperidone cause hyperprolactinemia as typicals
Parkinson disease therapy drugs
BALSA Bromocriptine, Amantadine, Levodopa with carbidopa, Selegiline with COMT inhibitors and Antimuscarinics
bromocriptine (ergot) + pramipexole and ropinirole (non-ergot) mechanism and toxicity
dopamine agonist
toxicity: nausea, impulse control disorder like gambling, confusion, hallucination and postural hypotension
amantadine mechanism and toxicity
increase dopamine availability by decreasing reuptake and increasing release
toxicity: livedo reticularis, ataxia, peripheral edema
carbidopa/levodopa mechanism and side effects
used in Parkinson disease mechanism: L-dopa can cross the BBB and there is converted by dopa decarboxylase and carbidopa is given with L-dopa to increase its bioavailability in the brain and decrease peripheral side effects
side effects: nausea, hallucinations, postural hypotension, in progressive disease it can lead to on-off phenomenon which leads to improved mobility in the on phase and impaired motor function in the off phase
selegiline, rasagiline
mechanism: selectively inhibit the MAO-B increasing the dopamine availability
used with L-dopa
side effects: increase those of L-dopa
tolcapone
crosses the BBB and blocks conversion of dopamine to 3-methoxytyramine (3-MT) in the brain by inhibiting central COMT
benztropine and trihexyphenidyl
antimuscarinic drugs for Parkinson disease by improving tremors and rigidity but has little effect on bradykinesia
