Antipsychotics

Question 1

What is psychosis?

Answer 1

Objective loss of contact with reality

Question 2

What type of symptoms do antipsychotics best treat?

Answer 2

Postive symptoms
- Hyperarousal
-Delusions
-Hallucinations
-Thought disorders

Question 3

How do many psychotics work?

Answer 3

Antagonists at dopamine D2 receptors

Question 4

How are antipsychotics subdivided?

Answer 4

Into generations
- First generation: Typical
-Second generation: Atypical

Question 5

First generation APs?

Answer 5

Haloperidol
Chlorpromazine

Question 6

Atypical APs?

Answer 6

Clozapine
Olanzapine
Risperidone
Quitiapine

Question 7

Difference between 1st and 2nd gen?

Answer 7

2nd less likely to impair EP function.
although carry higher risk of other adverse effects

Question 8

Generation of aripiprazole?

Answer 8

2nd

Question 9

Generation of chlorpromazine?

Answer 9

1st

Question 10

Clozapine gen?

Answer 10

2nd

Question 11

Haloperidol gen?

Answer 11

1st

Question 12

Levomepromazine gen?

Answer 12

1st

Question 13

Olanzapine gen?

Answer 13

2nd

Question 14

Promazine?

Answer 14

1st

Question 15

Quetiapine gen?

Answer 15

2nd

Question 16

Risperidone gen?

Answer 16

2nd

Question 17

How long should patient take drug before measuring response?

Answer 17

4-6 weeks

Question 18

SEs of antipsychotics?

Answer 18

-EPSEs
-Raised prolactin
-Metabolic changes

Question 19

What do the EPSE of anti psychotics arise from?

Answer 19

Antagonism of dopamine D2 receptors in nigrostriatal pathway

Question 20

Common adverse effects of APs?

Answer 20

Nausea
Dry mouth
Constiopation
Headache
Sedation
Postural hypotension
Wt gain
Raised prolactin

Question 21

EPSE of APs?

Answer 21

Acute dystonia
Akathisia
Hyperglycaemia
Raised blood lipids
QT interval prolongation

Question 22

Rare but serious risk of APs?

Answer 22

Neuroleptic malignant syndrome

Question 23

Characteristics of neuroleptic malignant syndrome?

Answer 23

Muscle rigidity
Raised temp
Altered mental status
Autonomic instability
Leucocytosis
Raised creatinine kinase

Question 24

Adverse effects of clozapine?

Answer 24

Agranulocytosis
Myocarditis
Cardiomyopathy
GI obstruction
Hypersalivation

Question 25

Prolactin sparing APs?

Answer 25

Quetiapine
Aripiprazole

Question 26

Definition of agranuloctosis?

Answer 26

Marked deficiency of WBCs (granulocytes) essential to immune functioning

Question 27

Akathasia definition?

Answer 27

Sensation of restlessness and a compulsion to move constantly