Antipsychotics Flashcards
What are the first generation antipsychotics?
-Phenothiazines
-Thioxanthenes
-Butyrophenones
What are the first generation antipsychotics of the phenothiazines class?
-Promethezine
-Chlorpromazine (Thorazine)*
-Prochorperazine (Compazine)
-Fluphenazine (Prolixin)
-Trifluoperazine (Stelazine)
-Perphenazine (Trilafon)
-Acetophenazine (Tindal)
-Carphenazine (Proketazine)
-Trifulpromazine (Vesperin)
-Mesoridazine (Serentil)
-Thioridazine (Mellaril)
What are the first generation antipsychotics of the thiozanthenes class?
-Thiothixene (Navene)
-Chlorprothixene (Taractan)
-Clopenthixol (Sordinol)
-Flupenthixol (Depixol)
-Zuclopenthixol (Acuphase)
-Thioxanthenes are similar to phenothiazines, where they are D2 antagonists, but they also have 5-HT, NE, H effects as well
What are the side effects of butyrophenones?
-There is a high incidence of EPS, particularly PD-like symptoms, dystonia, tardive dyskinesia*
What is loxapine (Loxitane)
-It has a similar structure to clozapine and has a high affinity for D2 and 5-HT receptors
-There is an inhaled version (Adasuve) that was approved by the FDA in 2012*
What is molindone (Moban)?
-Molindone has a similar structure to 5-HT and has a similar treatment profile to phenothiazines
-It is induces weight loss, which is an important advantage of traditional antipsychotics*
What is pimozide (Orap)?
-Primozide is used more for Tourette’s Syndrome in the USA
What is clozapine (Clozaril)?
-Clozapine is the first second generation antipsychotic and is still the model for antipsychotics*
-It also induces agranulocytosis which is low white blood cell count but it is reversible with the discontinuation of the drug. It requires constant monitoring
What is olanzapine (Zyprexa)
-Olanzapine is a second generation antipsychotic that reduces positive symptoms and improves negative symptoms*
What is Sertindole (Serlect)?
-Sertindole is a 5-HT2 antagonist (highest affinity) and a D2 antagonist
-It does not bind to H receptors so there is no sedative effects*
What is quetiapine (Seroquel)?
-Quetiapine is a second generation antipsychotic that effectively reduces positive symptoms
-Although it is abused more frequently than other antipsychotics, primarily due to sedative and anxiolytics effects*
What is ziprasidone (Geodon)
-Ziprasidone is a 5-HT2, D2 antagonist, 5-HT 1A partial agonist; 5-HT, NE reuptake inhibitor
-It has anxiolytic and antidepressant actions*
-It also has low weight gain*
What is amisulpiride (Solian)?
-Amisulpiride is a highly selective D2/D3 antagonist but only in the limbic system
-It has low diabetogenic effects*
Which of the following is NOT a negative symptom of schizophrenia?
Disorganized behavior
Phenothiazines are in the class of antipsychotics known as
First generation antipsychotics
What is the primary indication of haloperidol?
Psychosis
The word tardive in tardive dyskinesia indicates that the symptoms
Appear later in treatment
Amisulpiride is a good choice of antipsychotic for patients who have a high risk for
Diabetes
In general, antipsychotics have a __________ potential for dependence, and a ___________ potential for tolerance.
Weak and weak
The most problematic side effect caused by clozapine is
Agranulocytosis
The single best predictor of antipsychotic efficacy in a drug is an affinity for __________ receptors.
D2
Which of the following is NOT a positive symptom of schizophrenia?
Flat affects
An off-label use for risperidone is
OCD
Cariprazine should not be used by
Elderly patients with dementia related psychosis
