Antipsychotics Flashcards Preview

Neuro-Psych > Antipsychotics > Flashcards

Flashcards in Antipsychotics Deck (19):
1

Classes of antipsychotics

Typical and atypical

2

Typicals

Chlorpromazine
Thioridazine
Perphenazine
Haloperidol
Fluphenazine
Prochloroperazine, Droperidol, Metoclopramide

3

Chlorpromazine
Thioridazine
Perphenazine
Haloperidol
Fluphenazine
Prochloroperazine, Droperidol, Metoclopramide

MOA

100% block of D2 -- D2-receptor antagonists

4

Low potency typicals and their profile

Chlorpromazine, Thioridazine
-low affinity for D2, high for muscarinic and adrenergic --> low EPS but high anticholinergic sedation, hypotension

5

Mild potency typicals and their profile

Perphenazine
-moderate affinity for everything

6

High potency typicals and their profile

Haloperidol, Fluphenazine
-high affinity for D2, no or low for muscarinic and adrenergic --> high EPS and low anticholinergic sedation and hypotension

7

Prochloroperazine, Droperidol, Metoclopramide other uses

nausea, vomitting, migraine

8

EPS AE and treatment

-acute dystonia (treat with anticholinergic) -- more likely to progress to tar dative dyskinesia
-parkinsonism ((treat with anticholinergic or amantadine)
-Akathesia: (treat with anticholinergic, propanolol, or BZDs)
-Tardative dyskinesia (late onset, may be irreversible, anticholinergics will make it worse!!)

9

advantages of typicals

cheaper, good for positive symptoms treatment

10

advantages of atypicals

-less EPS, less hyperprolactinemia, better treatment of both positive and negative symptoms

11

major disadvantages of atypicals

cardiometabolic risks! increased weight, TG, DBM, and cardiovascular events b/c of blocked H1 and 5HT2C

12

Atypicals

Clozapine
Olanzapine
Risperidone
Quetiapine
Ziprasidone, Aripiprazole

13

Olanzapine AE

-weight gain

14

Clozapine AE

-weight gain, agranulocytosis, seizures -- monitor patients closely! use drug if not responsive to other drugs

15

Risperidone AE

weight gain and increased prolactin

16

Aripiprazole mechanism

partial dopamine agonist

17

Clozapine
Olanzapine
Risperidone
Quetiapine
Ziprasidon

MOA

DA antagonists with rapid dissociation; 5HT2A antagonists

18

Ziprasidon AE

weight gain, QT prolongation that can lead to arrhythmia and death

19

Neuroleptic malignant syndrome and treatment

catatonia, stupor, fever, autonomic instability, death -- treat with dantrolene and DA agonists (bromocriptine)