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Flashcards in AntiPsychotics Deck (28)
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1
Q

Most anti-psychotics function by which mechanism?

A

Blocking D2 receptors

2
Q

Positive symptoms of psychosis correlate with which type of receptor activity?

A

Hyperactivity of mesolimbic D2 receptors

3
Q

Negative symptoms of psychosis correlate with which type of receptor activity?

A

Hypoactivity of mesocortical neurons

4
Q

Typical antipsychotics influence which symptoms of schizophrenia

A

Alleviate positive but not negative symptoms of schizophrenia

5
Q

Atypical antipsychotics influence which symptoms of schizophrenia

A

Reduce positive and negative symptoms of schizophrenia

6
Q

Clozapine: mechanism & side effects?

A

Atypical anti-psychotic; Antagonist at D4 receptor; decreased risk of EPS but induces agranulocytosis (requires weekly WBC monitoring) and seizures

7
Q

How does the lipid solubility of anti-psychotics influence their pharmacokinetics?

A

Readily enter CNS; can sequester in lipid compartments increasing their duration of action

8
Q

How are anti-psychotics metabolized

A

Metabolized by P450s; metabolites not important for therapeutic action

9
Q

What is mesoridazine

A

Metabolite of thioriadazine - more active than parent compound

10
Q

How are anti-psychotics excreted

A

Bc extensively metabolized, little drugs are excreted

11
Q

Which drugs have higher risk for extrapyramidal symptoms (EPS)? How are these symptoms treated?

A

Trifluoperazine, fluphenazine, haloperidol (Try to fly high); treat via benztropine (anti-muscarinics) or diphenhydramine

12
Q

What is the most important unwanted side effect of antipsychotic drugs?

A

Tardive dyskinesias! Usually develop after several years but can be irreversible

13
Q

Which drugs have higher risk for autonomic side effects?

A

Chlorpromazine, thioridazine (Cheating thieves are low)

14
Q

Weight gain and hyperglycemia are common side effects in which anti-psychotics?

A

Atypicals - mostly clozapine and olanzapine

15
Q

Which type of drugs is neuroleptic malignant syndrome seen in? How is it treated?

A

Most severe adverse effect of typical agents. Treated by dantrolene (Ca channel blocker) and dopamine agonist (bromocriptine)

16
Q

What toxicities are associated with overdosage of anti-psychotics?

A

Usually not fatal (except thioridazine); most typicals may cause seizures

17
Q

Chlorpromazine: type of drug, adverse effects?

A

Typical; Corneal deposits, anticholinergic, anti-histamine and alpha adrenergic blockade effects

18
Q

Sedation is more common with which type of drugs

A

Phenothiazines - chlorpromazine

19
Q

Thioridazine: type of drug, adverse effects

A

Typical; reTinal deposits, anticholinergic, anti-histamine, and alpha adrenergic blockade effects

20
Q

Haloperidol: type of drug, adverse effects, clinical uses

A

Typical; neurologic effects including NMS; for delirium & dementia

21
Q

Risperidone: type of drug, adverse effects, clinical uses

A

Atypical; may increase prolactin (causing lactation & gynecomastia) –> decreased GnRH, LH, FSH (irregular menstruation and fertility issues); delirium & dementia

22
Q

Olanzapine: type of drug, adverse effects, clinical uses

A

Atypical; can cause significant weight gain, hyperglycemia, possibly diabetes; depression w/ SSRI

23
Q

Paliperidone: type of drug

A

Atypical

24
Q

Quetiapine: type of drug, clinical uses

A

Atypical; depression w/ SSRI

25
Q

Ziprasidone: type of drug, adverse effects

A

Atypical; May cause prolonged QT

26
Q

Aripiprazole: type of drug, mechanism of action

A

Atypical; Partial D2 agonist; depression w/ SSRI

27
Q

Which of the atypicals are the most weight and metabolically neutral?

A

Ziprasidone and aripiprazole

28
Q

Which drugs are used to treat mania?

A

All of the atypicals except clozapine and iloperidone