Antipsychotics

Question 1

What class is haloperidol?

Answer 1

Typical

Question 2

What class is olanzapine?

Answer 2

Atypical

Question 3

What class is trifluoperazine?

Answer 3

Typical

Question 4

What class is fluphenazine?

Answer 4

Typical

Question 5

What class is clozapine?

Answer 5

Atypical

Question 6

What class is thioridazine?

Answer 6

Typical

Question 7

What class is quetiapine?

Answer 7

Atypical

Question 8

What class is chlorpromazine?

Answer 8

Typical

Question 9

What class is risperidone?

Answer 9

Atypical

Question 10

What class is aripiprazole?

Answer 10

Atypical

Question 11

What class is ziprasidone?

Answer 11

Atypical

Question 12

What is the mechanism of typical antipsychotics?

Answer 12

Block dopamine2 receptors. (Increase cAMP)

Question 13

Which are the clinical uses for typical antipsychotics?

Answer 13

Schizophrenia - primarily positive sx
Psychosis/acute mania
Tourette’s syndrome

Question 14

Which typical antipsychotics have high potency?

Answer 14

Trifluoperazine, fluphenazine, haloperidol

TRI to Fly High

Question 15

Which typical antipsychotics have low potency?

Answer 15

Chlorpromazine, thioridazine

CHeating THIeves are low

Question 16

Why are typical antipsychotics slow to eliminate from body?

Answer 16

Highly lipid soluble, stored in body fat

Question 17

What are “extrapyramidal side effects”?

Answer 17

Dyskinesias.

Question 18

What EPS side effects of typical antipsychotics are seen within 4 hrs?

Answer 18

Acute dystonia - muscle spasm, stiffness, oculogyric crisis

Question 19

What EPS side effects of typical antipsychotics are seen within 4 days?

Answer 19

Akathisia - restlessness.

Question 20

What EPS side effects of typical antipsychotics are seen within 4 weeks?

Answer 20

bradykinesia/parkinsonism

Question 21

What EPS side effects of typical antipsychotics are seen within 4 months?

Answer 21

Tardive dyskinesia - stereotypic oral facial movements

Question 22

What medications control EPS side effects?

Answer 22

Benztropine or diphenhydramine

Question 23

What are the endocrine side effects of typical antipsychotics caused by/manifest as?

Answer 23

Dopamine receptor antagonism –> hyperprolactinemia –> galactorrhea

Question 24

What other side effects are associated with typical antipsychotics (non-dopamine receptor mediated)

Answer 24

Muscarinic block: dry mouth/constipation
Alpha1 block: hypotension
Histamine receptor block: Sedation
QT prolongation

Question 25

What is neuroleptic malignant syndrome?

Answer 25

FEVER: Fever, Encephalopathy, Vitals unstable, Enzymes Up (CK), Rigidity of muscles *myoglobinuria

Question 26

What is the treatment for NMS?

Answer 26

Dantrolene, D2 agonists (eg bromocriptine)

Question 27

Which antipsychotic is associated with corneal deposits?

Answer 27

chlorpromazine

Question 28

Which antipsychotic is associated with retinal deposits?

Answer 28

Thioridazine

Question 29

What is the mechanism of atypical antipsychotics?

Answer 29

Not completely understood. Varied effects on 5HT-2, dopamine, alpha and H1 receptors.

Question 30

What is the difference between 5HT-1 and 5HT-2?

Answer 30

5HT-1 couples to Gi. Decr cAMP. | 5HT-2 couples to Gq. Incr IP3

Question 31

What are the clinical uses for atypical antipsychotics?

Answer 31

Schizophrenia (pos and neg) Bipolar disorder OCD, anxiety disorder, depression, mania, tourettes

Question 32

What antipsychotics are assoicated with weight gain?

Answer 32

Olanzapine, clozapine

Question 33

Which antipsychotic is associated with agranulocytosis?

Answer 33

Clozapine. Requires weekly WBC monitoring.

Question 34

What side effects are associated with clozapine?

Answer 34

Agranulocytosis, weight gain, seizure

Question 35

Which side effects are associated with risperidone?

Answer 35

Increased prolactin: lactation/gynecomastia Decr GnrH/LH/FSH: irreg menstruation, fertility issues

Question 36

Which types of antipsychotics may prolong QT interval?

Answer 36

All of them.