Antipsychotics Flashcards Preview

Term IV: Behavioral Science > Antipsychotics > Flashcards

Flashcards in Antipsychotics Deck (32):
1

Another name for antipsychotic drugs

Neuroleptics

2

Another name for typical antipsychotics

Conventional antipsychotics

3

What receptors do typical antipsychotics block?

Dopamine type 2 (D2) receptors

4

Blocking the D2 receptor decreases neurotransmission in what pathway? What is the result?

Mesolimbic pathway - reduces positive symptoms like hallucinations

5

Are antipsychotic meds specific in terms of receptors blocked?

No - all receptors are blocked in multiple pathways, so lots of side FX

6

What pathway is the therapeutic target of D2?

Mesolimbic

7

Blocking the mesolimbic pathway additionally blocks what functions of the pathway? What side FX does this result in?

Reward and pleasure - leads to apathy, anhedonia, amotivation, social withdrawal, known as secondary negativism b/c it's in addition to negative symptoms

8

Dopamine blockade can worsen the deficit in what pathway, leading to worsening of cognitive and emotional symptoms? It may already be deficient in what disease?

Mesocortical pathway

Schizophrenia

9

Potent D2 blockade in the nigrostriatal tract results in what short-term extrapyramidal side effects (EPS):

- Parkinsonian symptoms
- Dystonic symptoms
- Akathesia

10

Dopamine normally suppresses what neurotransmitter activity in nigrostriatal pathway

Acetylcholine

11

What medications are used to treat extrapyramidal side effects (EPS)

Anticholinergics - diphenhydramine or benztropine

12

Long-term D2 blockade in nigrostriatal pathway results in what movement disorder

Tardive dyskinesia (TD) - involuntary tongue and facial movements

13

Dopamine blockade in tuberoinfundibular tract leads to what side effects as a result of increased plasma prolactin

Galactorrhea, amenorrhea, infertility, bone loss

14

Name the blockade that causes the following side FX:

Dry mouth, blurred vision, constipation, cognitive blunting

Muscarinic anticholinergic blockade

15

Name the blockade that causes the following side FX:

Weight gain and drowsiness

Histamine blockade

16

Name the blockade that causes the following side FX:

Orthostatic hypotension

a-1 adrenergic blockade

17

What syndrome is a rxn to antipsychotics and involves:

High fever, muscle rigidity, confusion, autonomic instability, high serum creatinine phosphokinase, high liver enzymes

Neuroleptic Malignant Syndrome (NMS)

18

Haloperidol (Haldol)

Side FX?

High potency typical anti-psychotic, potent D2 antagonism

-EPS, TD, NMS

19

Chlorpromazine (Thorazine)

Side FX?

Low potency typical anti-psychotic, less potent D2 antagonism

- Anticholinergic side FX

20

Mechanism differences that make an antipsychotic atypical

What side FX do these drugs decrease?

1) Shorter binding time at D2 receptors
2) 5HT2A antagonism

EPS and hyperprolactinemia, as well as tardive dyskinesia (b/c shorter D2 binding periods mean less striatum sensitization), decreases negative symptoms

21

What receptor does serotonin bind on dopamine neurons? What action does this have?

5HT2A - inhibits dopamine release

22

Clozapine (Clozaril)

Atypical antipsychotic

Reduces risk of suicide, decreases violence and aggression

Side FX: AGRANULOCYTOSIS (test question), sedation, seizures
causes few EPS, no TD, no prolactin elevation

23

Olanzapine (Zyprexa)

Atypical antipsychotic

No EPS symptoms, very sedating,

24

Risperidone (Risperdal)

Atypical antipsychotic at lower doses

At high doses, acts more like a typical antipsychotic, which leads to EPS and increases prolactin

Approved for pediatric use

25

Paliperidone (Invega)

Atypical antipsychotic

Next generation of Risperidone, sustained release, more easily dosed, less EPS FX

Increases QTc interval

26

Qeutiapine (Seroquel)

Atypical anti-psychotic

Used preferentially in Parkinson's patients

virtually NO EPS, no prolactin elev, may have enhanced NE activity

27

Ziprasidone (Geodon)

Atypical antipsychotic that SIGNIFICANTLY prolongs QTc interval

Low symptoms of EPS, low prolactin elev, less propensity for weight gain

28

Aripiprazole (Abilify)

Atypical antipsychotic

Role for augmentation in depression, not as sedating, can cause agitation or akathesia, lower CM risk

29

Drawbacks of atypical anti-psychotics?

- Increase risk factors for cardiac/metabolic disease
- Weight gain, obesity
- Diabetes
- Premature death

30

Successful treatment of though disorders involves optimizing ______ function (what neurotransmitter?)

Dopamine

31

Weight gain as a result of atypical anti-psychotics is mediated through what mechanisms

Histamine blockade and through actions of serotonin systems (5HT2C)

32

Most risk to least risk for weight gain and CM risk amongst atypical anti-psychotics?

COQR/PZA
Clozaril
Olanzapine
Quetiapine
Risperidone/Paliperidone
Zipasidone
Aripiprazole