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antipsychotics Flashcards

(PH-1) List the prototype antipsychotic drugs for the following classes of drugs: phenothiazines, thioxanthenes, and butyrophenones. (PH-2) Describe the mechanism of action of the prototype phenothiazine, thioxanthene, and butyrophenone drugs, categorize them according to potency, and describe their clinical uses and side effects. (PH-3) Describe the motor fluctuations seen both early and late during treatment with the first generation (Typical) antipsychotics. (PH-4) List the prototype atypi

1
Q

typical antipsychotics

A

chlorpromazine, thioridazine, fluphenazine, thiothixene, haloperidol

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2
Q

use of typical antipsychotics

A

schizophrenia and manic bipolar

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3
Q

most potent typical antipsychotics

A

thoridazine,fluphenazine,

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4
Q

least potent typical antipsychotics

A

chloropramazine

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5
Q

most sedating typical antipsychotics

A

chloropramazine and thoridazine

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6
Q

least sedating chloropramazine

A

thiothixene, fluphenazine, halperidol

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7
Q

typical antipsychotics with most antipyrimidal effects

A

fluphenazine, halperidol

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8
Q

typical antipsychotics good for hiccups

A

chlorpromazine

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9
Q

MOA of typical antipsychotics

A

block dopamine receptors in mesolimbic-mesocortical system

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10
Q

type of dopamine receptor blockage giving anti-psychotic use

A

D2

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11
Q

typical antipsychotics with active metabolites

A

cholorpromazine, thioridazine, fluphenazine

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12
Q

SE of typical antipsychotics

A

motor sx(acute dystonia, akathisia, parkinsonian syndrome, motor fluctations, periobital tremor), endocrine disturbances, edema and weight gain, sedation, covulsions, autonomic SE, skin effects

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13
Q

treatment for motor SE of typical antipsychotics

A

anticholergenics

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14
Q

drug class to avoid in epileptics

A

typical antipsychotics

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15
Q

typical antipsychotics that can be used in epileptcis

A

fluphenzine

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16
Q

rare, but severe SE of typical antipsychotics

A

neuroleptic malignant syndomre

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17
Q

sx of neuroleptic malignant syndomre

A

severe parkinsonism with autonomic instability, stupor

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18
Q

drug for neuroleptic malignant syndomre

A

dantrolene

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19
Q

causes blue-grey skin

A

typical antipsychotics

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20
Q

typical antipsychotics + CNS depressents/opioids/antihistamines

A

potentates effects of 2nd drug

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21
Q

typical antipsychotics + L-dopa

A

less effect of L dopa

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22
Q

typical antipsychotics + TCA

A

additive anticholergenic effects

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23
Q

classic Atypical

A

clozapine

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24
Q

use of clozapine

A

refreactory schizophrenia

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25
major, serious SE of clozapine
agranulocytosis
26
most potent antipsychotic of any class
clozapine
27
advantages of clozapine
less extrapyrimidal disfunction and hyperprolactinemia
28
receptor used by clozapine
D4
29
higher plasma levels of clozapine in users of
cigarettes
30
SE of clozapine
sedation, weight gain, diabetes, orthostatic hypotension, n/v, tachycardia,
31
contraindications of clozapine
bone marrow disorder, leukpenia, carbamazapine
32
atypical antipsychotics
risperidonw, olanzapine, quetiapine, ziprasidone
33
MOA of atypical antipsychotics
possibly acts at D2/serotinin receptors
34
SE of risperidone
high extrapyrimidal effects, weakness, sleep problems, sexual dysfunction
35
olanzipine SE
postural hypotension, somnolence, weightgain, akathisia
36
quietiapine SE
increased QT interval, possible cataracts
37
ziprasidone SE
possible weight loss, monot QT prolongment
38
prototype partial agonist antipsychotics
aripiprazole
39
use of aripiprazole
schizophrenia, actute mania
40
MOA of aripiprazole
partial D2 and 5-HT agonist
41
extensivly metabolized by CYP3A4 and CYP2D6
aripiprazole
42
SE of aripiprazole
anxiety, headache, sleep problems, GI problems
43
drug interactions with aripiprazole
CYP2D6 inhibitors (fluoxetine, paroxetine, quinadine)
44
advantages of aripiprazole
no extrapyrimidal sx, no weigh gain or male milk,
45
ways doc determine effective drug regimen
trial and error, prior history, premedical conditions, previoulis doc experience
46
time frame to see if drug(s) will work
2-3 weeks
47
new 2nd generation antipstchotics
asenapine,iloperidone, lurasidone
48
first line bipolar drugs
lithium, valproic acid
49
most commonly effective bipolar drug
lithium
50
first drug used to treat acute manic attack
antispychotic
51
drug used prophalacitly in bipolar
Li
52
most likely MOA of Li
dereases IP3 and DAG
53
SE of Li (therputic dose)
nausea, diarreha, drowiness, hypothyroidism, polydipsea/polyuria, bluntng of cognition,
54
bipolar drug not to be used in nursing moms
lithium
55
contraindicated drug with Li
NSAID, thiazides
56
clinical uses of valproic acid
anti-convulsant, manic phase of bipolar
57
black box warning of valprosic acid
possible hepatic failure (esp in kids)
58
tetragenic effects of valproic acid
neural tube defects
59
SE of valproic acid
possible liver failure, thrombocytopenia,
60
carbamazepine use
anti-convulsant also used in bipolar, aggressive behavior, anxiety
61
first line drug in mixed bipolar
carbamazepine
62
black box warnings of carbazepine
asian ancenstry, aplastic anemia/agranulocytosis, dermatigical tox
63
non black box SE of carbazepine
diplopia, ataxia

CNS I (36 decks)

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