Antipsychotics Flashcards

1
Q

What is an alternate name for antipsychotics

A

neuroleptics

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2
Q

What are the categories of antipsychotics

A

typical (first generation) and atypical (2nd and 3rd generation)

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3
Q

What is the general MOA of antipsychotics

A

blocking dopamine receptors

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4
Q

What common side effects of antipsychotics (6)

A
  • parkinsonian-like symptoms like tremors, lip smacking, grimacing, etc
  • Massive weight gain
  • increased prolactin release
  • tardive dyskinesia
  • extrapyramidal signs
  • dry mouth, eyes, constipation, urinary retention
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5
Q

What is dyskinesia

A

involuntary movement. Facial grimacing and involuntary movements of limbs are examples of dyskinesias. Tardive means it continues after discontinuation of the drug

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6
Q

What is neuroleptic malignant syndrome

A

catatonia, fluctuating BP, dysarthria, fever caused by antipsychotic drug

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7
Q

What is done for someone with neuroleptic malignant syndrome

A

administer a dopamine agonist like Bromocriptine

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8
Q

What drug class is chlorpromazine (thorazine)

A

typical neuroleptic

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9
Q

What is the MOA of chlorpromazine (thorazine)

A

D2 dopaminergic receptor site blockade and H1 histamine blocker, alpha adrenergic blocker

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10
Q

What is a common side effect of chlorpromazine

A

inceased prolactin d/t dopamin blockade

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11
Q

What drug class is prochlorperazine (compazine)

A

typical neuroleptic

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12
Q

What are the indications for prochlorperazine (compazine)

A

Psychosis as well as vertigo and nausea and vomiting, particularly when associated with migraine headaches

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13
Q

What category is prochlorperazine (compazine)

A

category C

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14
Q

what drug class is haloperidol (Haldol)

A

typical neuroleptc

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15
Q

What are the indications of haloperidol (Haldol)

A

Sun-downing, Psychosis, Tourette’s syndrome, Huntington’s disease, acute agitated behavior (combative)

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16
Q

What are the main side effects of haloperidol (haldol)

A

extrapyramidal effects, tremors, mb neuroleptic malignant syndrome

17
Q

What drug class is clozapine (clozaril)

A

Atypical neuroleptic

18
Q

What is the MOA of clozapine (clozaril)

A

D2 blockade and 5-HTP

19
Q

What are side effects of clozapine

A

agranulocytosis, myocarditis, diminished extrapyramidal effects compared to others

20
Q

What are the indications for clozapine

A

schizophrenia

21
Q

What are the side effects of respiradone (risperdal)

A

Weight gain (40lb in a month), hyperglycemia, diabetes. increase stroke risk in elderly

22
Q

What drug class is respiradone (risperdal)

A

Atypical neuroleptic

23
Q

What is an important characteristic of respiradone

A

processed by cyp450

24
Q

How does respiradone (risperdal) compare in side effects to typical neuroleptics

A

It causes much more significant weight gain, but was touted to cause fewer Parkinsonian and dyskinesia side effects

25
What tests should be run regularly for anyone on neuroleptic drugs
liver function
26
What drug class is Olanzapine (zyprexa)
atypical neuroleptic
27
What are the most common side effects of Olanzapine
Weight gain, hyperglycemia and diabetes. Increased risk for stroke in elderly patients. (same as respiradone)
28
What are the indications for Olanzapine (zyprexa)
Schizophrenia, especially when other antipsychotic agents have failed or have produced undesirable side effects
29
What is the MOA of Olanzapine (zyprexa)
Multiple receptor site blockade yet greatest effects at D2 and 5-HT2 receptor sites
30
What are the indications for lithium salts (Eskalith)
bipolar and maniac episodes. schizophrenia. Off-label for OCD
31
What are the dangers of using lithium
Very narrow TI, so blood levels must be checked frequently (every week)
32
What is the most common renal side effect of lithium
Impaired concentration capacity due to reduced renal response to antidiuretic hormone (ADH), causing nephrogenic diabetes insipidus
33
What side effect of lithium develops in 5-35% of patients
hypothyroidism