1. parkinsonism 2. dystonia 3. akathisia 4. tardive dyskinesia

Antipsychotics Flashcards by Sara Fieger

dopamine

CNS function

reward, emotion, cognition, memory, motor activity

How well did you know this?

Not at all

Perfectly

increased dopamine

schizophrenia

over stimulates sensory cortex

How well did you know this?

Not at all

Perfectly

decreased dopamine

parkinsons

less stimulation of motor cortex

How well did you know this?

Not at all

Perfectly

endocrine function dopamine

regulate prolactin secretion from pituitary gland

How well did you know this?

Not at all

Perfectly

dopamine

cardio

N.E./E. release

low con = vasoDILATION
high con = vasoCONSTRICTION

How well did you know this?

Not at all

Perfectly

schizophrenia pathophys

excessive dopamine

5HT2A agonism

Glutamate antagonism

How well did you know this?

Not at all

Perfectly

positive symptoms of schizophrenia

increased DA to sensory cortex

hallucinations, delusions, paranoia

How well did you know this?

Not at all

Perfectly

negative symptoms of schizophrenia

decrease DA to frontal cortex

social withdrawal, lack of personal hygiene

How well did you know this?

Not at all

Perfectly

which antipsychotic is good for POSITIVE symptoms

first generation and second generation antipsychotics effective

How well did you know this?

Not at all

Perfectly

which antipsychotic for NEGATIVE symptoms

second generation antipsychotics

How well did you know this?

Not at all

Perfectly

antipsychotic BBW

elderly patients with dementia psychosis are at higher risk of death

How well did you know this?

Not at all

Perfectly

FGA antipsych

have more ____, less ___

more extrapyramidal symptoms (EPS) and tardive dyskinesia

doesn’t block negative symptoms

How well did you know this?

Not at all

Perfectly

SGA MOA

blocks 5TH2 receptors – reducing negative symptoms

How well did you know this?

Not at all

Perfectly

antipsychotic

anticholinergic side effects

dry mouth
constipation
blurred vision
urinary hesitancy

How well did you know this?

Not at all

Perfectly

antipsychotic system side effects (8)

sedation
orthostatic hypotension
anticholinergic
EPS
endocrine
weight gain
sexual dysfunction
QT prolongation
agranylocytosis

How well did you know this?

Not at all

Perfectly

EPS symptoms

parkinsonism
dystonia
akathisia
tardive dyskinesia

How well did you know this?

Not at all

Perfectly

parkinsonism

bradykinesia, rigidity, tremor, akinesia

respond to anticholinergics (benadryl)

How well did you know this?

Not at all

Perfectly

dystonia

torticollis, larynogospasm

anticholinergics

difficult movements

How well did you know this?

Not at all

Perfectly

akathisia

somatic restlessness
inability to stay calm

reduce antipsychotic dose or switch age

beta blockers work

How well did you know this?

Not at all

Perfectly

tardive dyskinesia

abnormal, involuntary orofacial movements “lip smacking”

can be irreversible with continued drug exposure

DON’T GIVE ANTICHOLINERGICS

How well did you know this?

Not at all

Perfectly

endocrine effects of antipsychotics

prolactin secretion

galactorrhea, menstrual changes

How well did you know this?

Not at all

Perfectly

rare but severe side effect of antipsychotics

Study These Flashcards

agranulocytosis

neuroleptic malignant syndrome

Study These Flashcards

dopamine antagonism drugs

significant fever (103-108)
absence of GI 
elevated CK (muscle rigidity/cell lysis) --> kidney dysfunction

NMS treatment

Study These Flashcards

dantrolene IV skeletal muscle relaxant to prevent

FGAs

1. Chlorpromazine 2. Fluphenazine 3. Haloperidol (Haldol) 4. Loxapine 5. Perphenazine 6. Pimozide 7. Thiothizene 8. Thioridazine 9. Tricluroperazine

IM FGAs

chlorpromazine fluphenazine haldol

LAI FGAs

fluphenazine | haldol

chlorpromazine side effects

hypercholestolemia/weight gain/DM anticholinergic S.E. orthostatic hypotension

thiothizene S.E.

anticholinergics and orthostatic HTN

MC s.e. of all FGAs

weight gain EPS and prolactin

SGA drug list

1. ariprprazole/abilify 2. asenapine 3. brexpiprazole 4. caripraszine 5. clozapine 6. iloperidone 7. lurasidone 8. olanzapine 9. paliperidone 10. pimacanserin 11. quetiapine 12. risperadone 13. ziprasidone

aripiprazole

abilify

olanzapine

zyprexa

quetiapine

seroquel

risperidone

risperidal

ziprasidone

geodon

LAI SGAs

abilify paliperidone risperidone

IM SGA

abilify | zyprexa

clozapine S.e.

weight gain and diabetes hypercholesterolemia anticholinergics

olanzapine s.e.

weight gain and diabetes hypercholesterolemia

prolactin elevation and EPS symptoms of SGA

paliperidone | risperidone

antipsychotics with QTC prolongations

IV halloo or Ziprasidone

apriprazole moa, brand, ...

5HT1 partial agonist low risk for EPS, high akathisia abilify maintena ( long lasting injectable)

lurasidone

Latuda

lurasidone gen

theorized to have beneficial cognitive and anxiolytic effects (5HT1 and 5HT1 antagonism)

Paliperidone

active metabolite of risperidone available as monthly injection (Invega Sustenna)

ridperidone unique to

hyperprolactinemia watch doses -- EPS long acting (Risperdal Consta) every 2 weeks

quetiapine

high histamine affinity, lowest EPS risk preferred for parkinson's psychosis

agranulocytosis is common for which medication

clozapine req. ANC monitoring

clozapine

only use for treatment resistant schizoprehnia (lack of response in 2+ trials) need an 8 week trial

CATIE trial

difference between FGA and SGA are not as great as we thought still SGA has less sideeffects

PORT recommendations

first episode of schizophrenia use any agent other than clozapine or olanzapine

pregnancy special populations

risks for mom or baby caution with clozapine/olanzapine with breastfeeding CROSSES into breastmilk

geriatric special populations

avoid sedation, orthostatic hypotension more prone to QTc prolongation

Antipsychotics Flashcards

(54 cards)