Antipsychotics

Question 1

List of first generation antipsycholtics

Answer 1

Haloperidol --- Haldol
Fluphenazine -- Prolixin
Perphenazine -- Trilafon
Thioridazine -- Mellaril
Chlorpromazine -- Thorazine

Question 2

MOA of First Gen Antipsychotics

Answer 2

D2 Receptor Antagonists (reduces dopamine)

can induce low-dopamine sx
(dystonia, diskinesia, parkinson like stuff)

5-HT2 receptor antagonist (weight gain)

Unique to 1st gen:
Alpha 1 antagonist (Sedation)
H1 antagonist (sedation, weight gain)
M1 antagonist (anticholinergic)

Question 3

Which MOA receptors in 1st ten antipsychotics contribute to weight gain

Answer 3

5-HT2 receptor antagonists

H1 antagonist

Question 4

2nd Gen Antipsychotic Drugs

Answer 4

Aripriprazole - Abilify***
Brexpriprazole - Rexulti

Asenapine - Saphris
Clozapine - Clozaril
Olanzapine - Zyprexa
Quetiapine - Seroquel***

Iloperidone 
Lurasidone 
Paliperidone - Invega
Risperidone - Risperidol***
Ziprasidone -

Question 5

Benefit of 2nd gen antipsychotics

Answer 5

Antipsychotic effects without ANTIPYRAMIDAL effects

Question 6

2nd Gen Antipsychotic MOA

Answer 6

D2 receptor Antagonist (antipsychotic effect, relief pos symptoms)

5-HT1 receptor antagonist (antidepressant)
5-HT2 receptor antagonist (negative symptom improvement)

Question 7

5-HT2 receptor antagonist effects

Answer 7

Weight gain

Negative symptom improvement (apathy, social withdrawal)

Question 8

Drug to treat tar dice dyskinesia

Answer 8

Valbenazine

Question 9

Antipsychotic black box

Answer 9

Increased mortality in elderly w dementia psychosis

Question 10

Clozapine warning

Answer 10

Agranulocytosis

Myocarditis, bradyardia

Orthostasis

Avoid P450 / 3A4

Question 11

Interesting positie side effect of Clozapine

Answer 11

Decreased cigarette smoking

Question 12

Drug specifically indicated for schizophrenia

Answer 12

Iloperidone

Paliperidone

Question 13

Indicated for acute treatment of manic or mixed episodes, bipolar - acute schizo problems

Answer 13

Asenapine

Question 14

Lithium indications

Answer 14

1st line for manic bipolar episodes and maintenance

Question 15

Lithium contraindications

Answer 15

Renal or CV disease

Dehydration, sodium depletion

Patients receiving diuretics

Question 16

Lithium warnings

Answer 16

Pregnancy - teratogenic

Renal toxicity

Question 17

Diarrhea, vomitting, drowsy, muscle weakness, lack or coordination are early signs of

Answer 17

Lithium toxicity

Question 18

High level lithium toxicity symptoms

Answer 18

Giddiness
Ataxia
blurred vision
tinnitus
large output dilute urine