Antipsychotics - Neuroleptics Flashcards
What does psychosis present with
Delusions, hallucinations, thought disorganisation and agitation
What are antipsychotic drugs used to treat
Schizophrenia as well as bipolar disorder psychotic depression and drug induced psychosis
List the first generation antipsychotics
Haloperidol And azine suffix Chorpromazine Trifluroperazine Fluphenazine Thioridazine
First generation antipsychotic mechanism of action
Work by inhibiting post synaptic D 2 receptors in CNS mainly in the Mesolimibic system and striatofrontal system
High potency FGAs
Haloperidol
Fluphenazine
Trifluoperazine
Low potency FGAs
Thioridazine and chorpromazine
Thioridazine side effects
QT prolongation
Therapeutic uses of FGAs
FGAs treat positive symptoms of schizophrenia and not the negative symptoms
Treats psychosis in Many conditions like :-
Bio polar disorder
Acute agitation
Aggression (haloperidol)
Which FGA is used as a tranquilliser
Haloperidol
Other name for Second generation antipsychotics
Atypical antipsychotic
Second generation antipsychotics mechanism of action
- Work by blocking D2 receptors in the mesolimbic pathway
- block 5HT2a receptors
- enhance dopamine release in mesocortical pathway to reduce negative symptoms
List Second generation antipsychotics
Risperidon Ziprasidon Clozapine Olanzapine Quetiapine
Most sedative Second generation antipsychotics
Quetiapine
Which mechanism of action of Second generation antipsychotics treat positive symptoms
Blocking of D2 receptors in the mesolimbic
How long does it take for antipsychotics to show effect
After 4-6 weeks of treatment
Antipsychotics side effects
Parkinsonian symptoms
Akathisia
Triadive dyskinesia
What other effects does antipsychotics have
Antiemetic effect AntiMuscarinic effects Hypotension Lightheadedness (a1 blockade) And due to D2 block in tuberoinfundibular pathway -> Amenorrhea, glactorrhea and infertility
Antipsychotics mode of administration and metabolism
Oral or parenteral administration (typical)
P450
Antipsychotics Side effects
in acute - dystopia
In medium - term akathisia and Parkinsonism
In chronic - tar dive dyskinesia And dystonia
What is acute dystonia
Fixed muscle posture with spasm -Clenched jaw muscles, protruding tongue and oculogyric crisis
Acute dystonia treatment
Anticholinergic drugs (benztropine or procyclidine)
What is akathisa
Motor restless lower limb
Akathisia treatment
Reducing drug dose
Tardive dyskinesia
Lip smacking and tongue rotating
