Atypical (2nd generation) antipsychotics Flashcards Preview

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Flashcards in Atypical (2nd generation) antipsychotics Deck (16)
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1
Q

Atypical antipsychotics - 10 drugs

A
Clozapine
Olanzapine
Molindone
Risperidone
Ziprasidone
Lurasidone
Iloperidone
Asenapine
Aripiprazole
Paliperidone
2
Q

Atypical antipsychotics - MOA

A

Greater affinity for 5-HT receptors than for D2 receptors. Blockade of 5-HT2 receptors in mesocortical and nigrostriatal pathways cause increased dopamine release. Mesocortical pathway – blockade of negative symptoms.

3
Q

Atypical antipsychotics - indications

A

Schizophrenia

Manic episodes in bipolar disorder

4
Q

Comparison of adverse effects of typical and atypical antipsychotics

A

Atypical have fewer EPSs and a lower incidence of neuroleptic malignant syndrome.

5
Q

Potency of the atypical antipsychotics

A

Low potency: Clozapine
Medium potency: Molindone
High potency: Olanzapine, risperidone, ziprasidone, lurasidone, iloperidone, asenapine.

6
Q

Clozapine - MOA

A

5-HT2=D4 > D2.

Antagonism of histamine, muscarinic and alpha 1-adrenoceptors

7
Q

Clozapine - adverse effects

A

Significant sedation and autonomic side effects.
Potentially fatal agranulocytosis.
Cardiac arrhythmias

8
Q

Olanzapine - MOA

A

5-HT2>D2. Can also block D3 and D4 receptors. Blocks histamine, muscarinic and alpha1-adrenoceptors (less than clozapine)

9
Q

Olanzapine - indications

A

Schizophrenia.

Treatment-resistant depression (with fluoxetine)

10
Q

Olanzapine - adverse effects

A

Weight gain Sedation. Fewer autonomic side effects than clozapine.
Few EPSs except in high doses.

11
Q

Molindone - interactions

A

Additive effects with anticholinergic and CNS depressants. Concurrent use of beta-blocker or antidepressant may increase serum levels of both drugs.

12
Q

Very short acting atypical antipsychotic

A

Molindone

13
Q

Risperidone, ziprasidone, lurasidone, iloperidone, asenapine - MOA

A

5-HT2>D2

14
Q

Risperidone, ziprasidone, lurasidone, iloperidone, asenapine - adverse effects

A
Cardiac arrhythmia (prolonged QT interval – torsade de pointes) and elevated serum prolactin levels. 
Compared to olanzapine: less sedation, more orthostatic hypotension and EPSs.
15
Q

Aripiprazole - MOA

A

Partial agonist at dopamine and 5-HT1A receptors, but 5-HT2A antagonist

16
Q

Aripiprazole - indications

A

Irritability in autistic children