Chapter 4: Antipsychotics Flashcards Preview

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Flashcards in Chapter 4: Antipsychotics Deck (19)
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1
Q

in schizo, what psychotic symptoms do antipyschotic drugs alleviate?
what symptoms does it have less effect on?

A

positive pyschotic symptoms:

  • thought disorder
  • hallucinations
  • delusions

less effective on negative symptoms such as:

  • apathy
  • social withdrawal
2
Q

How do 1st gen antipsychotics work?

A
  • Blocking DA d2 receptors in the brain.
  • they are not selective for any of the 4 DA pathways in the brain so they cause a wide range of SEs,
  • especially EPSE and raised prolactin.
3
Q

How many groups are the phenothiazines derivatives split into?

A

3 groups

4
Q

List the group 1 phenothiazines derivatives?

A

-Chlorpromazine, levomepromazine and promzine (CLP)

  • PRONOUNCED sedatives effect
  • Moderate: EPSE and antimuscarinics SEs
5
Q

List the group 2 phenothiazines derivatives

A

Pericyazine

  • moderate sedative effects
  • fewer EPSE effects than group 1 and 3.
6
Q

List group 3 phenothiazines derivatives

A

Fluphenazine, perphenazine, prochlorperazine, trifluoperazine

  • FEWER sedative and antimuscarinics effects
  • MORE EPSE than groups 1 and 2.
7
Q

What drugs are butyrophenones?

A

Haloperidol and benperidol.

-resemble group 3 in the clinical properties.

8
Q

List thioxanthenes

A

Flupentixol, zuclopenthixol

-MODERATE EPSE, sedative and antimuscarinics effects

9
Q

What effects does pimozide ad sulpiride have?

A

Reduced sedative, EPSE and antimuscarinics effects

10
Q

How do 2nd gen antipsychotics work?

A

Act on a range of receptors compared to 1st gen.

Has more of a distinct clinical profile, particularly in regards to side effects.

11
Q

Can antipsychotics be used to treat mild to moderate psychotic symptoms in the elderly? Why?

A

NO!

  • Associated with a small increased risk of death and increased risk of stroke or TIA.
  • elderly are more susceptible to postural hypotension and hyper/hypothermia in hot or cold weather.
12
Q

What should be done if antipsychotics have to be started in the elderly?

A

Initial doses should be half of the adult dose or less

Regularly review treatment

13
Q

What does extrapyramidal side effects (EPSE) consist of?

A
  • Parkinsonian symptoms (including tremor): occurs more commonly in adults or elderly. Appear gradually.
  • dystonia and dyskinesia: occurs commonly in children or young people. Appears after a few doses.
  • akathisia: usually occurs after a high initial dose and may resemble an exacerbation of the condition being treated.
  • tardive dyskinesia: MOST SERIOUS. Usually develops after long term therapy or with high doses. Short lived tardive dyskinesia may occur after withdrawal of the drug
14
Q

What does dystonia mean?

A

Abnormal face and body movements

15
Q

What does akathisia mean?

A

Restlessness

16
Q

What does tardive dyskinesia mean?

A

Rhythmic, involuntary movements of tongue, face and Jaw

17
Q

In children when is tardive dyskinesia more likely to happen?

A

When the antipsychotic is being withdrawn

18
Q

What drugs are more likely to cause hyperprolactinaemia?

A
  • Aripiprazole (DA receptor partial agonist)

- risperidone, amisulpride and 1st gen antipsychotics.

19
Q

What drugs commonly use sexual dysfunction?

A
  • Risperidone

- haloperidol