CNS part 5 Flashcards
How do the side effects differ in antipsychotics first generation versus atypical second generation
Second generation box only selected neurotransmitters and therefore has fewer side effects than the typical first generation antipsychotics
Which generation of antipsychotics has more of the extra parental side effects and what causes this
The first generation and it is caused by the prolonged blockade of dopamine D2 receptors
What are the atypical second generation antipsychotics?
Clozapine, olanzapine, asenapine, quetiapine risperidone ziprasidone iloperidone paliperidone lurasidone and aripiprazole
What is the first like tx for schizophrenia
Clozapine
What is the advantage of atypical antipsychotics?
Lower investments of EPS
What is the disadvantage of the second generation antipsychotics
Increased risk of developing metabolic side effects like hyperglycemia, weight gain, and dyslipidemia
What is the MOA for 2nd generation antipsychotics
Binds to dopamine and acetylcholine , and serotonin
Which atypical antipsychotic has a decreased incidence of EPS neurotic, malignant syndrome and hyperprolactinemia
Clozapine
What are the AEs of clozapine
Orthostatic hypotension, tachycardia, weight gain, hypersalivation, and agranulocytosis
Which atypical antipsychotic is similar to clozapine with no risk for agranulocytosis
Olanzapine
Which atypical antipsychotic is associated with type two diabetes
Olanzapine
Which atypical antipsychotic can treat both positive and negative affects of schizophrenia
Risperidone
What are the AEs to risperidone
Anticholinergic and CV effects, extrapyramidal symptoms, and sexual dysfunction
How do African-Americans respond to atypical and typical antipsychotics differently than the rest of the population?
They respond more rapidly, which causes a greater risk of developing dyskinesia and extra pyramidal symptoms. It’s best to start at the lowest possible dose and monitor closely.
What is the primary receptor blocked by both typical and atypical antipsychotics?
Dopamine 2 receptors
Atypical is also block which additional receptor
Serotonin
Which atypical agent has an adverse effect of agranulouscytosis
Clozapine
What is a generalized seizure?
It occurs in both hemispheres of the brain and involves loss of consciousness
What are the partial focal seizures
Occurs in only one cerebral hemisphere :Simple partial, complex partial, and secondarily generalized seizure
What are the goals of pharmacological management of seizures
To lower neuronal excitability and raise seizure threshold
What are the three mechanisms of treating seizures
Inhibit Na+ or Ca+, inhibit GABA, and inhibit excitation glutamate
What are the Ca2 blockers used to treat seizures
Ethosuximide, and valproic acid
Which meds are used first like in tonic clonic seizures
Carbamazepine, lamotrigine, oxcarbazepine, sodium valproate
What meds are first line in tonic or atonic absence
Sodium valproate, ethosuximide, lamotrigine
