Katzung 13th ed - Chapter 29 - Antipsychotics (2) Flashcards Preview

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Flashcards in Katzung 13th ed - Chapter 29 - Antipsychotics (2) Deck (14):
1

There are two classes of CNS receptors that are stimulated to produce psychosis, and are antagonized by the atypical antipsychotics to prevent psychosis. Which two are these?

Serotonin (5HT2A) receptors and Dopamine (D2) receptors.

2

Name two classical (typical) antipsychotics that are still in common use today.

Haloperidol
Chlorpromazine (Largactil)

3

What is the key pharmacodynamic feature of the atypical antipsychotics that causes prevention of psychosis?

5HT2A receptor blockade.

4

What is the key difference in the pharmacodynamic features of typical and atypical antipsychotics, in their mechanism of preventing psychosis?

Typical antipsychotics:
D2 receptor blockade is greater than 5HT2A receptor blockade
Atypical antipsychotics:
5HT2A receptor blockade is greater than D2 receptor blockade

5

Name some atypical antipsychotics.

Clozapine
Risperidone
Olanzapine
Quetiapine
Aripiprazole

6

Name some receptors that are antagonized by atypical antipsychotics.

5HT2A (serotonin)
D2 (dopamine)
Alpha-1 (adrenaline)
Alpha-2
H1 (histamine)
Muscarinic (acetylcholine)

7

Name some of the extrapyramidal side effects.

Akathisia
Parkinsonism
Tardive dyskinesia
Dystonia
Autonomic effects

8

Which antipsychotic has the highest extrapyramidal toxicity?

Haloperidol

9

What is the pharmacodynamic feature of antipsychotics that causes extrapyramidal side effects?

D2 receptor blockade.

10

Describe the adverse effects of antipsychotics.

EPS
Anticholinergic symptoms
Alpha-1 antagonism: postural hypotension, tachycardia
Neuroleptic malignant syndrome

11

What are the features of Neuroleptic Malignant Syndrome?

Muscle rigidity
Fever
Autonomic instability
Reduced sweating

12

Describe some basic pharmacokinetics of antipsychotics.

Lipid soluble, highly protein bound (95%), large volume of distribution. Long half-lives. Metabolized in liver and excreted in urine.

13

What is the most common clinical indication for lithium?

Bipolar affective disorder

14

What are some basic pharmacokinetics of lithium?

Bioavailability: 100%
Peak plasma levels in 30 mins - 2hrs.
Distributed in total body water.
Zero metabolism.
Excreted entirely in urine.

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