Lecture 32 - Antipsychotic drugs Flashcards Preview

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Flashcards in Lecture 32 - Antipsychotic drugs Deck (7):
1

what are the two classes of antipsyhcotic drugs

common mechanism for each

what is the most concerning side effect of each

typicals --- antiD2
EPS is most concerning side effect

atypicals -- anti D2 (but also anti 5HT)
Weight gain is most concerning side effect

2

Dopamine projections:

what regions of the brain mediate what symptoms/side effects

Nigrostriatal -- EPS

Mesolimbic -- too much DA = positive sx

Mesocortical -- too little DA = negative sx + cognitive sx

Tuberoinfundibular = HPA; decreased DA = galactorrhea

3

Typicals -- two classes; name some drugs

what are the differneces

high affinity for D2 -- Try to Fly High
(Trifluoperazine, Fluphenazine, Haloperidol)
High D2 affinity -- EPS side effects, but few alpha 1, M1, H1 side effects


Low affinity D2 - Cheating thieves are low
(Chlorpormazine, Thioridazine)
Lower D2 affinity = fewer EPS side effects; higher M1, H1, alpha 1 side effects

4

Evolution of EPS:

dystonia
akathisia
bradykinesia
tardive dyskinesia

5

Atypical Drugs --
Mechanisms
benefits of these mechanisms

Most concerning side effect

Anti 5HT + Low affinity Anti DA
good for negative and postive symptoms
no risk for EPS


Serotonin inhibits DA release; therefore by blocking 5HT can increased DA release and target negative symptoms, but there is some blockage of DA so as not to induce postive symptoms

most concerning side effect: weight gain and potential for DM

6

Name the atypical drugs

Its atypical for old closets to risper from apip to zip

Olanzapine
Clozapine
Quietipine (seroquel)
Risperidone (rispderdol)
Aripiprazole -- abilify
ziprasidone -- geodon

7

side effect profile of Clozapine

M1 -- anticholinergic (anti sludge)
A1 -- Low BP, dizziness
H1 -- Drowsiness, weight gain
5HT2C -- weight gain
Neutropenia (Agranulocytosis) in .5-2% of patients; life threatening