Pharm II, neuroleptics

Question 1

who should never be given antipsycotic medications

Answer 1

dementia patients or older population

Question 2

what are antipsycotics used for?

Answer 2

schizophrenia, delirium, mania, sever aggitation

Question 3

psycosis

Answer 3

distorted reality, disorganized thinking hallucinations

Question 4

hallucinations

Answer 4

sensory perception in absence of external stimuli - any of the sences

Question 5

what is secondary psychosis

Answer 5

psychosis from non psychological cnditons like neurological disorders, electrolyte disorders, multiple medical conditons and drugs

Question 6

neuro disorders than can cause psycosis

Answer 6

frontal lobe tumors, syphilis

Question 7

what is more deadly, hypo or hyperglycemia

Answer 7

hypoglycemia

Question 8

medical conditnos that cause psycosis

Answer 8

Lyme, AIDS lupis etc

Question 9

what OTC drugs can cause psycosis

Answer 9

dextromethorphan and antihistamines

Question 10

what do neuroleptic drugs do

Answer 10

they do not cure, they permit patient to function more effectively

Question 11

two categories of neuroleptic

Answer 11

Typical/first generation or Atypical/second generation

Question 12

what is neuroleptic another word for

Answer 12

antipsycotic

Question 13

what is the MOA of both the typical and atypical neuroleptic drugs

Answer 13

both block of dopamine receptors in the brain and have some effect on receptor subtypes NE, ACH and serotonin receptors

Question 14

what does the atypical neuroleptic dodifferent than typical

Answer 14

atypical are antagonist or partial antagonist of serotonin receptors

Question 15

what receptor seems to be the one that neuroleptic uses

Answer 15

Dopamine receptor D2 - blocking receptor

Question 16

what pathway does excess dopamine cause psycosis

Answer 16

mesolimbic pathway

Question 17

what may cause many of the unwanted side effects of neuroleptics

Answer 17

the non selective dopamine receptor blockaid in pathways other than mesolimbic

Question 18

common side effects of neuroleptics

Answer 18

Parkinsonian like sx, weight gain, tadive, blurred vision, benedryl , increased prolactin

Question 19

dyskinesia

Answer 19

involuntary movement ie grimacing, pill rollling

Question 20

tardive

Answer 20

dyskinesia contiues after drugs have been discontinued

Question 21

extrapyramidal signs

Answer 21

akinesia/cant initiate movement - akathisia/cant remain motionless

Question 22

what is neuroleptic malignant syndrome

Answer 22

Rare side effect of neuroleptics - fatal if drug isn’t discontinued and antidoted with dopamine agonist

Question 23

sx of neuroleptic malignant syndrome

Answer 23

catatonia, fluxuatiing BP dysarthria and fever

Question 24

antidote for neuroleptic malignant syndrome

Answer 24

dopamine agonist - bromocriptine

Question 25

what causes most neuroleptic drugs to be antiemetic

Answer 25

Blockage of D2 dopaminergic receptors in the chemoreceptor triggerzone

Question 26

why are some neuroleptic drugs used in chemo

Answer 26

antiemetic effects reducing nausea of chemo

Question 27

typical neuroleptic /block dopamine receptor D2

Answer 27

Chlorpromazine/thorazine

Question 28

chlorpromazine /thorazine MOA

Answer 28

typical neuroleptic - Primary a D2, alpah and HI blockaide

Question 29

side effects of chlorpromazine/thorazine

Answer 29

typical neuroleptic- increased prolactin from dopamine blockate causing galactorrhea amenorrhea and infertility

Question 30

indication for chlorpromazine/thorazine

Answer 30

typical neuroleptic- mania - schizophrenia - hiccoughs

Question 31

moa for prochlorperazine/compazine

Answer 31

typical neuroleptic - primary HI receptor antagonist, D2 receptor agonist

Question 32

indication for prochlorperazine/compazine

Answer 32

typical neuroleptic- verdigo - nausea vomiting from migraines

Question 33

what is the difference in the moa or thorazine and compazine

Answer 33

Thorazine primary D2 receptor antagonist/ Compazine primary and H1 receptor antagonist

Question 34

what is the safer typical neuroleptic

Answer 34

Compazine has the greatest anti-emetic effect and is concidered safer than thorazine

Question 35

side effects of prochlorperazine/compazine

Answer 35

benedryl like sx with lower of seizure threshold*

Question 36

what is haloperidol/haldol

Answer 36

typical neuroleptic that chiefly blocks D2 receptor

Question 37

why must you be careful with haloperidol/halodol administration

Answer 37

to prevent excessive setation and tardive dyskinesia

Question 38

side effects of haloperidol/haldol

Answer 38

typical neuroleptic: extrapyramidal/parkinsonian and neuroleptic malignant syndrome is possible

Question 39

indication for haloperidol/haldol

Answer 39

typical neuroleptic huntingtons dz, tourettes, acute agitate behavior

Question 40

typical neuroleptics

Answer 40

chlorpromazine/thorazine (D2) - Prochlorperazine/compazine (H1) - Haloperidol/Haldol (D2 blocker)

Question 41

atypical neuroleptics

Answer 41

Clozapine/clozaril (D2-5HT20 - Respiradone/risperdal (dop ser block)

Question 42

atypical neuroleptic for schizo when other meds have failed

Answer 42

Clozapine/clozaril(D2-5HT2) - Olanzapine/zyprex (D2-5HT2)

Question 43

Why is atypical neuroleptic clozapine/clozaril (D2-5HT) not first line treatment for schizo

Answer 43

because of the side effects:

Question 44

side effects of clozapin/clozaril(D2-5HT2)

Answer 44

agranulocytosis 1-2% and myocarditis and weight fain and diabetes

Question 45

what is a problem with all atypical neuroleptics

Answer 45

weight gain and increased diabetes

Question 46

atypical neuroleptic just for psychosis with unknown MOA

Answer 46

Respiradon/risperdal : dopamine serotonin receptor blockade

Question 47

what atypical neuroleptic must you adjust dose if patient has liver dysfunction

Answer 47

Respiradone/risperadal: metabolized by CYP 450

Question 48

when would you specifically not use respiradone/risperadal side effects

Answer 48

those with dementia and combative behavior: risks of wt gain, high sugar and increased risk of stroke in elderly

Question 49

side effects of olanzapine/zyprexa

Answer 49

atypical neuroleptic: extream weight gain, diabetes,stroke

Question 50

what neuroleptic has diminished extrapyramidal effects compaire to the others

Answer 50

atypical neuroleptic - Olanzapine/zyprex (D2-5HT2)

Question 51

what is mania

Answer 51

elevated or irritable mood with increased activity, speech thought etc

Question 52

what are lithium salts used for

Answer 52

prophylactically in bipolar and manic episode treatment

Question 53

MOA or lithium

Answer 53

unknown - dampen transmission NE and diminish glutamate respones

Question 54

what is signifigant about Lithium carbonate/eskalith

Answer 54

very small therapeudic index effective dose is close to toxic dose - must monitor blood

Question 55

side effects of lithium

Answer 55

weight gaoin, cognitive impairment- memory deficits, renal impairment

Question 56

What is the most common renal effect of lithium

Answer 56

diabetes insipidus due to reduce renal response to ADH 20%

Question 57

what is the thyroid problem with Lithium carbonate Eskalith

Answer 57

hypothyroidism that is not autoimmune in 5-35% its not reversable