Flashcards in psychiatry Deck (22):
Typical antipsychotics mechanism
Haloperidol, trifluoperazine, fluphenazine, thioridizine, chlorpromazine. D2 antagonists. Increase intracellular cAMP. Used for schizophrenia, psychosis, mania, tourettes.
High potency antipsychotics
Trifluoperadine, fluphenazine, haloperidol- Have lots of eps symptoms
Low potency antipsychotics
clorpromazine, thioridazine,. Have a lot of non-neurologic side effects like anticholinergic, antihistaminergic, a1 blockade
Toxicity of typical antipsychotics
Highly lipid soluble and stored in body fat so slow to be removed from system. Extrapyramidal side effects like dyskinesias. Endocrine side effects (hyperprolactinemia, menstrual arrest).
Dry mouth, constipation, hypotension, sedation
How to treat EPS of antipsychotics
Benztropine or diphenhydramine
Neuroleptic malignant syndrome and treatment
Rigidity, myoglobinuria, autonomic instability, hyperpyrexia Treat with dantrolene or bromocriptine (d2 agonist).
Fever, encephalopathy, unstable vitals, increased inzymes, muscle rigity.
Sterotypic oral facial movements as a result of lerg term antipsychotic use. Potentially irreversible
Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone.
Mechanism not completely understood. Varied effects on 5ht dopamine, alpha and histamine receptors
Atypical antipsychotics side effects
Fewer EPS and anticholineric side effects.
Olanzapine causes weight gain
Clozapine causes agranulocytosis and seizures
Risperidone can increaes prolactin.
Ziprasidone can prolong the QT interval.
Used for bipolar, blocks relapse and used for acute panic events. Can be used for SIADH.
Tremor, nephrogenic DI, hypothyroidism, ebstein's abnormality.
Stimulates 5HT1a receptors used for anxiety no sedation. Takes 1-2 weeks to work. Don't interact with alcohol.
Hyperthermia, confusion, myoclonus, diarrhea. Treat with cyprohepatidine
5HT2 receptor antagonist used to treat serotonin syndrome.
Venlafaxine, duloxetine. Used for depression, GAD/panic disorders, diabetic peripheral neuropathy. Increase in BP common, also some stimulant effects.
Amytriptyline, nortryptaline, imipramine, desipramine, clomipramine, amoxapine. Block reuptake of NE and serotonin. used for fibromyalgia. Sedation, a1 blocking effects like hypotension, anticholinergic side effects,
Used for OCD
Which TCA have more anticholinergic effects?
less sedation but can cause serizures.
Convulsions, coma, cardiotoxity. Treat with NAHCO3 for arrythmias.
MAOI causing serotonin syndrome
SSRIs TCA st johns wort, meperidine, dxm