Psychotic drugs Flashcards
(15 cards)
Phenothiazine drugs
Chlorpromazine, perphenazine, trifluoperazine, thioridazine (more A1 cardio QT increase and Eye pigment retinopathy)
Thioxanthenes
Thiothixene
Butyrophenones
Haloperidol (more likely to cause EPS)
Antipsychotic mechanism of action
Block DA D2 receptors +symptoms from mesilimbic
-symptoms from hypoactiivity of the mesocortical
Anti muscarinic, anti alpha 1, anti H1
Can reduce seizure threshold and modify temperature regulation, increase prolactin secretion by inhibiting the tuberoinfundibular dopa system, also weight gain.
Adverse reactions
Early- reversible
Parkinsonian syndrome via increased ACh
Akathisia
Acute dystonic reactions
Late- irreversible
Tardive dyskinesia
Parkinsonian syndrome drug of choice
Benzotropine and trihexyphenidyl anti muscarinic
Diphenhydramine also has anti muscarinic and H1
Neuroleptic malignant syndrome
RHAM
Rigitiy, hyperthermia, akinisia, males/mutism
NMS treatment
Stop antipsychotics, cool down, rehydrate, give dopamine agonist like bromocriptine or amantadine, and give a direct muscle relaxant like dantrolene
Second generation antipsychotics (atypical)
Clozapine, resperidone, olanzapine, quitiapine, ziprasidone, aripiprazole
Clozapine
less EPS and less prolactin release, Gold standard
Also associated with agranulocytosis and weight gain
Second gen. antipsychotics mechanism
highly non selective, D1/D2 activity, 5ht1A and 5ht2a
Risperidone
Can increase prolactin levels
Aripiprazole
Can lower prolactin levels
Ziprasidone
Can cause QT lengthening
5HT neuron projections
To terminal fields of DA neurons at caudate, accumbens, amygdala, and medial prefrontal cortex. Can decrease DA release or change DA effects.
