Stimulants and Antipsychotics Flashcards Preview

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Flashcards in Stimulants and Antipsychotics Deck (22):
1

CNS stimulants:

Methylphenidate, dextroampetamine, methamphetmamine, phentermine

2

CNS stimulants mech:

increase catecholamines at synaptic cleft, especially norepinephrine and dopamine

3

CNS stimulants use:

ADHD, narcolepsy, appetite control

4

Mood stabilizers:

Valproic Acid analogs, Carbamazepine, Conazepam are anti-epileptic drugs that appear to be effective in manic depressive disorders.
Tx in bipolar disorder is becoming common

5

Antipsychotics (neuroleptics):

Haloperidol, trifluoperazine, fluphenazine, thiridazine, chlorpromazine
(haloperidol + "azines")

6

Antipsychotics: mech

All typical antipsychotics block D2 receptors (increase cAMP)

7

Antipsychotics: use

Schizophrenia (primarily positive symptoms), Psychosis, Mania, Tourette syndrome

8

Antipsychotics: toxicity

Highly lipid soluble --> stored in body fat; thus, removed from body slowly
EPS side effects (dyskinesias). Tx: benztropine, diphenhydramine
Endocrine side effects (block dopamine, increase prolactin --> hyperprolactinemia --> galactorrhea
SEs arising from blocking muscarinic (dry mouth, constipation), alpha1 (hypotension), and histamine (sedation) receptors

9

Antipsychotics: other toxicities

Neuroleptic Malignant syndrome (NMS): rigidity, myoglobinuria, hyperpyrexia, autonomic instability.
Tx: dantrolene, D2 agonists (ex. bromocriptine)
Tardive dyskinesia: stereotypic oral-facial movements as a result of long-term antipsychotic use. Potentially irriversible.

10

High potency antipsychotics:

Try to Fly High
Trifluoperazine, Fluphenazine, Haloperadol
Neurologic side effects (EPS)

11

Low potency antipsychotics:

Cheating Thieves are Low
Chlorpromazine, Thioridazine
non-neurologic effects (anticholinergic, antihistamine, alpha1-blockade effects)

12

Chlorpromazine: major side effect

Corneal deposits

13

Thioridazine: major side effect

ReTinal deposits

14

Haloperidol: major side effect

NMS, Tardive dyskinesia

15

Evolution of EPS side effects:

4 hr: acute dystonia (muscle spasm, stiffness, oculogyric crisis)
4 day: akathisia (restlessness)
4 week: bradykinesia (parkinsonism)
4 month: tardive diskinesia

16

Atypical antipsychotics:

Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone
"It's atypical for OLd CLosets to QUIETly RISPER from A to Z"

17

Atypical antipsychotics: mech

Not completely understood. Varied effecs on 5-HT2, dopamine, and alpha and H1 receptors

18

Atypical antipsychotics: uses

Schizophrenia - both positive and negative symptoms. Also used for bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.

19

Atypical antipsychotics: tox

Fewer extrapyramidal and anticholinergic side effects than traditional antipsychotics.

20

Olanzapine/Clozapine: tox

may cause significant weight gain (can precipitate Type II diabetes --> black box warning)

21

Clozapine: tox

Agranulocytosis (requires WEEKLY WBC monitoring) and seizures
Olanzapine is much safer.

22

Risperidone: tox

may increase prolactin (causing lactation and gynecomastia) --> decreased GnRH, LH, and FSH (causing irregular menses and fertility issues)