Typical (1st generation) antipsychotics Flashcards

1
Q

Typical antipsychotics - 7 drugs

A
Chlorpromazine
Fluphenazine
Thioridazine
Haloperidol
Trifluoperazine
Thiothixene
Loxapine
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2
Q

Typical antipsychotics - MOA

A

Blockade of D2 receptors in mesolimbic pathway represses positive symptoms within 1-3 weeks. Blockade of D2 receptors in basal ganglia cause adverse effects.

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3
Q

Typical antipsychotics - adverse effects caused by D2 blockade

A

Tuberoinfundibular pathway: Increased prolactin levels, gynecomastia, menstrual irregularities.
EPSs:
1. Akathisia
2. Psuedoparkinsonism
3. Dystonias: oculogyric crisis, glossospasm, tongue protrusion, torticollis, life-threatening pharyngeal dystonias

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4
Q

Typical antipsychotics - adverse effects caused by supersensitivity and effect on hypothalamus

A

Supersensitivity: Tardive dyskinesia - Abnormal facial movements, abnormal limb and truncal movements.
Hypothalamus: Poikilothermy, heat stroke, hypo- and hyperthermia.

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5
Q

Potency of the different typical antipsychotics

A

Low potency: Chlorpromazine, thioridazine.
Medium potency: Loxapine.
High potency: Fluphenazine, haloperidol, trifluoperazine, thiothixene.

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6
Q

Thioridazine - adverse effects

A

Pigmentary retinopathy and cardiac toxicity (high doses). Fewer EPSs.
Greater anticholinergic effect.
Poikilothermy.

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7
Q

Haloperidol - indications

A

Schizophrenia

Tourette syndrome

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8
Q

Typical antipsychotics - general interactions

A

Additive effects with antiadrenergic, anticholinergic, CNS depressants. Betablockers and antidepressants may increase levels of both drugs.

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9
Q

Which typical antipsychotics may decrease the levels of lithium?

A

Chlorpromazine
Thioridazine
Trifluoperazine

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10
Q

Typical antipsychotics with more EPSs

A

Fluphenazine

Haloperidol

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11
Q

Haloperidol - interactions

A

Barbiturates and carbamazepine decrease serum levels.

Quinidine increases serum levels

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12
Q

Typical antipsychotics with fewer autonomic effects

A

Fluphenaizne

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13
Q

Typical antipsychotic with a greater anticholinergic effect

A

Thioridazine

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14
Q

Administration of antipsychotics

A
Chlorpromazine: Oral, IM, IV
Fluphenazine: Oral, IM
Thioridazine: Oral
Haloperidol: Oral, IM
Trifluoperazine: Oral, IM
Thiothixene: Oral, IM
Loxapine: Oral, IM
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