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Advanced Pharmocology > Week 6 Second-Generation Antipsychotics > Flashcards

Week 6 Second-Generation Antipsychotics Flashcards

(45 cards)

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1
Q

What are second-generation antipsychotics also known as?

A

Atypical antipsychotics

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2
Q

List some medications included in the class of second-generation antipsychotics.

A
  • Aripiprazole
  • Asenapine
  • Brexpiprazole
  • Cariprazine
  • Clozapine
  • Iloperidone
  • Lumateperone
  • Lurasidone
  • Olanzapine
  • Paliperidone
  • Pimavanserin
  • Quetiapine
  • Risperidone
  • Ziprasidone
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3
Q

What receptors do second-generation antipsychotics primarily antagonize?

A
  • Dopamine (D2)
  • Serotonin (5-HT2)
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4
Q

What are the clinical indications for second-generation antipsychotics?

A
  • Schizophrenia
  • Bipolar disorder
  • Treatment-resistant depression
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5
Q

True or False: Second-generation antipsychotics cause more extrapyramidal symptoms than first-generation antipsychotics.

A

False

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6
Q

What are some metabolic adverse effects associated with second-generation antipsychotics?

A
  • Hyperglycemia
  • Hyperlipidemia
  • Weight gain
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7
Q

What is the mechanism of action for second-generation antipsychotics?

A

Blockade of postsynaptic dopamine D2 receptors

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8
Q

What is the primary physiological effect of second-generation antipsychotics?

A

Reduction of dopaminergic positive symptoms in schizophrenia

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9
Q

Fill in the blank: The bioavailability of aripiprazole is _______.

A

87% (oral); 100% (IM)

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10
Q

What is the half-life of clozapine?

A

12 hours

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11
Q

List two serious adverse effects of second-generation antipsychotics.

A
  • Neuroleptic malignant syndrome (NMS)
  • QT prolongation
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12
Q

What is the risk associated with clozapine?

A

Severe neutropenia leading to infection and death

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13
Q

What is the most common antipsychotic associated with hyperprolactinemia?

A

Paliperidone

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14
Q

What should be monitored in patients taking clozapine?

A

CBC for absolute neutrophil count (ANC)

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15
Q

True or False: Second-generation antipsychotics are approved for treating behavioral disorders in dementia.

A

False

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16
Q

What is the peak plasma time for quetiapine?

A

1.5 hours (immediate-release); 6 hours (extended-release)

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17
Q

What is a common side effect of all second-generation antipsychotics?

A

Sedation

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18
Q

Fill in the blank: The half-life of risperidone for extensive metabolizers is _______.

A

3 hours

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19
Q

List some conditions where second-generation antipsychotics may be indicated.

Study These Flashcards
A
  • Schizophrenia
  • Bipolar disorder
  • Treatment-resistant depression
  • Delirium
20
Q

What is the advantage of second-generation antipsychotics over first-generation antipsychotics?

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A

Less likely to cause extrapyramidal side effects

21
Q

What is the consequence of using second-generation antipsychotics in elderly individuals with dementia-related psychosis?

Study These Flashcards
A

Increased risk of death

22
Q

What metabolic syndrome risk is highest with clozapine?

23
Q

What is the incidence of severe neutropenia/agranulocytosis with clozapine?

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A

3%–4%

Leads to serious infection and death with an incidence of 1.3 in 10,000 (0.013%)

24
Q

What monitoring is required for patients on clozapine?

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A

Obtain CBC and ANC at baseline, then regularly thereafter

25
Which atypical antipsychotics are primarily metabolized by CYP2D6 and CYP3A4?
Aripiprazole and risperidone
26
List some drugs to avoid concomitant use with CYP2D6 and CYP3A4 substrates.
* Benztropine * Carvedilol * Flecainide * Fluoxetine * Hydrocodone/oxycodone * Methadone * Methamphetamine * Metoprolol/propranolol * Tricyclic antidepressants * Trazodone * Venlafaxine
27
What are some strong CYP3A4 inhibitors to avoid?
* Allopurinol * Amiodarone * Erythromycin * Azithromycin * Cyclosporine * Diltiazem * Verapamil * Fluconazole * Selective serotonin reuptake inhibitors (SSRIs) * Isoniazid * Metronidazole * Quinolone antibiotics * Omeprazole * Valproic acid
28
What should be avoided with strong CYP3A4 inducers?
* Carbamazepine/oxcarbazepine * Glucocorticoids * Phenytoin * Progesterone
29
What are the primary metabolic pathways for asenapine and olanzapine?
CYP1A2
30
Which drugs are contraindicated with SGAs due to QT interval prolongation?
* Quinolone antibiotics * Erythromycin, clarithromycin, azithromycin * Ketoconazole, itraconazole * Amiodarone * Sotalol * Procainamide * Tricyclics * SSRIs * Ondansetron * Sumatriptan, zolmitriptan * Methadone
31
What is the half-life of aripiprazole after oral administration?
75 hours (parent drug) to 94 hours (active metabolite)
32
What is a major adverse effect of aripiprazole with > 10% incidence?
Weight gain
33
What is the incidence of akathisia with cariprazine?
9–14%
34
What are the common side effects of clozapine?
* Cholinergic side effects (hypersalivation, sweating) * Anticholinergic side effects (constipation, dry mouth) * Agranulocytosis (3%)
35
What is a significant risk associated with clozapine?
Potential for seizures (3%), fatal myocarditis, cardiomyopathy, and mitral valve incompetence
36
What is the half-life of lurasidone at steady state?
29–37 hours
37
What are common side effects of olanzapine?
* Weight gain * Somnolence * Orthostatic hypotension * Hyperglycemia
38
What is the primary metabolism route for quetiapine?
CYP3A4
39
What is a common adverse effect of risperidone?
Somnolence (42%)
40
Fill in the blank: The half-life of ziprasidone is _______.
7 hours (oral); 2–5 hours (IM)
41
What is the incidence of dizziness with quetiapine?
> 10%
42
Which drug has a very long half-life of 200 hours for its active metabolite?
Pimavanserin
43
True or False: Quetiapine has strong anticholinergic effects.
True
44
What is the common adverse effect associated with paliperidone?
Injection-site reaction
45
What are the common side effects of lumateperone?
* Somnolence * Nausea * Xerostomia * Dizziness

Advanced Pharmocology (42 decks)

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