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Antipsychotic Pharm


Typical Drugs used to treat Schizphrenia ? *Haloperidol *Chlorpromazine *Thioridazine *Fluphenazine
Atypical Drugs for Schizophrenia ? *Risperidone *Clozapine *Quetiapine *Olanzapine *Ziprazadone *Aripiprazole
Typical antipsychotic drug receptor affinity and side effects ? * higher affinity for Dopamine receptor over Sreotonin * extrapyramidal side effects (EPS)
Atypical antipsychotic drug receptor affinity and side effects ? * higher affinity for serotonin receptor over dopamine *NO extrapyramidal side effects (EPS)
Antipsychotic drug metabolism ? *CYP2D6, 1A2, 3A4
Excretion of the drugs ? * some remain in the system and ar eexcreted long times after last treatment with that drug (Haloperidol and chlorpromazine) Typicals
Antipsychotic drugs and EEG ? * watch use is seizure prone ppl, bc they can lower the seizure threshold and cause them
Antipsychotic drugs and CV side effects of Typical drugs? * Lots * Thioridazine - long QT and elevated ST segments *Haloperidol - torsades de pointes * orthostaticHTN and Tachy
Antipsychotic drugs and CV side effects of Atypical drugs? * increased QT interval - Ziprasidone and Quetiapine
Endocrine Side Effects ? * can lower dopamine and cause prolactinemia
Non-psychiatric indications for antipsychotics ? * anti-emetics and H1 blocking to treat pruritus
Give to treat Positive Sx ? * Typical and Atypical Drugs
Give to treat Negative Sx ? * Atypical Drugs - see way lower adverse side effects
Why Typicals are used more despite the EPS effects ? * cheaper bc they are older
Usually used in non-compliant patients ? * IM injections bc they last longer than the oral routes
Best guide on drug selection ? * patients past drug response
For typical drugs, what is preferred ? * high potent drugs (halo.)
Minimal side effects and lower risk of tardive dyskinesia, and why we see an increased use in it ? * Risperidone
Indicated to reduce the risk of suicide in schizophrenia or as a last resort medication * Clozapine
Drug Combos ? * usu combine with other drugs to control other issues, like depression, anxiety, manic, etc
Neuro Side Effects ? * usu the Typicals * Extrapyramidal Side Effects (EPS)- Tremor-Slurred speech-Akathisia-Dystonia-Anxiety -Distress-Paranoia-Bradyphrenia
If neuro side effects continue for a while ? * Parkinson’s Syndrome - tmt=Benztropine or trihexylphenidyl
Akathisia tmt ? * Sedative antihistamine with anticholinergic properties (diphenhydramine)
Acute dystonic reactions tmt ? * Sedative antihistamine with anticholinergic properties (diphenhydramine)
Late-occurring syndrome of abnormal choreathetoid movements that are also a side effect? * Tardive Dyskinessia - can be treated early on, so recognize it......late stages are untreatable
Usu drugs that cause Tardive Dyskinessia, and what to switch them to? * Caused by: Typicals and possibly risperidone ** Patients should be switched to quetiapine or clozapine (atypicals), and be taken off TCADs, and given a benzo to increase GABA activity
Cause seizures ? * Chlorpromazine (RARE) * Clozapine (de novo seizures)
ANS Side Effects ? * Antimuscarinic Activity ---- * Urinary retention, constipation, dry mouth * Orthostatic hypotension or impaired ejaculation (chlorpromazine or mesoridazine)
Causes Deposits in cornea and lens ? * chlorpromazine
Causes Deposits in retina ? * thioridazine - associated with browning of vision
Metabolic Side Effects ? * Weight gain (clozapine or olanzapine)
Reproductive Side Effects ? *WOMEN - false + preg tests, amenorrhea, increased sex drive * MEN - low sex drive and gyno
Drug that causes AGRANULOCYTOSIS ? * clozapine - starts between weeks 6 - 18...Weekly blood counts for first 6 months Every 3 weeks after
Tmt of Side Effect Neuroleptic Malignant Syndrome (NMS), which is rigidity, no sweating, fever, high EPS Sx ? * diazepam or dantrolene and switch to Atypical Drug
Drugs that cause Cardiotoxicity Side Effects ? * Thioridazine - T waves and torsades * Ziprasidone - QT prolongation * Clozapine - assoc. w/ myocarditis
Antipsychotics in pregnancy? * Potential teratogenic risk (small)
Overdoses ? *Rarely fatal EXCEPT: mesoridazine and thioridazine * also causes Ventricular tachyarrythmias
Created by: thamrick800