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