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Pharm II
Neuroleptic drugs
46
Pharmacology
Graduate
09/16/2014

Additional Pharmacology Flashcards

 


 

Cards

Term
delusions, halucinations, disorganized speech, bizarre behaviors
Definition
positive symptoms
Term
neurovegative - flat affect, poor eye contac, and lack of goal-directed activity
Definition
negative symptoms
Term
Most patient exhibit postive/negative symptoms?
Definition
both
Term
MOA: older neuroleptic drugs are
Definition

competitive blockers of dopamine receptors (D2) 

(TYPICAL)

Term
MOA: newer agents are blockers of
Definition

serotonin receptors (5HT2)

(ATYPICAL)

Term
Also block muscarinic, alpha adrenergic, and histamine receptors to varying degrees
Definition
atypical and typical
Term
All have equivalent therapeutic efficacies
Definition
atypical and typical antipsychotics
Term
Prototype neuroleptic
Definition
chlorpromazine
Term
low potency first generation antipsychotic agents
Definition

chlorpromazine

prochlorperizine

thioridazine

Term
first generation antipsychotic agent (high potency)
Definition

fluphenzaine

haldol

thiothixine

Term
second generation antipsychotic "atypical"
Definition

clozapine

olanzapine

resperdal

Term
All reduce "positive" symptoms hallucinations and agitation by blocking dopamine receptors
Definition
antipsychotics
Term
First generation antipsychotics are most effective against which symptoms
Definition
positive
Term
Newer (atypical) antipsychotics are most effective against which symptoms
Definition
negative
Term
Helps minimize the risk of EPS w/ first generation
Definition
anticholinergic effects
Term

due to blockage of D2 in the CTZ of the medulla

second generation less effective

Definition
antiemetic effect
Term
used to handle agitated and disruptive behavior
Definition
tranquilizers
Term
Intractable hiccups
Definition
chlorpromazine
Term
Adverse effects of dopamine blockade
Definition

akathisia

EPS

tardive dyskinesia

gynecomastia, amenorrhea, and galactorrhea

Term
80% show adverse effects but TI is high
Definition
neuroleptics
Term

dopamine/Ach imbalance

 

Definition
extra pyramidal symptoms
Term
irreversible oral facial dyskinesia
Definition
tardive dyskinesia
Term
prolactin increase (D2) with all D2 antagonists
Definition

gynecomastic, amonrrhea, galactorrhea

typical >> atypical

Term
Caution for neuroleptics
Definition

may cause drowiness

avoid in ETOH and other depressants

do not give to pts with glaucoma or BPH

caution in CV or hepatic disease

safety in pregnancy NOT established

Term
can cause acute agitation w/ alcohol may be aggravated with neuroleptics -->
Definition
benzo's preferred
Term

Antipschotic, control manifestations of mania, intractable hiccups 

(not used much anymore due to AE)

Definition
chlorpromazine
Term
highest occurance of sedation because of antimuscarinic and antihistaminic adverse effects
Definition
chlorpromazine
Term

antipsychotic good in patients refusing oral medications because it comes in depot injection 

 

Definition
fluphenazine
Term
butyrophenone
Definition
haldol
Term

common EPS due to low anticholinergic action

used for acute agitation

available as PO, IM, decanoate

Definition
haldol
Term

antipsychotic, control manifestations of mania, control of agitation

rapid acting for highly agitated patients

Definition
haldol
Term
causes less drowsiness than the rest of the antipsychotics because less antimuscarinic, antihistaminic effects
Definition
haldol
Term

low risk for EPS or tardive dyskinesia 

(becaue lower effectiveness of blocking D2 receptors)

Definition
clozapine
Term

high risk for agranulocytosis 

(loss of WBC)

reserve for refractory patients

Definition
clozapine
Term
antipsychotic with less toxicity than haldol
Definition
risperidone
Term

no agranulocytosis risk

1st line therapy

Definition
risperdal
Term
Paliperidone (Invega) - major metabolite
Definition
risperdal
Term

AE orthostatic hypotention & reflex tachy @ start of tx 

fewer problems with EPS and TD 

Definition
risperdal
Term
weight gain is a major problem
Definition
olanzapine
Term
less weight gain noted
Definition
seroquel
Term

no weight gain

QT prolongation?

available as both oral and injectable

Definition
geodon
Term
low risk for EPS or TD w/ no agranulocytosis risk
Definition

olanzapine

seroquel

geodon

Term
Warning on ALL atypical antipsychotics that they may induce...
Definition
hyperglycemia and diabetes type 2 (insulin insensitivity)
Term
chart slide 22
Definition
Term

often used for treatment of nausea and vomiting 

(phenothiazine)

Definition

prochlorperazine

promethazine

droperidol

tigan

Term
these can cause EPS and other adverse effects
Definition
phenothiazine
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