Shared Flashcard Set

Details

Winter Exam #3 - Antipsychotics
n/a
22
Pharmacology
Graduate
01/29/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
"Positive" Symptoms of Schizophrenia
Definition
delusions, hallucinations, flight of thought
Term
"Negative" Symptoms of Schizophrenia
Definition
social withdrawal, dementia, blunted affect
Term
Pharmacological Effects of Most Antipsychotics (chlorpromazine (Thorazine) - GOLD STANDARD)
Definition
Effects: antipsychotic - alleviation of psychotic symptoms without depressing most intellectual fcns (greater affect against "positive" symptoms), decreased initiation of behavior, decreased interest in environment; effects develop over 2-4 wks; allows pt to fcn better (NOT CURE); effects perceived as unpleasant; Sedation - early in tx, tolerance develops; Inhibition of conditioned avoidance response in animals; Lowers seizure threshold; Antiemetic; Poikilothermic Effect; Antihistaminic; CV - orthostatic hypotension, tachycardia, cardiac arrest, sudden death; inhbiton of sexual ejaculation; endocrine effects (prolactin secretion, affects other hormones); weight gain; possible Teratogenic effects
Term
chlorpromazine (Thorazine)
Definition
first modern antipsychotic; traditional antipsychotic standard; aliphatic phenothiazine
Term
Toxic Effects of Antipsychotics
Definition
high "margin of safety" - acute poisoning not a problem; Idiosyncratic/allergic rxns - blood dyscrasias, jaundice, skin rashes, phototoxicity, retinopathy; Extrapyramidal Motor Symptoms (EPS): acute dystonic reaction, akathisia, parkinsonism, neuroleptic malignant syndrome (NMS), tardive dyskinesia
Term
Acute Dystonic Reaction
Definition
EPS side effect: bizarre muscle spasms, facial grimacing, twitching, torticollis; early in tx; Tx: remove drug or add centrally-acting anticholinergic (trihexyphenidyl [Artane])
Term
Akathisia
Definition
EPS side effect: compelling need to be in motion --> fidgeting or pacing, mistaken for psychotic agitation; onset early tx; Tx: add anticholinergic med or remove causative drug, also can use propranolol & benzodiazepines
Term
Parkinsonism
Definition
EPS side effect: similar to Parkinson's dx - tremor & muscle rigidity; Develops early in therapy; Tx: remove drug or administer anticholinergic
Term
Neuroleptic Malignant Syndrome (NMS)
Definition
EPS side effect: stupor, severe rigidity, hyperthermia (can be fatal); develops early in therapy, persists weeks after drug is stopped; Tx: treat with dantrolene [Dantrium] - inhibits release of Ca from SR; or tx with bromocryptine [Parlodel] - dopamine agonist
Term
Tardive Dyskinesia
Definition
EPS side effect: involuntary movements (sucking lips, jaw movements, protrusion of tongue, choreiform movements) of face & extremities - due to too much DA activity compared to ACh; develops after long-term therapy; more common in females; symptoms often appear upon removal of medication; Tx: supress symtpoms by giving MORE antipsychotic drug, made WORSE by anticholinergic drugs; Tx: NO ADEQUATE tx for this SE, to reduce risk --> use lowest possible drug dose to control dx symptoms
Term
promethazine (Phenergan)
Definition
aliphatic phenothiazine with NO antipsychotic activity; used as an antihistamine - mainly for antiemetic properties
Term
thioridazine (Mellaril), mesoridazine (Serentil)
Definition
piperidine phenothiazine; more anticholinergic activity; fewer EPS SEs; significant sedation; more Cardiotoxicity
Term
trifluoperazine (Stelazine)
Definition
piperazine phenothiazine; more potent; LESS sedation; LESS anticholinergic activity; MORE EPS
Term
fluphenazine (Prolixin)
Definition
piperazine phenothiazine; similar to trifluoperazine; LONG ACTING FORMS (decanoate, enanthate) given by DEPOT injection every 2 wks to ensure pt compliance
Term
prochlorperazine (Compazine)
Definition
piperazine phenothiazine; antipsychotic activity similar to trifluoperazine but commonly used as ANTIEMETIC
Term
haloperidol (Haldol)
Definition
butyrophenone; LESS anticholinergi activity; MORE EPS; LESS sedation; available in LONG ACTING DEPOT form (Decanoate)
Term
clozapine (Clozaril)
Definition
2nd generation antipsychotic; preferentially blocks mesolimbic D4 receptors, also blocks 5-HT2 receptor, also has strong anticholinergic activity; LOW EPS; MOST EFFICACIOUS but 2nd line due to GRANULOCYTOPENIA, AGRANULOCYTOSIS; other SEs: seizures, WEIGHT GAIN, TYPE-2 DM, myocarditis; HIGH COST; also approved for suicidal behavior
Term
olanzapine (Zyprexa)
Definition
analog of clozapine; similar to clozapine but DOES NOT cause bone marrow toxicity; SEs: weight gain, hyperglycemia; more EPS; Used for tx of schizophrenia, mania
Term
risperidone (Risperdal)
Definition
newer antipsychotic; blocks both DA & 5-HT receptors; LESS EPS; SEs: weight gain, hyperglycemia; VERY WIDELY USED; Depot formulation available
Term
quetiapine (Seroquel), ziprasidone (Geodon), paliperidone (Invega)
Definition
newer antipsychotics; similar to clozapine in MoA; effective against both POSITIVE & NEGATIVE symptoms; very low EPS; DO NOT cause agranulocytosis; EXPENSIVE; Less efficacious than older 2nd generations; Similar metabolic SEs
Term
aripiprazole (Abilify)
Definition
newest antipsychotic; MoA: partial agonist/antagonist of D2 & 5-HT1a receptors; Tx: against positive & negative symptoms, also approved for mania; LESS EPS; less efficacious than other 2nd gens but LESS tendency to cause weight gain & hyperglycemia
Term
Clinical Uses of Antipsychotics
Definition
psychosis (schizophrenia); severe acute mania & bipolar disorder; organic brain syndromes; drug-induced psychotic rxns; depression with psychotic syndromes; tic disorders; antiemetics; intractable cough
Supporting users have an ad free experience!