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42 Cards in this Set
- Front
- Back
Phenothiazines
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1) Chlorpromazine
2) Thioridazine 3) Fluphenazine |
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Thioxanthene
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Thiothixene
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Butyrophenone
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Haloperidol
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New Generation "Atypical" Antipsychotics
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1) Clozapine
2) Risperidone 3) Ziprasidone 4) Olanzepine 5) Quetiapine 6) Aripiprazole |
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Mood stabilizers
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1) Lithium
2) Divalproex/Valproic acid 3) Topiramate |
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Classical antipsychotics
Mechanism of action |
Block D2, alpha adrenergic and Histamine receptors, and muscarinic
Block positive symptoms |
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Classical antipsychotics
Beneficial effects |
1) Blocks D2 in the limbic system
2) Decreases fear, hostility, agitation, delusions 3) Anti-emetic blockade of dopamine in chemoreceptor trigger zome |
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Classical antipsychotics
Side effects |
1) Extrapyramidal effects
2) Tardive Dyskinesia 3) Endocrine effects 4) Autonomic effects 5) Seizures 6) Neuroleptic malignant syndrome |
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Classical antipsychotics
Extrapyramidal effects |
1) Decreased dopamine in the Nigrostriatal system
2) Akathisia (rocking) 3) Dystonia (involuntary muscle spasm) 4) Parkinsonian Symptoms Tx: anticholinergics |
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Classical antipsychotics
Tardive dyskinesia |
1) Occurs late in treatment
2) Uncontrollable movements of mouth and tongue 3) Less likely with clozapine and olanzapine |
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Classical antipsychotics
Endocrine effects |
1) Supress appetite
2) Deregulate temperature 3) Weight gain 4)Increase prolactin release-->infertility, impotence, amenorrhea |
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Classical antipsychotics
Autonomic effects |
1) Anticholinergic: Dry mouth, blurred vision, tachycardia
2) Alpha blockade: Orthostatic hypotension 3) Histamamine: Sedation |
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Classical antipsychotics
Neroleptic Malignant syndrome |
1) Life threatening
2) Muscle rigidity 3) Catatonia 4) Hyperthermia 5) Altered BR and HR Tx: Dantrolene |
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Phenothiazine uses
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1) Prototype Chlorpromazine
2) Nausea and vomiting 3) Pre-anesthetic 4) Psychotic mania 5) alcoholic hallucinations (other drugs too) |
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Phenothiazine
Chlorpromazine Side effects |
1) Anticholinergic
2) Postural hypotension 3) Inhibition of ejaculation 4) Jaundice |
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Phenothiazine
Thorioridazine |
1) High anticholinergic
2) Lower extrapyramidal effects 3) More sedation and hypotension 4) Retinal Deposits |
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Phenothiazine
Fluphenazine |
1) Low anticholinergic activity
2) High Extrapyramidal symptoms 3) Less sedation and hypotension |
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Haloperidol
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1) Selective D2 blocker
2) Injected in acute psychosis 3) Worst for Extrapyramidal symptoms |
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Atypical antipsychotics
Clozapine |
1) Inhibits D4 and 5-HT2A, Muscarinic, histamine and alpha1
2) Very low extrapyramidal effects 3)Used in Parkinson's patients 4)Causes Agranulocytosis |
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Atypical antipsychotics
Olanzapine |
1) Blocks D2,D4, 5-HT2A
2) Anticholinergic effects 3) Rarely causes extrapyramidal effect 4) Treats Negative symptoms 5)Used to treat Bipolar 6) No agranulocytosis |
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Atypical antipsychotics
Olanzapine side effects |
1) Weight Gain
2)Hyperglycemia and type II diabetes |
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Atypical antipsychotics
Risperidone |
1) First Line
2) Blocks D2, 5-HT2A, alpha 3) Enhances DA in basal ganglia 4) Low extrapyramidal effects 5) Low Tardive dyskinesia |
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Atypical antipsychotics
Risperidone side effects |
1) Lengthens Q-T interval
2) Postural Hypotension |
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Atypical antipsychotics
Ziprasidone |
1) Blocks D2 and 5-HT2A
2) Some antidepressant activity 3) Metabolized by CYP3A4 |
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Atypical antipsychotics
Ziprasidone Side effects |
1) Prolongs QT interval
2) Sedation 3) Hyperprolactinemia 4) Decreases seizure threshold |
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Atypical antipsychotics
Quetiapine |
1) NO agranulocytosis
2) No hyperprolactinemia Side effects 1) Drowsiness, 2) Weight gain 3) Xerostomia |
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Atypical antipsychotics
Aripiprazole |
1) Dopamine system stabilizer
2) Partial agonist D2 and 5-HT1A 3)Blocks 5-HT2A, alpha, histamine 4)No hyperprolactinemia, weight gain or lengthened Q-T |
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Atypical antipsychotics
Aripiprazole side effects |
1) Orthostatic Hypotension
2) Increase Blood glucose, worsen diabetes 3) Seizures 4)Decrease motility of esophagus 5) Low extrapyramidal effects |
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Antipsychotics
Drug interactions |
1) Anticholinergics
2) Sedatives 3) Carbamazepine and smoking induce liver enzymes increasing metabolism 4) Antihypertensive drugs |
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Uses of Antipsychotics
Schizophrenia |
1) Risperidone
2) Quetiapine 3) Olanzepine |
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Uses of Antipsychotics
Depression and Mania with psychosis |
Antiphsychotic or Benzodiazepines (Alanzepine) with Mood stabilizers
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Uses of Antipsychotics
Tourette's syndrome |
Haloperidol
Primazide |
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Uses of Antipsychotics
Alzheimer's Disease |
Resperidone for agitation and hyperactivity
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Uses of Antipsychotics
Antemetic |
Prochlorperazine
|
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Mood Stabilizers
Lithium |
Use with antipschotic for mania
and antidepressant for depression when initiating treatment |
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Mood Stabilizers
Lithium Pharmacokinetics |
1) Monitor Serum concentration ( 0.6-1.2 mEq/L)
2) Excreted by the kidney reabsorbed by proximal tubule, 3)Competes with Na+ for reabsoption 4)Decrease in Na+, Increase in Li 5)Thiazide Diuretics, NSAIDs decrease clearance of Li |
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Mood Stabilizers
Lithum Side effects |
1) Tremor
2) Nausea 3) Headache 4) Decrease Thyroid function 5) Nephrogenic Diabetes Insipidus 6) Weight Gain 7) Can be used during pregnancy |
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Mood Stabilizers
Lithium Toxicity |
Extremely toxic
Mild: >2 mEq/L Nausea, vomiting, impaired memory and concentration Severe: > 2.5 mEq/L- Cardiac arrythmias Tx: Saline and dialysis |
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Mood Stabilizers
Lithium Drug interactions |
Antidepressants: increase mania
Benzodiazepines and antipsychotics: safe Thiazide: increase Li plasma Amilioride: Improve Diabetes insipidus NSAIDs: increase plasma Li |
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Mood Stabilizers
Valproic acid/Divalproex Sodium |
1) Widely used mood stabilizer
2) As good or better than Li 3) Fairly Rapid onset of action |
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Mood Stabilizers
Valproic acid/Divalproex Sodium Side effects |
1) GI upset
2) Transient liver enzymes 3) Weight gain 4) Contraindicated in pregnancy |
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Mood Stabilizers
Topiramate |
Effective monotherapy bipolar
Causes weight loss |