Term
| What are the Positive Symptoms of Psychosis? |
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Definition
| Delusions Hallucinations Disorganized speech Disorganized or catatonic behavior |
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Term
| What are the Negative symptoms of Psychosis? |
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Definition
| Impoverished thoughts Deficits of attention Blunt affect Lack of initiative |
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Term
| What receptors do the Atypical antipsychotics have affinity for? What symptoms do these treat? |
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Definition
| Low D2 Affinity - for + symptoms High 5-HT2 affinity - for - symptoms |
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Term
| What are the Typical antipsychotics largely effective for? |
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Definition
| Treat Positive Symptoms (delusions, hallucinations, disorganization of though and behavior) |
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Term
| What receptors do the Typical Antipsychotics block? What side effects do they have? |
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Definition
| Dopamine D2 Blockers Produce extrapyramidal symptoms Elevate Prolactin Levels |
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Term
| What does the addition of 5HT2A blockade in the Atypical drugs do? |
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Definition
| Reduce EPS improve efficacy for negative symptoms |
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Term
| What are the Typical Antipsycotics? |
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Definition
Phenothiazenes: Chlropromazine
Thioxanthenes: Thiothixene Butyrophenones&Diphenylbutylpiperidines: Haloperidol |
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Term
| What are the Atypical Antipsychotics? |
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Definition
| Clozapine Risperidone Olanzapine Quetiapine Ziprasidone Aripiprazole |
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Term
| What Typical AP has an Aliphatic Side Chain? |
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Definition
| Chlropromazine (Low Potency) |
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Term
| Which Typical AP has a Piperidine ring in side chain? |
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Definition
| Thiothixene (Lower incidence of EPS) |
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Term
| What Typical AP has the highest potency? |
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Definition
| Haloperidol (Butyrophenones) |
|
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Term
| What is the only approved agent for use in children and teens? |
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Definition
|
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Term
| What Atypical has low potency? |
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Definition
|
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Term
| What Atypical AP is a D2 partial agonist? |
|
Definition
|
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Term
| What effect does Aripiprazole have on what receptors? What effect does this have? |
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Definition
| D2 partial agonist (reduces actions of full agonist) 5-HT2A antagonist 5-HT1A partial agonist Lower incidence of side effects |
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Term
| What Atypical has limited EPS at low doses? |
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Definition
|
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Term
| What Atypical has Limited EPS? What receptors does it effect? |
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Definition
| Ziprasidone 5-HT2A, 5-HT1A, 5-HT2C/D2 antagonist |
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Term
| What is Neuroleptic Syndrome? |
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Definition
| Suppression of spontaneous movements and complex behaviors Reduced initiative and interest in environment Decreased manifestations of emotion or affect Psychotic symptoms disappear over time |
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Term
| What antipsychotic agents are more likely to lower the seizure threshold? |
|
Definition
| phenothiazines: Chlropromazine |
|
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Term
| What Antipsychotics are unpredictable when it comes to seizure threshold? |
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Definition
| Butyrophenones: Haloperidol (more likely in predisposed patients) |
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Term
| What is associated with extrapyramidal side effects? |
|
Definition
| Decreased Dopamine Activity |
|
|
Term
| How is Prolactin Secretion effected with the antipsychotics? |
|
Definition
Increased: All Typicals Risperidone
Little Increase: Clozapine Olanzapine Ziprasidone
No Increase: Quetiapine Aripiprazole (decreased?) |
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Term
| What are the clinical consequences of sustained Hyperprolactinemia? |
|
Definition
| Sexual Dysfunction Amenorrhea Gynecomastia/Galactorrhea Hypoestrogenism/Osteopenia |
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Term
| What effects do antipsychotics have on the brainstem and chemoreceptor trigger zone? |
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Definition
| Decreased vasomoter reflexes - decreased BP Protect against nausea and vomiting |
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Term
| What antipsychotic may act as an antidiuretic? |
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Definition
|
|
Term
| What AP impairs glucose tolerance and decreases insulin release? |
|
Definition
|
|
Term
| What AP cause more orthostatic hypotension? Which cause Less? |
|
Definition
More: Chlorpromazine
Less: Haloperidol, Risperidone |
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Term
| What anticholinergic effects can the Antipsychotics have? What agents do these occur in more often? |
|
Definition
Nasal stuffiness Dry mouth Blurred vision More often with Low Potency agents constipation Orthostatic Hypotension
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|
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Term
| What are the Extrapyramidal Side effects that AP can cause? What agents do these occure in more often? |
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Definition
| Acute Dystonia Akathesia Parkinsonian Syndrome Neuroleptic Malgnant Syndrome Perioral Tremor Tardive Dyskinesia More often in High Potency Agents |
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Term
| What is Neuroleptic Malignant Syndrome? How is it treated? |
|
Definition
| Occurs in first few weeks of treatment Fever, Severe Parkinsonism, Fluctuations Tremor, Autonomic instability, Elevated Creatine Kinase, Myoglobinemia Treat with D2 Agonists: Dantrolene, Bromocriptine |
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Term
| Use of what AP can cause Jaundice in the 2nd-4th week of treatment? |
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Definition
|
|
Term
| What AP can cause Blood Dyscrasis? |
|
Definition
| Clozapine (Mild leukocytosis, leukopenia, eosinophilia) |
|
|
Term
| What APs is Urticaria or dermatitis common with? |
|
Definition
| Phenothiazines: Chlorpromazine (5% on it have it) |
|
|
Term
| What APs cause the most weight gain? |
|
Definition
| Clozapine and Olanzapine (all atypicals lead to weight gain) |
|
|
Term
| What is the incidence of Metabolic Syndrome occuring in the Atypical Antipsychotics? |
|
Definition
Olanzapine - High
Quetiapine - Moderate
Risperidone- Moderate
Zisprasidone- Low
Aripiprazole- Low |
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|
Term
| What causes EPS and Hyperprolactinemia? |
|
Definition
|
|
Term
|
Definition
| alpha adrenergic blockade |
|
|
Term
|
Definition
| histaminic and serotonergic blockade |
|
|
Term
| What are the pharmokinetics for the Antipsychotics? |
|
Definition
| Highly Lipophilic Highly protein and membrane bound Accumlates in high blood supply tissues Crosses placenta and Breast milk Peak - 2-4hrs Elimination t1/2 = 20-40hrs |
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Term
| How do the APs disappear from the plasma? |
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Definition
| Rapid redistribution Phase t1/2 = 2hr Slow early elimination Phase t1/2 = 30h |
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Term
| What effects of Physical dependence can develop from the antipsychotics? |
|
Definition
| Malaise Difficulty sleeping if aburpt stoppage |
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|
Term
| What Drug interactions do the Typical Antipsychotics have? |
|
Definition
Inhibit 2D6
(Increase plasma levels of TCAs, SSRIs, other antipsychotics) |
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