Antipsycotics
Pharmacology 521 with Oakes at University of Wisconsin - Madison
About this deck
By: Dan Ruhland
Created: 2011-12-06
Size: 47 flashcards
Views: 13
Created: 2011-12-06
Size: 47 flashcards
Views: 13
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Antipsycotic MoA
-Mesolimbic: arousal, memory, motivational behavior; Antagonism - reduces pos symptoms
-Mesocortical: cognition, communication, social function; Antagonism - inc. neg symptoms
-Nigrotstriatal: extrapyramidal system, movement; Antagonism - causes EPS
-Tuberoinfundibular: reglates prolactin release; Antagonism - inc. prolactin levels
Also, muscarinic, alpha, H1, 5-HT2 blockade
-Mesocortical: cognition, communication, social function; Antagonism - inc. neg symptoms
-Nigrotstriatal: extrapyramidal system, movement; Antagonism - causes EPS
-Tuberoinfundibular: reglates prolactin release; Antagonism - inc. prolactin levels
Also, muscarinic, alpha, H1, 5-HT2 blockade
Atypical MoA
Usually have weak D2 blockage and more potent 5-HT2A blockage
Antipsycotic Indication
Schiz (non-cat), schizoaffective disorder, bipolar mania, Tourettes, Alzheimer aggression, psychotic depression
Antipsycotic AEs
Behavioral effects, neurological effects, TD, seizures, autonomic nervous system effects, metabolic effects, endocrine effects, allergenic rxns, ocular complications, cardiac toxicity, NMS
Chlorpromazine Indication
Uncontrollable hiccups
Chlorpromazine AEs
Orthostasis, tachycardia
May cause Seizures
May leave deposits in anterior eye
Skin reactions/photosensitivity
May cause Seizures
May leave deposits in anterior eye
Skin reactions/photosensitivity
Chlorpromazine PK
Inhibit 2D6
Metabolites stick around for a long time
Metabolites stick around for a long time
Chlorpromazine/Thioridazine vs. other Phenothiazines
Less potent but more sedation and wt gain
Thioridazine Indication
NOT antiemetic
No parenteral
No parenteral
Thioridazine AEs
Abnormal ECG (QT prolongation)
Cardiotoxicity (higher risk for cardiac death than hal)
Lower risk of EPS
"Browning" of vision
Cardiotoxicity (higher risk for cardiac death than hal)
Lower risk of EPS
"Browning" of vision
Thioridazine Contraindication
Must be careful w/ TCAs
Thioridazine PK
Inhibit 2D6
Trifluoperazine/Perphenazine/Fluphenazine vs. Other Phenothiazines
More potent, more selective
Perphenazine PK
Inhibit 2D6
Fluphenazine AEs
Tardive dyskinesia
Rare seizures
Rare seizures
Thiothixene AEs
Lower TD risk
Haloperidol AEs
High levels of EPS
Increased risk for torsade
No QT prolongation
Increased risk for torsade
No QT prolongation
Primozide AEs
Prolongs OTc
Primozide structure
Closely related to Butyrophenones
Typical AP Indication
Antiemetic (except Thioridazine)
Typical AP AEs
Hyperprolactinemia
Typical AP Contraindication
Smoking
Clozapine Indication
Good for tx-resistant or refractory pts
Reduces risk of suicide
Reduces risk of suicide
Clozapine AEs
Lower EPS
Agranulocytosis
Lower sz theshold
Wt gain
Least risk for TD
Myocarditis
Strongly associated w/ const.
Agranulocytosis
Lower sz theshold
Wt gain
Least risk for TD
Myocarditis
Strongly associated w/ const.
Clozapine Contraindications
Smokin
Clozapine Notes
Relapse can be rapid and severe - need to taper
ECT may augment tx
Need weekly blood counts
ECT may augment tx
Need weekly blood counts
Olanzapine Indication
Monotx for mania
High doses-refractory
Effective against neg and pos symptoms
High doses-refractory
Effective against neg and pos symptoms
Olanzapine AEs
Wt gain
Lower sz threshold
Lower sz threshold
Olanzapine Contraindications
Smoking
Quetiapine Indication
Monotx for mania
Low doses-sleep
Low doses-sleep
Quetiapine AEs
Less wt gain than olanz
Least risk for TD
FDA warning for arrhythmia
Least risk for TD
FDA warning for arrhythmia
Quetiapine PK
Short half-life - BID
Risperidone Indication
Irritability in autism
Cannot substitue for clozapine
Cannot substitue for clozapine
Risperidone AEs
May cause hyperprolactinemia, TD at high doses
Risperidone PK
Active metab of risperidone
Paliperidone PK
Active metab of risperidone
Paliperidone AEs
May cause hyperprolactinemia
Ziprasidone AEs
QTc prolongation
Least wt gain
FDA warning for arrhythmia
Least wt gain
FDA warning for arrhythmia
Ziprasidone Contraindications
Drugs that prolong QTc or quinidine (thioridazine, pimozide, etc)
Aripiprazole MoA
Partial D2 Agonist
Aripiprazole AEs
Doesn't inc prolactin levels
Little EPS b/c it is a partial D2 agonist
Little EPS b/c it is a partial D2 agonist
Aripiprazole PK
Long half-life
Loxapine AEs
No wt gain
Loxapine MoA
Sometimes considered a typical b/c it has antiemetic, sedative and high EPS properties, and a D2 binding ratio that is similar to typicals
Prochlorperazine Indication
Antiemetic
Promethazine Indication
Antipruritis
Preop sedative
Preop sedative
Droperidol Indication
Neurolept anesthesia
Post-op N/V
Post-op N/V
About this deck
By: Dan Ruhland
Created: 2011-12-06
Size: 47 flashcards
Views: 13
Created: 2011-12-06
Size: 47 flashcards
Views: 13
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“I have used this website for three exams, and I see a huge difference in my test results.”
Naj
Naj