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Pharm Exam 4-Anti Psych
Pharmacology
44
Pharmacology
Professional
11/14/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
When does schizophrenia usually present
Definition
Late adolescence to adulthood
Term
What are positive symptoms Schizophrenia
Definition
Hallucinations
Delusions
Aggressive behavior
Term
What are Negative symptoms Schizophrenia
Definition
Lack of speech
difficult emotional expression
withdrawal
Term
What are cognitive symptoms Schizophrenia
Definition
Difficult concentration and memory
Problems executive decision making
Term
Some complications w/ Schizophrenia
Definition
High suicide rate
Homelessness
Poor compliance w/ drug therapy
Term
Typical Antipsych examples
Definition
Chlorpromazine
Haloperidol
Term
Typical Antipsych mechanism of action
Definition
Dopamine especially D2 receptor blocker
especially in mesocortical and mesolimbic area
Term
Typical Antipsych, other receptor binding
Definition
HAMS:
Histamine
a1 adrenergic
muscarinic
serotonin
Term
Typical Antipsychs- 2 limitations
Definition
1/3 don't respond, "treatment refractory"
small amount of improvement only in negt. and cognitive symps
Term
Typical Antipsychs- SEs
Definition
1. EPS
2. Hyperprolactemia
3. Sedating
Term
Atypical antipsychs definition
Definition
reduced cause EPS and Hyperprolactemia
Term
Atypical antipsychs characterized by
Definition
1. weak D2 dopamine receptor blocker
2. Serotonin 2A (5HT 2A) receptor antagonism
Term
How do atypical antipsychs partially rescue dopamine transmission
Definition
blocks D2 receptors in striatum and serotonin receptors
so more dopamine released from nigostriatal neurons
Less EPS
Term
Bad SE with atypical antipsychs
Definition
Metabolic Syndrome
Term
Examples atypical antipsychs
Definition
1. clozapine
2. olanzapine
3. quetiapine
4. risperidone
5. ziprasidone
6. aripiprazole
Term
How atypical antipsychs work
Definition
all have different mechanism of action
Term
How select which antipsych for pts?
Definition
More based on anticipated SEs than effectiveness
Term
What else can use antipsychs for?
Definition
acute psychosis
schizoaffective disorder
Acute manic episode in bipolar
tourette's
huntington's
autistic disorders
Term
SEs of Dopamine antagonists
Definition
-Positive symptoms- mesocortical and mesolimbic
-Parkinson like symptoms- Nigrostriatal pathway,EPS
-Hyperprolactemia- tuberoinfundibular, amenorrhea, galactorrhea, impotence, infertility
Term
SEs of muscarinic antagonists
Definition
dry mouth, urinary retention, blurred vision
cognitive defects
Anti-EPS (tx parkinson's)
Term
SEs of a1 adrenergic antagonist
Definition
postural hypotension
Term
SEs Histamine H1
Definition
sedation, weight gain
Term
SEs Serotonin 5HT-2A
Definition
Anti-EPS
Term
SEs Serotonin 5HT-2C
Definition
satiety blockade (weight gain)
Term
What are EPS symptoms
Definition
1. Parkinsonism
2. Tardive dyskinesia
3. Neuroleptic malignant syndrome
Term
Parkinsonism symptoms
Definition
-Parkinson's Disease
-Tx anti-muscarinics (except L-DOPA)
Term
Tardive Dyskinesia symptoms
Definition
-Stereotyped, repetitive involuntary choreoathetoid movements of face, hands, eyelids, extremities, trunk
-Can be irreversible in adults, most important concern long term antipsych use
-Unknown mechanism
-No Tx
Term
Neuroleptic malignant syndrome
Definition
-Life threatening
-Marked muscle rigidity, fever, leukocytosis
-mechanism: believe from extensive rapid blockade of postsynaptic dopamine receptors
-Tx: immediately stop medication, give dopamine agonist and muscle relaxant
Term
Chlorpromazine
Definition
-prototype neurolyptic drug
-inexpensive
-Anti-muscarinic and anti-alpha adrenergic
Term
Chlorpromazine SEs
Definition
Many SE's including autonomic
-Highly sedative
Term
Haloperidol
Definition
-inexpensive
-potent
-less autonomic SEs
Term
Haloperidol SEs
Definition
severe EPS and Hyperprolactemia
Term
Clozapine
Definition
-Most efficacious
-Less EPS (better compliance)
-Only for pts resistant to typical drugs
-must monitor WBCs
Term
Clozapine SEs
Definition
-Small chance of agranulocytosis - very dangerous
-Weight gain, sedation, hyperlipidemia
-LOWER SEIZURE THRESHOLD
Term
Olanzapine
Definition
-2nd most efficacious
-one of most prescribed
-Strong Histamine H1 blocker
Term
Olanzapine SEs
Definition
-Sedation
-Metabolic Syndrome
-LOWERS SEIZURE THRESHOLD
Term
Quetiapine
Definition
-similar structure to clozapine
-Strong Histamine H1 receptor antagonist
Term
Quetiapine SEs
Definition
-Sedation
-Weight gain
Term
Risperidine
Definition
-Strongest D2 receptor blockert of atypicals
-less anti-muscarinic
Term
Risperidine SEs
Definition
-EPS and Hyperprolactemia at high doses
Term
Ziprasidne
Definition
Less affinity for muscarinic, Histamine H1, and alpha 1 adrenergic
Term
Ziprasidine SEs
Definition
-Less sedation, weight gain, and postural hypotension

Contraindicated for Heart problems- prolongs QT interval
Term
Aripiprazole
Definition
D2 receptor Partial agonist- high affinity but only 30% activity
-Serotonin 5HT 2A antagonist
Term
Aripiprazole SEs
Definition
minimally sedating
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