antipsychotics

Question 1

paliperidone (trade name) is….

Answer 1

Invega

SGA

Question 2

xanomeline-trospium (trade name) is….

Answer 2

KarXT

Question 3

cariprazine (trade name) is….

Answer 3

Vraylar

Question 4

lumaterperone (trade name) is….

Answer 4

caplyta

Question 5

the most problematic side effect of clozapine is….

Answer 5

agranularcytosis

Question 6

in general, antipsychotics have a _____ potential for dependence, and a ____ potential for tolerance

Answer 6

weak ; weak

Question 7

an off label use for risperidone is…

Answer 7

OCD

Question 8

the percentage of the world’s population suffering with schizophrenia is….

Answer 8

1%

Question 9

examples of positive symptoms of schizophrenia

Answer 9

disordered thinking, hallucinations, delusions

Question 10

flat affect is a ______ symptom of schizophrenia

Answer 10

negative

Question 11

cariprazine should not be used by….

Answer 11

elderly patients with dementia-related psychosis

Question 12

chloropromazine was originally develloped to be a….

Answer 12

sedative

Question 13

the word “tardive” in tardive dyskinesia indicates that….

Answer 13

the symptoms show up later in treatment

Question 14

the single best predictor of efficacy for an antipsychotic drug is an affinity for ____ receptors

Answer 14

D2

Question 15

loxapine is the only antipsychotic that …

Answer 15

is administered via inhalation

Question 16

what class were the first antipsychotics

Answer 16

phenothiazines

Question 17

issues with FGAs

Answer 17

bad motor sx

Question 18

pharmacological causes of schizophrenia

Answer 18

dopamine hypothesis (too much DA)

Question 19

phenothiazines binding profile

Answer 19

DA D2, AChM, H, NE

Question 20

EPS versus TD

Answer 20

EPS are reversible and have rapid onset ; TD is permanent and develops over time

Question 21

butyrophenones side effects

Answer 21

High incidence of EPS, particularly PD-like symptoms, dystonia, TD

Anticholinergic effects

Neuroleptic Malignant Syndrome (NMS)

Question 22

molindone / moban advantages

use?

Answer 22

induces weight loss

Question 23

what is pimozide (Orap) used for?

Answer 23

tourettes syndrome

Question 24

issues with pimozide (Orap)

Answer 24

higher incidence of cardia abnormalities

Question 25

common side effects of SGAs

Answer 25

“Metabolic Syndrome” – Weight Gain – Diabetes/Hyperglycemia – Cardiac Abnormalities

Question 26

what are some of the SGAs?

Answer 26

Clozapine (Clozaril) Olanzapine (Zyprexa) Risperidone (Risperidol) Sertindole (Serlect) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify) Amisulpride (Solian)

Question 27

Phenothiazines are in the class of antipsychotics known as

Answer 27

FGAs

Question 28

Amisulpiride is a good choice of antipsychotic for patients who have a high risk for

Answer 28

diabetes

Question 29

Cariprazine should not be used by

Answer 29

Elderly patients with dementia related psychosis

Question 30

What is the most common side effect of treatment with olanzapine

Answer 30

weight gain

Question 31

Chlorpromazine was originally developed to be a

Answer 31

sedative

Question 32

The major side effect of the first-generation antipsychotics is

Answer 32

motor impairment

Question 33

phenothiazines binding profile

Answer 33

Binding Profile: Primarily block DA D2, but also AChM1, H1, NEα1 – Blockade of AChM produces dry mouth, pupil dilation, blurry vision, cognitive impairment, constipation, urine retention, tachycardia (Sympathetic NS) – H blockade produces sedation, antiemesis – NE blockade produces sedation and hypotension

Question 34

phenothiazines sites of action (in brain)?4

Answer 34

– 1: Medulla 2: Limbic System/Frontal Lobes 3: hypothalamus 4: basal ganglia

Question 35

symptoms of Neuroleptic Malignant Syndrome (NMS); what drugs have this as a SE?

Answer 35

fever, muscle rigidity, autonomic fluctuations, alterations in consciousness. phenothiazines

Question 36

QT prolongation occurs with what types of drugs?

Answer 36

SGAs

Question 37

diabetes occurs as a SE of ______

Answer 37

SGAs

Question 38

clozapine (trade name, drug class)

Answer 38

Clozaril ; SGA

Question 39

why was/is clozapine special?

Answer 39

reduces negative symptoms as well as positive sx ; effective in tmt resistant pts

Question 40

most serious SE of clozapine?

Answer 40

agranularcytosis

Question 41

olanzapine special because it is effective at _______

Answer 41

reducing negative symptoms

Question 42

sertindole is special because _______

Answer 42

Does not bind to H receptors, so no sedative effects

Question 43

_________ is a commonly abused SGA due to __________ and _____ effects

Answer 43

quetiapine (Seroquel) ; anxiolytic and sedative

Question 44

ziprasidone (Geodon) also has _________ and _______ actions, and may be used for treatment of ___________ disorder

Answer 44

antidepressant ; anxiolytic ; schizoaffective

Question 45

ziprasidone has a risk of __________

Answer 45

QT prolongation

Question 46

ziprasidone has the benefit of __________

Answer 46

low weight gain

Question 47

amprisulfride has the benefit of _________

Answer 47

low diabetogenic effects

Question 48

Chlorpromazine (Trade name; class of drug)

Answer 48

Thorazine FGA