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Typical Anti-psychotics (12)
- Thioridazine (Mellaril)
- Chlorpromazine (Thorazine)
- Mesoridazine (Serentil)
- Molindone (Moban)
- Perphenazine (Trilafon)
- Loxapine (Loxitane, Daxolin)
- Trifluoperazine (Stelazine)
- Thiothixene (Navane)
- Haloperidole (Haldol)
- Fluphenazine (Prolixin)
- Pimozide (Orap)
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Atypical (6)
- Aripiprazole (Abilify)
- Clozapine (Clozaril)
- Risperidone (Risperdal)
- Olanzapine (Zyprexa)
- Quetiapine (Seroquel)
- Ziprasidone (Geodon)
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Typical anti-psychotics and risperidone strongly block which receptors?
D2 receptors
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Blockade of dopamine in cortical and limbic produces?
Reduction in psychotic S/S
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Blockade of dopamine in basal ganglia produces?
Extrapyramidal S/S
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Which antipsychotic is effective in treating refractory psychotic S/S?
Clozapine (Clozaril)
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Which anti-psychotic is approved for use in acute bipolar mania and for maintenance tx of bipolar disorder?
Olanzapine (Zyprexa)
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Which 2 anti-psychotics are approved for agitation in schizophrenia?
- Olanzapine (Zyprexa)
- Ziprasidone (Geodon)
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Which atypical anti-psychotics are approved for bipolar disorder?
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
- Aripiprazole (Abilify)
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What neurological SE must be monitored for when taking antipsychotics?
- Akathisia (restlessness)
- Neuroleptic malignant syndrome (NMS)
- Extrapyramidal S/S (EPS)
- Seizure activity
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What must be monitored in pt taking clozapine?
Why?
- WBC counts
- B/c of agranulocytosis
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What are common SE of low potency antipsychotics? (4)
- Anti-cholinergic SE (dry mouth, constipation, urinary retention, blurred vision)
- Reduced seizure threshold
- Cardiac SE (QT prolongation - torsade de pointes)
- Orthostatic hypotension
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Which atypical anti-psychotic reduces seizure threshold?
Clozapine
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Which anti-psychotics are associated with orthostatic hypotension?
- Low-potency agents
- Risperidone (Risperdal)
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Which anti-psychotic is associated with agranulocytosis?
Clozapine (Clozaril)
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Which anti-psychotics are associated with QT prolongation?
- Low-potency agents
- Ziprasidone (Geodon)
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Which anti-psychotics are associated with high rates of weight gain, dyslipidemia, and adult-onset of diabetes? (2)
- Olanzapine (Zyprexa)
- Clozapine (Clozaril)
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Which anti-psychotic can cause pigmentary retinopathy and increased prolactin levels at high does?
Thioridazine (Mellaril)
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Which anti-psychotic increases risk of developing cataracts?
Quetiapine (Seroquel)
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Which class of anti-psychotics are considered the 1st line tx for psychotic disorders?
Atypical anti-psychotics
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What is the MOA of atypical anti-psychotics?
Dopamine and serotonin blockade of receptors
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Which are the traditional high-potency anti-psychotics?
- Haloperidol (Haldol)
- Droperidol (Inapsine)
- Fluphenzaine (Prolixin)
- Thiothixene (Navane)
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Which are the traditional medium-potency anti-psychotics?
- Trifluoperazine (Stelazine)
- Perphenazine (Trilafon)
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Which are the traditional low-potency anti-psychotics?
- Thioridazine (Mellaril)
- Chlorpromazine (Throazine)
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What are common SE of high potency anti-psychotics? (3)
- Tardive dyskinesia
- anti-cholinergic SE
- Neuroleptic malignant syndrome
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What is neuroleptic malignant syndrome?
- Uncommon complication of antipsychotic meds that starts w/in days of usage
- High fever, muscle rigidity, increased BP and HR
- Tx: stop drug and administer dantrolene
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What is tardive dyskinesia?
- Complication of anti-psychoitc use begins several months after therapy
- Characterized by repetitive facial movements
- Tx: stop drug, may be irreversible
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