Antipsychotic drugs - aa

Question 1

What is the MOA of antipsychotics?

Answer 1

First-generation (typical): block D2 dopamine receptors
Second-generation (atypical): block dopamine and serotonin receptors, along with lots of other types of receptors in the body

Question 2

Name the two atypical (second-generation) antipsychotics we need to know about.

Answer 2

risperidone

olanzapine

Question 3

What is the main side effect of antipsychotics?

Answer 3

Extrapyramidal symptoms

Question 4

Are extrapyramidal symptom side effects worse with first-generation (typical) or second-generation (atypical) antipsychotics?

Answer 4

worse with first-generation (typical)

Question 5

Extrapyramidal symptom side effects get worse over time. When do the various specific symptoms appear?
Hours to days:
Days to weeks:
Weeks to months:
Months to years:

Answer 5

Hours to days: dystonias
Days to weeks: akathisia
Weeks to months: parkinsonism
Months to years: tardive dyskinesia

Question 6

What is a potentially fatal reaction to antipsychotics and what are its symptoms?

Answer 6

Neuroleptic malignant syndrome

~muscle rigidity, fever, altered mental status, stupor, unstable BP, myoglobinemia

Question 7

First-generation (typical) antipsychotics are more likely to have extrapyramidal symptoms as side effects; what are the more likely side effects of second-generation (atypical) antipsychotics?

Answer 7

METABOLIC

e.g. diabetes, hypercholesterolemia, weight gain

Question 8

Since antipsychotics block dopamine, what is a possible side effect related to its action in the pituitary?

Answer 8

increased prolactin -> galactorrhea

Question 9

Antipsychotics treat both the positive symptoms and the negative symptoms of schizophrenia equally well.
T/F

Answer 9

FALSE.

Work much better at treating the positive symptoms; not very effective for the negative symptoms

Question 10

What is the treatment for acute dystonic reactions that are a side effect of antipsychotics?

Answer 10

treat acute dystonic reactions with diphenhydramine

Question 11

What is the most common extrapyramidal symptom?

Answer 11

akathisia (inability to sit still)

Question 12

What is the first-line treatment for akathisia?

Answer 12

benzodiazepines