Psychotic Disorders & Antipsychotic Drugs — Study Pack Flashcards

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Antipsychotic

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A psychotropic drug class used to treat psychosis, including schizophrenia and mania. They primarily reduce positive symptoms like hallucinations and delusions by modulating neurotransmitters.

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Typical antipsychotic

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First-generation antipsychotics that mainly block dopamine D2 receptors. They are effective for positive symptoms but commonly cause extrapyramidal side effects.

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Atypical antipsychotic

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Second-generation agents that combine weaker D2 blockade with significant 5-HT2A antagonism and other receptor effects. They tend to have lower EPS risk but higher metabolic side effects for some drugs.

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Chlorpromazine

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An early phenothiazine antipsychotic (CPZ) with sedative, hypotensive, and anticholinergic properties. It set the stage for modern psychopharmacology but causes photosensitivity and hepatic metabolism complexities.

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Haloperidol

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A high-potency typical antipsychotic with strong D2 antagonism and significant EPS risk. It is effective for acute agitation and psychosis with minimal anticholinergic effects.

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Clozapine

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An atypical antipsychotic especially effective for treatment-resistant schizophrenia. It has low EPS risk but serious risks like agranulocytosis and metabolic disturbances, requiring regular blood monitoring.

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Risperidone

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A second-generation antipsychotic with relatively potent D2 blockade and 5-HT2 antagonism. It can raise prolactin levels and cause EPS at higher doses but has moderate metabolic risk.

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Olanzapine

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An atypical antipsychotic notable for significant weight gain and metabolic side effects. It blocks multiple receptors including antimuscarinic and is effective for psychosis and bipolar mania.

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Quetiapine

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An atypical antipsychotic with sedating properties and modest metabolic risk; useful in bipolar disorder and as maintenance therapy. It is primarily metabolized by CYP3A4.

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Aripiprazole

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A unique atypical antipsychotic acting as a partial D2 and 5-HT1A agonist and 5-HT2 antagonist. It has lower metabolic and EPS liability and a long half-life requiring cautious dose changes.

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Amisulpride

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A D2/D3-selective antipsychotic often classified as atypical for its low EPS and benefit on negative symptoms. It may cause hyperprolactinemia and QT prolongation risks.

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Dopamine hypothesis

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A theory proposing that dopamine overactivity in mesolimbic pathways contributes to positive psychotic symptoms. Antipsychotics reduce dopamine transmission to alleviate these symptoms.

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Extrapyramidal symptoms

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Motor side effects from D2 blockade including parkinsonism, dystonia, akathisia, and tardive dyskinesia. Severity varies by drug potency and dose.

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Tardive dyskinesia

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A late-onset, sometimes irreversible movement disorder with repetitive involuntary movements often of the face and limbs. Long-term typical antipsychotic use and older age increase risk.

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Malignant neuroleptic syndrome

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A rare, life-threatening reaction to antipsychotics featuring rigidity, hyperthermia, autonomic instability, and altered consciousness. Immediate drug cessation and intensive supportive care are required.

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Agranulocytosis

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A dangerous drop in white blood cells associated with clozapine therapy. It necessitates routine blood monitoring and immediate discontinuation if counts fall below safety thresholds.

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Metabolic syndrome

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A cluster of metabolic abnormalities—weight gain, hyperglycemia, dyslipidemia—associated with some atypical antipsychotics like clozapine and olanzapine. Regular metabolic monitoring is recommended.

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QT prolongation

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A cardiac conduction abnormality that increases risk of arrhythmia and can be caused by several antipsychotics. Risk is higher with predisposing factors and polypharmacy.

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WBC monitoring

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Weekly or regular blood count checks required for clozapine to detect agranulocytosis early. Frequency is highest early in treatment and may be reduced if counts remain stable.

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EPS management

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Acute dystonia is treated with anticholinergics or antihistamines; akathisia responds to benzodiazepines or propranolol; parkinsonism may respond to anticholinergics or switching to atypicals. Dose reduction is a common strategy.