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What is a common characteristic of second-generation antipsychotics, except for aripiprazole?
What is a common characteristic of second-generation antipsychotics, except for aripiprazole?
- They have higher rates of metabolic adverse effects and weight gain
- They are associated with lower rates of extrapyramidal adverse effects and TD (correct)
- They are anticholinergic antagonists
- They are dopamine D2 agonists
What is the primary mechanism of action of clozapine?
What is the primary mechanism of action of clozapine?
- Dopamine D1 receptor agonist
- Weak D2-receptor antagonist (correct)
- Selective serotonin reuptake inhibitor
- Strong D2-receptor antagonist
What is a specific use of clozapine in the treatment of schizophrenia?
What is a specific use of clozapine in the treatment of schizophrenia?
- Reducing the risk of recurrent suicidal behavior (correct)
- Managing acute psychotic episodes
- Treating EPS in patients with schizophrenia
- Improving cognitive function in patients with schizophrenia
What is a common adverse effect of risperidone?
What is a common adverse effect of risperidone?
What type of receptors does risperidone have high affinity for?
What type of receptors does risperidone have high affinity for?
What is a benefit of risperidone in the treatment of psychoses?
What is a benefit of risperidone in the treatment of psychoses?
What is a common adverse effect of clozapine?
What is a common adverse effect of clozapine?
What is a unique characteristic of clozapine compared to other antipsychotics?
What is a unique characteristic of clozapine compared to other antipsychotics?
What is the mechanism of action of asenapine?
What is the mechanism of action of asenapine?
Which of the following is a side effect of olanzapine?
Which of the following is a side effect of olanzapine?
What is the indication of asenapine?
What is the indication of asenapine?
What is the mechanism of action of serotonin-dopamine activity modulators (SDAMs)?
What is the mechanism of action of serotonin-dopamine activity modulators (SDAMs)?
What is the use of aripiprazole?
What is the use of aripiprazole?
What is the side effect of asenapine?
What is the side effect of asenapine?
What is the mechanism of action of aripiprazole?
What is the mechanism of action of aripiprazole?
What is the advantage of asenapine compared to typical antipsychotics?
What is the advantage of asenapine compared to typical antipsychotics?
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Study Notes
Second-Generation Antipsychotics (Atypical)
- Characterized as dopamine D2 antagonists, except for aripiprazole, with lower rates of extrapyramidal adverse effects and tardive dyskinesia (TD) compared to first-generation antipsychotics.
- However, they are associated with higher rates of metabolic adverse effects and weight gain.
Clozapine
- Weak D2-receptor antagonist with significant anticholinergic, antihistaminic, and antiserotoninergic (5-HT1C, 5-HT2, 5-HT3) properties.
- Used to treat refractory schizophrenia, especially atypical type with negative manifestations, and to reduce the risk of recurrent suicidal behavior in schizophrenia or schizoaffective disorder.
- Adverse effects include:
- Neurological: sedation, drooling, dizziness
- Cardiovascular: tachycardia, cardiomyopathy, myocarditis
- Hematological: agranulocytosis (frequent CBC required)
- GIT: constipation
- Metabolic: weight gain
Risperidone
- Has high affinity for serotonin type 2 (5-HT2) receptors and binds to dopamine D2 receptors, antagonizing alpha1-adrenergic, alpha2-adrenergic, and histaminergic receptors.
- Improves negative symptoms of psychoses and reduces incidence of extrapyramidal symptoms (EPS).
- Adverse effects include:
- Mild sedation
- Hypotension
- Akathisia
- Increase in prolactin
- Weight gain
Other Atypical Antipsychotic Drugs
Asenapine
- Acts as an antagonist at dopamine D2 and serotonin 5-HT2 receptors, improving negative symptoms of psychoses and reducing incidence of EPS.
- Indicated for acute and maintenance treatment of schizophrenia.
- Adverse effects include:
- Sedation
- Weight gain
- Dizziness
- Extrapyramidal symptoms
Olanzapine
- Acts through combination of dopamine and serotonin type 2 receptor site antagonism.
- Side effects include:
- Weight gain
- Sedation
- Akathisia
- Hypotension
- Dry mouth
- Constipation
Aripiprazole (Serotonin-Dopamine Activity Modulator (SDAM))
- Acts as a partial agonist at 5-HT1A and dopamine D2 receptors, and as an antagonist at 5-HT2A and noradrenaline alpha1/2 receptors.
- Used for acute and maintenance treatment of schizophrenia, acute and maintenance treatment of bipolar I disorder, and adjunctive therapy for major depressive disorder.
- Adverse effects include:
- Headache
- Nausea
- Vomiting
- Insomnia
- Tremor
- Constipation
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