Podcast Beta
Questions and Answers
What is the black box warning associated with anti-psychotic medications in elderly patients?
What is the result of blocking D2 centers in the mesolimbic dopamine system?
What is the umbrella term for symptoms caused by chronic blocking of D2 receptors in the nigrostriatal pathway?
Which of the following is a risk factor for acute dystonia?
Signup and view all the answers
What is the most common form of extrapyramidal syndrome?
Signup and view all the answers
What is the characteristic of Parkinsonian syndrome?
Signup and view all the answers
What is the percentage of patients who develop tardive dyskinesia over a 5-year period?
Signup and view all the answers
What is the result of chronically blocking D2 receptors in the nigrostriatal pathway?
Signup and view all the answers
What is a potential consequence of prolonged hyperprolactinemia in men?
Signup and view all the answers
Which of the following antipsychotics is least likely to increase prolactin levels?
Signup and view all the answers
What is a common side effect of blocking Histamine H1 receptors?
Signup and view all the answers
What is a differential diagnosis of Neuroleptic Malignant Syndrome?
Signup and view all the answers
What is a treatment for Neuroleptic Malignant Syndrome?
Signup and view all the answers
What is a characteristic of Muscarinic Cholinergic side effects?
Signup and view all the answers
What is a metabolic side effect of antipsychotics?
Signup and view all the answers
What is the dosing schedule for Invega Sustenna?
Signup and view all the answers
Study Notes
Anti-Psychotic Medications
Black Box Warning
- Increased mortality in elderly patients with dementia-related psychosis
Side Effects of Anti-Psychotic Medications
Blocking of D2 Receptors
- Apathy, anhedonia, poor motivation/interest, lack of joy from social interactions
- Apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease
Extrapyramidal Syndrome (EPS)
- Umbrella term for symptoms caused by chronic blocking of D2 receptors in the nigrostriatal pathway
- Symptoms include:
- Dystonia
- Akathisia
- Parkinsonian Syndrome
- Tardive Dyskinesia
Dystonia
- Acute dystonia: involuntary contractions of major muscle groups
- Risk factors: young age, male, use of cocaine, and history of dystonia
- Not dose-related
Akathisia
- Most common form of EPS, dose-related
- Risk factors: older age, female, negative symptoms
- Presents as motor restlessness, urge to move, and inability to sit still
Parkinsonian Syndrome
- Symptoms include:
- Mask-like face
- Resting tremor
- Cogwheel rigidity
- Shuffling gait
- Pill rolling
- Bradykinesia
Tardive Dyskinesia (TD)
- Results from chronic blocking of D2 receptors in the nigrostriatal pathway
- Hyperkinetic movement disorder that may cause tongue and facial movements
- 25% develop TD over a 5-year period
- May be reversed if D2 blockade is removed early enough, but irreversible in some patients
Neuroleptic Malignant Syndrome (NMS)
- Life-threatening emergency
- Can occur at any time in treatment
- Symptoms include:
- Mental status change
- Muscular rigidity
- Hyperthermia (usually high fever)
- Autonomic instability
- Treatment:
- Discontinuation of antipsychotic
- Treatment of hyperthermia
- IV hydration
- IV dantrolene
- IV benzodiazepines
Hyperprolactinemia
- Blocking of D2 receptors in the tuberoinfundibular pathway
- May cause:
- Galactorrhea
- Gynecomastia
- Amenorrhea in women
- Sexual dysfunction
- Prolonged hyperprolactinemia may lead to osteoporosis, infertility, and hypogonadism in men
- Treatment: changing to a prolactin-sparing medication such as Aripiprazole, Caripiprazine, or Quetiapine
Muscarinic Cholinergic Side Effects
- Degrees of muscarinic cholinergic blockade differ by antipsychotic
- Typical agents often cause more EPS and have weak anticholinergic properties
- Atypical agents often cause fewer EPS and have stronger anticholinergic properties
Other Side Effects
- Blockade of Histamine H1 receptors: weight gain and sedation
- Blockade of α1-adrenergic receptors: orthostatic hypotension and drowsiness
- Metabolic side effects: weight gain, dyslipidemia, diabetes/insulin resistance, and hypertension
Long-Acting Injectables (LAI)
- Dosing schedules:
- Invega Sustenna: 4 weeks
- Invega Trinza: ...
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Learn about the potential side effects of antipsychotic medications, including black box warnings, effects on dopamine systems, and extrapyramidal syndrome (EPS).
