12 Questions
What is the primary mechanism of action of typical antipsychotics, and which specific dopamine receptors do they mainly act on?
Typical antipsychotics act as dopamine receptor antagonists, and they mainly act on D2 receptors in the mesolimbic pathway.
What is tardive dyskinesia, and what is its relationship to typical antipsychotics?
Tardive dyskinesia is a side effect characterized by slow, involuntary movements, often involving the lips, tongue, or face. It is a result of long-term use of typical antipsychotics, which can cause irreversible damage to the brain.
What is neuroleptic malignant syndrome (NMS), and what are its symptoms?
Neuroleptic malignant syndrome (NMS) is a rare but life-threatening side effect of antipsychotics, characterized by symptoms such as muscle rigidity, tremors, fever, and changes in mental status.
How do atypical antipsychotics differ from typical antipsychotics in terms of their mechanism of action and side effect profile?
Atypical antipsychotics act as dopamine and serotonin receptor antagonists, and they have a more selective receptor binding profile compared to typical antipsychotics, resulting in a different side effect profile.
What is agranulocytosis, and which atypical antipsychotic is associated with this side effect?
Agranulocytosis is a rare but serious side effect characterized by a severe decrease in white blood cells. Clozapine is an atypical antipsychotic that is associated with this side effect.
What is the relationship between dopamine and prolactin, and how does this affect side effects of antipsychotics?
Dopamine inhibits prolactin production, and when dopamine is blocked by antipsychotics, prolactin levels can increase, leading to side effects such as galactorrhea, amenorrhea, and sexual dysfunction.
What is the primary reason antipsychotics are prescribed, and what are the two main types of antipsychotics?
Antipsychotics are prescribed when there is danger to oneself or others, or when the patient is in distress. The two main types of antipsychotics are typical and atypical antipsychotics.
What is the effect of blocking dopamine receptors on the mesolimbic pathway, and what is the resulting side effect?
Blocking dopamine receptors on the mesolimbic pathway leads to a decrease in dopamine, resulting in extrapyramidal side effects, such as parkinsonism, tremor, bradykinesia, and rigidity.
What is the relationship between antipsychotics and prolactin, and what are the resulting side effects?
Antipsychotics, as dopamine antagonists, can lead to uncontrolled prolactin production, resulting in hyperprolactinaemia, which can cause galactorrhoea, amenorrhea, and sexual dysfunction.
What is the effect of atypical antipsychotics on various receptors, and what are the resulting side effects?
Atypical antipsychotics, such as clozapine and risperidone, have anticholinergic, antihistaminergic, and anti-adrenergic effects, leading to side effects such as dry mouth, constipation, sedation, hypotension, and brady/tachycardia.
What is the risk of taking typical antipsychotics with regards to muscle damage, and what is the resulting complication?
Taking typical antipsychotics can lead to a risk of neuroleptic malignant syndrome (NMS), which can cause rhabdomyolysis, resulting in the release of creatine kinase and potentially damaging the kidneys, leading to organ failure and death.
What is the unique side effect of clozapine, and what is its effect on the blood?
Clozapine is associated with the unique side effect of agranulocytosis, which is a decrease in white blood cells, and neutropenia, which is a decrease in a specific type of white blood cell.
Study Notes
Antipsychotics
- Indicated when there is danger to oneself or others, or when a patient is in extreme distress
Typical Antipsychotics
- Examples: chlorpromazine, haloperidol
- Mechanism of action: dopamine receptor antagonist
- Effects on dopamine receptors:
- Blocks 60% of receptors with minimal effect on other receptors
- Mainly acts on D2 receptors in the mesolimbic pathway
- Side effects:
- Extra pyramidal side effects
- Parkinsonism, tremor, bradykinesia, rigidity
- Tardive dyskinesia (slow involuntary movements, lip smacking, lip licking)
- Irreversible
- Treatment for side effects:
- Anticholinergics (e.g. procyclidine) to reduce imbalance between ACH and dopamine
- Rare but deadly side effects:
- Neuroleptic Malignant Syndrome (NMS): rhabdomyolysis, creatine kinase release
- Can lead to organ failure, death
- Endocrine side effects:
- Hyperprolactinaemia (uncontrolled prolactin production) due to dopamine antagonism
- Galactorrhoea, amenorrhea, sexual dysfunction
Atypical Antipsychotics
- Examples: clozapine, risperidone
- Mechanism of action: dopamine antagonist and 5HT antagonist
- Selective for specific receptors
- Side effects:
- Anticholinergic: dry mouth, constipation
- Antihistaminergic: sedation
- Antiadrenergic: hypotension, brady/tachycardia
- Metabolic: weight gain, insulin resistance
- Specific side effects to clozapine:
- Agranulocytosis
- Hypersalivation
- Neutropenia
Antipsychotics
- Indicated when there is danger to oneself or others, or when a patient is in extreme distress
Typical Antipsychotics
- Examples: chlorpromazine, haloperidol
- Mechanism of action: dopamine receptor antagonist
- Effects on dopamine receptors:
- Blocks 60% of receptors with minimal effect on other receptors
- Mainly acts on D2 receptors in the mesolimbic pathway
- Side effects:
- Extra pyramidal side effects
- Parkinsonism, tremor, bradykinesia, rigidity
- Tardive dyskinesia (slow involuntary movements, lip smacking, lip licking)
- Irreversible
- Treatment for side effects:
- Anticholinergics (e.g. procyclidine) to reduce imbalance between ACH and dopamine
- Rare but deadly side effects:
- Neuroleptic Malignant Syndrome (NMS): rhabdomyolysis, creatine kinase release
- Can lead to organ failure, death
- Endocrine side effects:
- Hyperprolactinaemia (uncontrolled prolactin production) due to dopamine antagonism
- Galactorrhoea, amenorrhea, sexual dysfunction
Atypical Antipsychotics
- Examples: clozapine, risperidone
- Mechanism of action: dopamine antagonist and 5HT antagonist
- Selective for specific receptors
- Side effects:
- Anticholinergic: dry mouth, constipation
- Antihistaminergic: sedation
- Antiadrenergic: hypotension, brady/tachycardia
- Metabolic: weight gain, insulin resistance
- Specific side effects to clozapine:
- Agranulocytosis
- Hypersalivation
- Neutropenia
This quiz covers the effects of antipsychotics, including typical antipsychotics like chlorpromazine and haloperidol, and their side effects such as extrapyramidal symptoms and tardive dyskinesia.
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