Antipsychotics Overview

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Questions and Answers

What is a primary indication for antipsychotic agents?

Obsessive-compulsive disorder

Schizophrenia (correct)

Anxiety disorders

Depressive disorders

Which type of antipsychotic has a higher affinity for dopamine D2 receptors?

Atypical antipsychotics

Low-potency antipsychotics

High-potency antipsychotics (correct)

Moderate-potency antipsychotics

What is a characteristic of atypical antipsychotics?

They primarily bind to dopamine D2 receptors only.

They are less tolerable than typical antipsychotics.

They have no effect on serotonin receptors.

They cause fewer extrapyramidal side effects. (correct)

How are peak plasma levels of oral antipsychotics typically reached?

Within 2-4 hours Signup and view all the answers

What is the typical process when switching to an atypical antipsychotic?

Tapering off the former medication over time Signup and view all the answers

Which pathway do atypical antipsychotics primarily affect?

Mesolimbic pathway Signup and view all the answers

What percentage of protein binding do antipsychotic agents typically exhibit?

85-90% Signup and view all the answers

What type of symptoms are atypical antipsychotics effective in treating?

Substance-induced psychotic disorders Signup and view all the answers

What should be considered when choosing a neuroleptic for treatment?

Past history of neuroleptic response and side effects Signup and view all the answers

Which type of antipsychotic has shown superior long-term outcomes in schizophrenia treatment?

Atypical antipsychotics Signup and view all the answers

What is the minimum duration needed to observe a significant antipsychotic effect from treatment?

2 weeks Signup and view all the answers

In cases of tardive dyskinesia, which type of antipsychotic should be considered to avoid worsening neurological impairment?

Atypical agents Signup and view all the answers

What common symptom is characterized by painful, involuntary muscle spasms associated with typical antipsychotic agents?

Dystonic reactions Signup and view all the answers

Which of the following is NOT a symptom of drug-induced parkinsonian symptoms?

Ocular muscles spasms Signup and view all the answers

Which antipsychotic is specifically noted for its effectiveness in treatment-resistant psychosis?

Clozapine Signup and view all the answers

What treatment is recommended for dystonic reactions occurring with typical antipsychotics?

Antiparkinsonian agents Signup and view all the answers

What is the correct dosage of propranolol for tremor treatment?

10-40 mg PO bid to qid Signup and view all the answers

Which treatment option is NOT recommended for akathisia?

Increasing antipsychotic dose Signup and view all the answers

What characterizes tardive dyskinesia (TD)?

Involuntary, irregular movements Signup and view all the answers

What is a significant risk factor for neuroleptic malignant syndrome (NMS)?

Dehydration Signup and view all the answers

Patients on atypical antipsychotics should be monitored for which metabolic side effects?

Type II diabetes and hyperlipidemia Signup and view all the answers

What should be done if a patient's WBC drops below 3,000/mcL during treatment with clozapine?

Discontinue clozapine Signup and view all the answers

Which of the following agents is associated with minimal risk of tardive dyskinesia?

Atypical agents Signup and view all the answers

What is the immediate treatment required for neuroleptic malignant syndrome?

Discontinue the neuroleptic Signup and view all the answers

Which side effect is associated with muscarinic (cholinergic) agents?

Dry mouth Signup and view all the answers

What is a potential risk of antipsychotic overdose when combined with alcohol?

Increased sedation Signup and view all the answers

Which condition should be considered when prescribing antipsychotics in elderly patients?

Increased sensitivity to side effects Signup and view all the answers

Which drug interaction may increase the levels of antipsychotics?

Lithium Signup and view all the answers

What side effect do antihistamines cause that is also associated with other drugs?

Sedation Signup and view all the answers

Which of the following is NOT a possible effect of antipsychotic overdose?

Death Signup and view all the answers

In the context of drug interactions, how do barbiturates affect antipsychotics?

Cause respiratory depression Signup and view all the answers

What is a recommended starting dose for high-potency agents in elderly patients?

0.5 mg of haloperidol Signup and view all the answers

Study Notes

Antipsychotics

Antipsychotics are used to treat a variety of mental health conditions including schizophrenia, bipolar disorder, and dementia with psychotic symptoms.
Typical antipsychotics bind to dopamine D2 receptors and are less tolerable than atypical antipsychotics. Atypical antipsychotics have higher affinity for serotonin receptors and are thought to be more effective in treating negative symptoms of psychosis.
Antipsychotics are typically absorbed within 2-4 hours with peak plasma concentrations.
Antipsychotics undergo extensive hepatic metabolism and are highly protein bound.
Atypical antipsychotics are generally considered first-line treatment for psychosis and may be more effective in treating negative symptoms, like affective flattening and anhedonia.
Treatment with antipsychotics typically requires at least two weeks to achieve a significant effect.
Atypical antipsychotics may have less risk of tardive dyskinesia (TD) than typical agents.
Clozapine is the only antipsychotic with proven efficacy in treatment-resistant psychosis.

Side Effects

Dystonic reactions are painful muscle spasms that can involve the extremities, neck, and ocular muscles. These side effects are more common with typical antipsychotics.
Drug-induced Parkinsonian symptoms can include bradykinesia, tremor, rigidity, and shuffling gait.
Akathisia is characterized by intense restlessness or anxiety.
Tardive dyskinesia is a long-term, often permanent involuntary movement disorder that can affect any striated muscle in the body.
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal adverse reaction to antipsychotics characterized by fever, muscle rigidity, delirium, and autonomic instability.
Metabolic side effects associated with atypical antipsychotics include type II diabetes and hyperlipidemia.
Agranulocytosis is a serious side effect of Clozapine, characterized by a decrease in white blood cells.

Drug Interactions

Antipsychotics can interact with a variety of other medications, including antidepressants, antihypertensives, anticonvulsants, and stimulants.
Certain medications may increase the levels of antipsychotics in the body, while others may decrease levels.

Pre-Existing Conditions

Patients with cardiac history should be monitored closely for any potential conduction abnormalities.
Elderly patients are more sensitive to the side effects of antipsychotics and may benefit from lower doses of high-potency agents.
Patients with hematologic disorders should be monitored for any changes in their blood count.

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Description

This quiz explores the key aspects of antipsychotic medications, including their types, mechanisms, and treatment applications for mental health conditions such as schizophrenia and bipolar disorder. Understand the differences between typical and atypical antipsychotics and their impact on psychotic symptoms.