10 - Psychotherapeutic Drugs

TYPICAL

Ratio: Prochlorperazine is a 1st Generation Anti-Psychotic | ANTI-EMETIC

ATYPICAL OR TYPICAL?

1. Prochlorperazine

DOC for Hiccups

Uses of the drug:

2. Chlorpromazine

Antihistamine

Uses of the drug:

3. Promethazine

Management of Irritability for Autistic

Uses of the drug:

4. Aripiprazole

For tardive dyskinesia

Uses of the drug:

5. Clozipine

a. Haloperidol

6. Which of the ff drug has the highest Dopamine-2 Receptor blockade?

   a. Haloperidol

   b. Clozapine

   c. Aripiprazole

   d. Chlorpromazine

b. Atypical Anti psychotic

7. Clozapine is a

   a. Typical antipsychotic

   b. Atypical Anti psychotic

   c. anti seizure

   d. anti-parkinsonism

b. Olanzapine

8. Atypical anti-psychotic

   a. Chlorpromazine

   b. Olanzapine

   c. Haloperidol

   d. Thioridazine

PSYCHOSES/SCHIZOPRENIA

exhibit gross disturbances in their comprehension of reality, as evidenced by false perceptions (hallucinations) and false beliefs (delusions)

mesoCORTICAL pathway

• Dopamine travels from the midbrain to the prefrontal lobe cortex

↓ neurotransmission of DA

Problem w/ mesoCORTICAL pathway

• anhedonia,

• alogia,

• apathy

mesoCORTICAL pathway can result to (-) symptoms:

increase DA neurotransmission by giving atypical

Goal therapy for mesoCORTICAL pathway’s problem:

mesoLIMBIC pathway

Dopamine travels from the midbrain tegmental area to the nucleus accumbens

↑neurotransmission of dopamine

Problem w/ mesoLIMBIC pathway

• agitation,

• delusion,

• disorganized thinking,

• speech,

• schizophrenia

mesoLIMBIC pathway can result to (+) symptoms:

decrease DA neurotransmission by giving typicals

Goal therapy for mesoLIMBIC pathway’s problem:

NIGROSTRIATAL PATHWAY

The pathway from the substantia nigra to the striatum (involved in the coordination of body movements)

Inhibition of this pathway causes the extrapyramidal side effects of antipsychotic drugs (typicals)

Problem w/ NIGROSTRIATAL PATHWAY

TUBEROINFUNDIBULAR PATHWAY

The pathway from the hypothalamus to the pituitary inhibits the release of prolactin.

HYPERPROLACTINEMIA

Inhibition of TUBEROINFUNDIBULAR PATHWAY pathway leads to:

D2 > 5HT2

Typical receptor blockade

5HT2 > D2

Atypical has a great affinity in

Effective

Effective or Not Effective

Typical in positive symptoms

Effective

Effective or Not Effective

Atypical in positive symptoms

Less effective

Less effective or more Effective

Typical in negative symptoms

More effective

Less effective or more Effective

Atypical in negative symptoms

More case

Less effective or more Effective

Typical in Extrapyramidal effects

Less case

Less effective or more Effective

Atypical in Extrapyramidal effects

More case

Less effective or more Effective

Typical in Tardive Dyskinesia

Less case

Less case or more case

Atypical in Tardive Dyskinesia

TRUE

TRUE or FALSE

Atypical agents is beneficial to schizophrenia but it’s expensive

Haloperidol

highest activity to block dopamine 2

ANTIPSYCHOTIC DRUGS

• reduce psychotic symptoms and improve the behavior of schizophrenic patients

• aka neuroleptic drugs because they suppress motor activity and emotional expression

neuroleptic drugs

ANTIPSYCHOTIC DRUGS is also known as _ because they suppress motor activity and emotional expression

Typical Antipsychotic Agents

1st generation Antipsychotic Agents

• EPS,

• Tardive dyskinesia,

• Anticholinergic effects (Thioridazine),

• Neuroleptic malignant syndrome

A/E of Typical Antipsychotic Agents

• Fluphenazine

• Trifluoperazine

• Thiothixene

• Haloperidol

High Potency Typical Antipsychotic Agents

• Chlorpromazine

• Thioridazine

Low Potency Typical Antipsychotic Agents

• Loxapine

Intermediate Potency Typical Antipsychotic Agents

• Clozapine

• Olanzapine

• Risperidone

• Aripiprazole

2nd generation Antipsychotic Agents

Clozapine

• the first of a new generation of atypical antipsychotic drugs

• less EPS

sedation & autonomic side effects, potentially fatal Agranulocytosis

Clozapine A/E:

Olanzapine

• causes fewer ANS

• NO agranulocytosis reports

• S/Es: sedation, weight gain

sedation, weight gain

Olanzapine S/E

Risperidone

• properties similar to olanzapine, but it appears to cause less sedation

• S/Es: orthostatic hypotension cardiotoxicity (QT interval prolongation

Aripiprazole

• partial agonist at dopamine and 5-HT1A receptors

• first drug approved to treat irritability in autistic children

orthostatic hypotension cardiotoxicity (QT interval prolongation)

Risperidone S/Es:

Chlorpromazine

DOC for hiccups

Haloperidol

Tx for Tourette

Clozapine

5HT2 = D4 > D2