Schizophrenia Pharmacology and Neuroleptic Side Effects

Comprehensive vocabulary flashcards covering the motor, cardiac, sensory, and metabolic side effects of antipsychotic medications used in schizophrenia pharmacology.

Dopamine D2/3 Blockade

The mechanism of action of neuroleptics that leads to extra-pyramidal side effects and hyperprolactinemia.

Tardive Dyskinesia (TD)

A common side effect occurring after long-term treatment, characterized by involuntary jerky movements of the face and body, such as lip smacking and tongue sticking out.

Vesicular monoamine transporter 2 (VMAT2) inhibitors

A type of treatment for Tardive Dyskinesia that causes intrasynaptic dopamine depletion by preventing its storage.

Acute Dystonia

A very common side effect following acute administration of neuroleptics, involving muscle spasms that cause facial grimacing.

Benzhexol or Procycline

Antimuscarinic drugs used to treat Acute Dystonia.

Pseudo-Parkinsonism

A reversible syndrome characterized by tremors, rigidity, bradykinesia, akinesia, hypersalivation, and a shuffling gait.

Bradykinesia/Akinesia

Symptoms of pseudo-parkinsonism that can be misidentified as severe depression or negative symptoms.

Akathisia

A state of inner restlessness and excessive pacing that is often difficult to differentiate from psychiatric anxiety.

Propranolol

A low-dose beta blocker, administered at $20-80\,mg/day$, used as a treatment for Akathisia.

Hyperprolactinemia

A side effect that can cause gynecomastia, sexual dysfunction, infertility, and an increased risk of breast cancer.

Osteoporosis

A long-term risk associated with chronic hyperprolactinemia from antipsychotics, which can lead to hip fractures.

Aripiprazole and Quetiapine

Two antipsychotics noted for not raising prolactin levels.

Prolonged QT interval

A cardiac side effect caused by prolongation of ventricular repolarisation, which can lead to sudden cardiac death.

Thioridazine and Ziprasidone

Specific antipsychotic drugs (one FGA and one SGA) known to cause prolongation of the QT interval.

Sedation

A dose-related side effect most common with low potency FGAs and Clozapine, though tolerance often develops over time.

Orthostatic hypotension

A drop in blood pressure caused by alpha-1-adrenoreceptor antagonism, common with Clozapine, Risperidone, and Quetiapine.

Seizure threshold

A level lowered by all antipsychotics, making them risky for patients with epilepsy; the more sedating the drug, the more it lowers this threshold.

Depot antipsychotics

A formulation of medication that cannot be used in patients with epilepsy because they cannot be quickly withdrawn if a seizure occurs.

Neuroleptic Malignant Syndrome (NMS)

A rare but fatal condition caused by high potency antipsychotics like Haloperidol, characterized by high fever, confusion, and muscle rigidity.

Benzodiazepines

Medications recommended to be used in association with regular-dose antipsychotics to calm very agitated patients in emergencies.

Clozapine and Olanzapine

The two Second Generation Antipsychotics (SGAs) associated with the greatest metabolic disturbances.

Metabolic Issues Receptors

The combination of receptors responsible for metabolic side effects: histamine H1, muscarinic M1/3, 5-HT2C, and D2/3.

Weight Gain Mechanism

A metabolic side effect likely caused by the combination of muscarinic M3 and histaminic H1 antagonism.

Glycaemic abnormalities

Metabolic issues ranging from mild insulin resistance to ketoacidosis.

Metabolic Monitoring

The process of tracking weight, waist circumference, fasting plasma glucose, blood pressure, and lipid profiles in patients on antipsychotics.

Metformin and Liraglutide

Add-on therapies used to treat metabolic issues and manage appetite suppression in patients on antipsychotics.