Youtor
Antipsychotics neuroleptics
>> YOUR LINK HERE: ___ http://youtube.com/watch?v=gGOwAk1nf1c
This is a brief video on antipsychotics, also called neuroleptics, including their mechanisms, their indications, and side effects • I created this presentation with Google Slides. • Image were created or taken from Wikimedia Commons • I created this video with the YouTube Video Editor. • ADDITIONAL TAGS: • Anti- • psychotics • (neuroleptics) • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics • By Unknown - http://www.flickr.com/photos/x-ray_de..., Public Domain, https://commons.wikimedia.org/w/index... • First generation (typical) antipsychotics • Haloperidol and -azines • High potency: haloperidol, trifluoperazine, fluphenazine • Medium potency: perphenazine • Low potency: chlorpromazine, thioridazine • MoA: high affinity antagonist for dopamine (D2) receptor, thus increasing concentration of cAMP • Indications: schizophrenia positive symptoms (and brief psychotic disorder, schizophreniform), schizoaffective, other psychoses, bipolar, delirium, Tourette, Huntington’s • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics • First generation (typical) antipsychotics: • Side effects • Delay cardiac conduction (prolong QTc interval), risk of torsades de pointes • Anticholinergic effects → • Blurred vision, constipation, dry mouth, urinary retention • Worse with lower potency antipsychotics • Antihistamine effect → sedation • Anti alpha1 effect → orthostatic hypotension • Endocrine: hyperprolactinemia → osteoporosis, amenorrhea, galactorrhea, gynecomastia, and sexual side effects • Caused by D2 blockage on tuberoinfundibular pathway • Extrapyramidal symptoms • Neuroleptic malignant syndrome • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics • First generation (typical) antipsychotics: • SEs: extrapyramidal side effects • Caused by D2 blockage on nigrostriatal pathway • Hours to days: acute dystonic rxn (sustained muscle contraction); tx with IM diphenhydramine or benztropine • Days to weeks: akathisia (restlessness) • Weeks to months: parkinsonism (tremor, cogwheel rigid, hypokinesia); tx with lower dose antipsychotic or diphenhydramine or benztropine • Months to years: tardive dyskinesia (hyperkinetic movement of head, limbs, trunk → perioral movements (tongue, facial grimacing, and lip puckering) are common) • Tx by switching 1st-gen→2nd-gen or 2nd-gen→clozapine • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics • First generation (typical) antipsychotics: • SEs: neuroleptic malignant syndrome • Idiosyncratic reaction presenting with confusion, vital sign (autonomic) instability, hyperpyrexia (high fever), rhabdomyolysis (myoglobinuria), renal failure, cardiovascular collapse • Fever • Encephalopathy • Vitals unstable • Enzyme increase • Rigidity of muscles • Treat with dantrolene • Don’t confused with malignant hyperthermia! • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics • Atypical (2nd generation) antipsychotics • Aripiprazole, -apines, -idones • aripiprazole, asenapine, clozapine, olanzapine, quetiapine, iloperidone, lurasidone, paliperidone, risperidone, ziprasidone • MoA: weaker D2 antagonist and serotonin (5-HT2a) agonist • Indications: schizophrenia (positive and negative symptoms) • Side effects: • Delay cardiac conduction (prolong QTc interval), risk of torsades de pointes • Less anticholinergic and EPS effects • Metabolic (weight gain, diabetes, high lipid) → -apines • Agranulocytosis → clozapine (very potent) • Hyperprolactinemia → risperidone • First-generation antipsychotics • First-gen side effects • Extrapyramidal side effects • Neuroleptic malignant syndrome • Atypical antipsychotics
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