First Generation Antipsychotics
Antipsychotics, as a class, target this receptor to treat the positive symptoms of schizophrenia
D2 dopamine receptor (D2 antagonists)
The most common group of side effects from SGAs
Metabolic side effects
EPS, the group of movement disorder side effects from antipsychotics, stands for this
Extrapyramidal side effects
Purpose of antipsychotics formulated as LAIs
Medication nonadherence
Overactivity of this neurotransmitter is thought to be responsible for the positive symptoms of schizophrenia
Dopamine
Name 3 FGAs
Haloperidol, chlorpromazine, fluphenazine, perphenazine, pimozide, thiothixene, trifluorperazine, thioridazine
This second generation antipsychotic is the only medication FDA-approved for treatment-resistant schizophrenia
Clozapine
Benztropine (Cogentin) mechanism of action
Acetylcholine receptor antagonist
This second generation antipsychotic comes in monthly, every 3 month, and every 6 month long acting injectable formulations
Paliperidone (Invega)
Invega Sustenna/Trinza/Hafyera
DSM-V criteria for schizophrenia diagnosis includes presence of 2+ of these 4 positive symptoms
Delusions
Hallucinations
Disorganized thinking/speech
Grossly disorganized/abnormal motor behavior
The first antipsychotic to be FDA-approved
Chlorpromazine (Thorazine)
Aripiprazole (Abilify) and brexpiprazole (Rexulti) act on the D2 dopamine receptor in this unique way
Partial D2 dopamine agonist
Another name for restlessness (in context of antipsychotic side effects)
Akathisia
This second generation antipsychotic comes in IM and subQ formulations
Risperidone
Risperdal Consta (12.5/25/37.5/50 mg q2weeks)
Perseris (90 mg/120 mg q4weeks)
Clozapine REMS program requires monitoring of this laboratory value
Absolute Neutrophil Count (ANC)
Side effect of highest concern from long term exposure to antipsychotics (primarily FGAs)
Tardive dyskinesia
This antipsychotic, and one of its main metabolites, are both on the market
Risperidone (Risperdal)- metabolized to - paliperidone (Invega)
The 4 main effects of anticholinergic drugs
Blurry vision
Urinary retention
Constipation
Dry mouth
This first generation antipsychotic has a "loading dose" dosing strategy upon initiation
Haloperidol (Haldol)
This symptom/presentation can occur with high doses of antipsychotics or antipsychotic polypharmacy
Pseudoparkinsonism
Risk of this life-threatening side effect increases with medications with higher affinity for D2 dopamine receptors
Neuroleptic malignant syndrome
Tobacco smoke induces this CYP enzyme, primarily affecting clozapine and olanzapine metabolism
CYP1A2
Term for increased prolactin levels
Hyperprolactinemia
The injection technique needs to be used for haloperidol and fluphenazine LAIs - and why
Z-track injection method
Sesame oil-based formulations - risk of spilling out of injection site
Prevalence percentage of schizophrenia
1%