NURS 4010 Unit 1 Exam
Antipsychotic/Neuroleptic Medications
Questions With Verified Answers
Bind with dopamine receptors (commonly D2 receptors - in all 4 pathways of the brain, causing side
effects)
MOA of Antipsychotic/Neuroleptic Medications
Antipsychotics
Used for schizophrenia, paranoia, psychosis, mania, severe anxiety, Tourette's, autism; Note: just b/c
someone is on an antipsychotic does not mean they have a thought disorder; Metabolized by the liver
and excreted in urine, feces, breastmilk; All cause weight gain r/t poor glycemic control
Mesolimbic, mesocortical, nigrostriatal, tuberoinfundibular
4 dopamine pathways of the brain
Positive s/sx (hallucinations, delusions), thought disorders, and aggressive and hostile symptoms
Excessive dopamine in the Mesolimbic Pathway contributes to what?
Negative symptoms and cognitive symptoms
The Mesocortical Pathway mediates what type of symptoms, which results from either a decrease in
dopamine or a "burnout" of neuronal systems; Could be due to glutamate overactivity; Antipsychotics
that block the dopamine in this pathway contribute to these symptoms (seen especially with first
generation antipsychotics); The newer antipsychotics do not cause this as much b/c they have a lower
affinity for the D2
Nigrostriatal Pathway
Part of the extrapyramidal nervous system and control motor movements
Rigidity, akinesia, bradykinesia, dystonia, tremors, etc.
Deficits in the Nigrostriatal Pathway can cause what s/sx?
Tics or other hyperkinetic movement disorders (ex. restless leg syndrome, Huntington's disease)
Increased dopamine in the Nigrostriatal Pathway can cause what s/sx?
Extra Pyramidal Symptoms (EPS)
When antipsychotics decrease dopamine in the Nigrostriatal Pathway, it causes what?
Tuberoinfundibular Pathway
Normally the neurons in this pathway are active and INHIBIT prolactin release; During postpartum
periods, their activity is decreased and prolactin increases so that lactation can occur; When
antipsychotics block dopamine in this pathway, it also causes in increase in prolactin (contributes to
the side effects of galactorrhea in women and gynecomastia in men)
Thioridazine (Mellaril), Acetophenazine (Tindal), Carphenazine (Proketazine), Pimozide (Orap), and
Loxapine
, 1st Generation or Typical Antipsychotics - that only come in a pill
Chlorpromazine (Thorazine), Trifluoperazine (Stelazine), Perphenazine (Trilafon), Mesoridazine
(Serentil), Trifluopromazine (Vesperin), Promazine (Sparine), Prochloperazine (Compazine),
Fluphaneazine (Prolixin), Thiothixene (Navane), Chlorprothixene (Taractan), Haloperidol (Haldol), and
Loxapine Succinate (Loxitane)
1st Generation or Typical Antipsychotics - that come in both a pill and injectable
Prolinix Deconoate (Fluphaneazine)
1st Generation or Typical Antipsychotic that comes in a long acting injectable; Get every 2 weeks,
which helps with compliance
Haldol Deconoate (Haloperidol)
1st Generation or Typical Antipsychotic that comes in a long acting injectable
Chlorpromazine (Thorazine)
1st medication in the 1st Generation or Typical Antipsychotics class to come out; FDA indicated for
intractable hiccups
Prochloperazine (Compazine)
1st Generation or Typical Antipsychotics that is FDA indicated for severe nausea and vomiting
Haldol (haloperidol)
Which 1st Generation or Typical Antipsychotic medication in IV form is not FDA approved?
- Is instead off label, meaning research approves it but is not FDA approved
pimozide (Orap)
1st Generation or Typical Antipsychotic that is FDA indicated for Tourettes who have failed standard
treatment
Prolong QT interval; Need EKG, and cannot mix with other drugs that could also prolong QT interval
What is a major s/sx that 1st Generation or Typical Antipsychotics can cause? What lab needs to be
taken during tx of these drugs?
1st Generation or Typical Antipsychotics
Great job in D2 receptors (strong affinity); Drives dopamine down; can cause negative s/sx or make
negative s/sx worse; Pregnancy category C (aren't prescribed if pregnant)
2nd Generation or Atypical Antipsychotics
Target D2 and 5-HT Receptors; Work differently - don't target D2 as much but also now hits serotonin
levels as well; Helps balance out serotonin imbalances; Can help with negative s/sx or not cause them;
Pregnancy category B (not as bad)
Clozapine (Clozaril, FazaClo), Olanzepine (Zyprexa Zydis), Quentiapine (Seroquel, Seroquel XR),
Risperidone (Risperdal), Aripiprazole (Abilify Discmelt), Paliperidone (Invega), Iloperidone (Fanapt),
Antipsychotic/Neuroleptic Medications
Questions With Verified Answers
Bind with dopamine receptors (commonly D2 receptors - in all 4 pathways of the brain, causing side
effects)
MOA of Antipsychotic/Neuroleptic Medications
Antipsychotics
Used for schizophrenia, paranoia, psychosis, mania, severe anxiety, Tourette's, autism; Note: just b/c
someone is on an antipsychotic does not mean they have a thought disorder; Metabolized by the liver
and excreted in urine, feces, breastmilk; All cause weight gain r/t poor glycemic control
Mesolimbic, mesocortical, nigrostriatal, tuberoinfundibular
4 dopamine pathways of the brain
Positive s/sx (hallucinations, delusions), thought disorders, and aggressive and hostile symptoms
Excessive dopamine in the Mesolimbic Pathway contributes to what?
Negative symptoms and cognitive symptoms
The Mesocortical Pathway mediates what type of symptoms, which results from either a decrease in
dopamine or a "burnout" of neuronal systems; Could be due to glutamate overactivity; Antipsychotics
that block the dopamine in this pathway contribute to these symptoms (seen especially with first
generation antipsychotics); The newer antipsychotics do not cause this as much b/c they have a lower
affinity for the D2
Nigrostriatal Pathway
Part of the extrapyramidal nervous system and control motor movements
Rigidity, akinesia, bradykinesia, dystonia, tremors, etc.
Deficits in the Nigrostriatal Pathway can cause what s/sx?
Tics or other hyperkinetic movement disorders (ex. restless leg syndrome, Huntington's disease)
Increased dopamine in the Nigrostriatal Pathway can cause what s/sx?
Extra Pyramidal Symptoms (EPS)
When antipsychotics decrease dopamine in the Nigrostriatal Pathway, it causes what?
Tuberoinfundibular Pathway
Normally the neurons in this pathway are active and INHIBIT prolactin release; During postpartum
periods, their activity is decreased and prolactin increases so that lactation can occur; When
antipsychotics block dopamine in this pathway, it also causes in increase in prolactin (contributes to
the side effects of galactorrhea in women and gynecomastia in men)
Thioridazine (Mellaril), Acetophenazine (Tindal), Carphenazine (Proketazine), Pimozide (Orap), and
Loxapine
, 1st Generation or Typical Antipsychotics - that only come in a pill
Chlorpromazine (Thorazine), Trifluoperazine (Stelazine), Perphenazine (Trilafon), Mesoridazine
(Serentil), Trifluopromazine (Vesperin), Promazine (Sparine), Prochloperazine (Compazine),
Fluphaneazine (Prolixin), Thiothixene (Navane), Chlorprothixene (Taractan), Haloperidol (Haldol), and
Loxapine Succinate (Loxitane)
1st Generation or Typical Antipsychotics - that come in both a pill and injectable
Prolinix Deconoate (Fluphaneazine)
1st Generation or Typical Antipsychotic that comes in a long acting injectable; Get every 2 weeks,
which helps with compliance
Haldol Deconoate (Haloperidol)
1st Generation or Typical Antipsychotic that comes in a long acting injectable
Chlorpromazine (Thorazine)
1st medication in the 1st Generation or Typical Antipsychotics class to come out; FDA indicated for
intractable hiccups
Prochloperazine (Compazine)
1st Generation or Typical Antipsychotics that is FDA indicated for severe nausea and vomiting
Haldol (haloperidol)
Which 1st Generation or Typical Antipsychotic medication in IV form is not FDA approved?
- Is instead off label, meaning research approves it but is not FDA approved
pimozide (Orap)
1st Generation or Typical Antipsychotic that is FDA indicated for Tourettes who have failed standard
treatment
Prolong QT interval; Need EKG, and cannot mix with other drugs that could also prolong QT interval
What is a major s/sx that 1st Generation or Typical Antipsychotics can cause? What lab needs to be
taken during tx of these drugs?
1st Generation or Typical Antipsychotics
Great job in D2 receptors (strong affinity); Drives dopamine down; can cause negative s/sx or make
negative s/sx worse; Pregnancy category C (aren't prescribed if pregnant)
2nd Generation or Atypical Antipsychotics
Target D2 and 5-HT Receptors; Work differently - don't target D2 as much but also now hits serotonin
levels as well; Helps balance out serotonin imbalances; Can help with negative s/sx or not cause them;
Pregnancy category B (not as bad)
Clozapine (Clozaril, FazaClo), Olanzepine (Zyprexa Zydis), Quentiapine (Seroquel, Seroquel XR),
Risperidone (Risperdal), Aripiprazole (Abilify Discmelt), Paliperidone (Invega), Iloperidone (Fanapt),
