Walden University – NURS 6630 Psychopharmacology | Midterm Study Guide with Questions
and Answers | 2025 | Drug Mechanisms, Side Effects, and Indications
Less severe neurotransmitter side effects of Typical Antipsychotics include: ORTHOSTATIC
HYPOTENSION (Alpha-1 receptor inhibition), ANTICHOLINERGIC SIDE EFFECTS (muscarinic
receptor inhibition), and SEDATION (H1 receptor inhibition).
Which Typical Antipsychotics have a stronger sedating effect but less extrapyramidal side
effects? Low potency or High potency Typical Antipsychotics: Low potency
Metabolic side effects of Typical Antipsychotics include: Weight gain, dyslipidemia, and
hyperglycemia
Cardiac side effects of Typical Antipsychotics include: Prolongation of the QT interval
(normal = 0.4-0.44 seconds)
Typical Antipsychotic, chlorpromazine specific side effects: Corneal deposits
Typical Antipsychotic, thioridazine specific side effects: Retinal deposits
Block Dopamine D2 receptors in the Mesolimbic pathway to alleviate positive symptoms of
psychosis (hallucinations, delusions, disorganized thoughts) and block Serotonin 5-HT2A
receptors in the Mesocortical pathway that usually prevent Dopamine release from
dopaminergic neurons, thus increasing mesolimbic dopamine levels and improving negative
symptoms of psychosis (lack of motivation, social withdrawal, and flat affect): Atypical
Antipsychotics
Which type of Antipsychotics are preferred? Typical (first-generation) or Atypical (second
generation): Atypical (second generation)
,Eight common Atypical Antipsychotics: clozapine, olanzapine, quetiapine, paliperidone,
risperidone, lurasidone, ziprasidone, aripiprazole
This Atypical Antipsychotic uniquely partially stimulates D2 and 5-HT1 receptors:
Aripiprazole
Five other indications for Atypical Antipsychotics: Bipolar disorder, OCD, Anxiety,
Depression, Tourette Syndrome
First line agent for Acute Mania: Atypical Antipsychotics
Because they also block D2 receptors in the tuberoinfundibular pathway Atypical Antipsychotics
can cause: Hyperprolactinemia
Hyperprolactinemia caused by Atypical Antipsychotics blocking D2 receptors in the
tuberoinfundibular pathway can result in these three side effects: Oligomenorrhea,
Galactorrhea, and Gynecomastia
Because of its effect on blocking dopamine receptors in the tuberoinfundibular pathway, this
Atypical Antipsychotic is the most likely to cause Hyperprolactinemia (oligomennorhea,
galactorrhea, and gynecomastia): risperidone
Atypical Antipsychotics also block Dopamine receptors in the Nigrostriatal pathway and can
cause these symptoms: Extrapyramidal symptoms (dyskinesias and dystonic reactions,
tardive dyskinesia, pseudoparkinsonism, akinesia, akathisia, and neuroleptic malignant
syndrome)
Acute extrapyramidal symptoms include: Dystonia, Akathisia, and Pseudoparkinsonism
, Tardive (delayed) extrapyramidal symptoms include: Tardive Dyskinesia and Neuroleptic
Malignant Syndrome
This generation of Antipsychotics binds more loosely to D2 receptors and can get "kicked off' if
there is a lot of Dopamine around resulting in less extrapyramidal symptoms: Second-
Generation Antipsychotics (Atypical)
14. First generation Antipsychotics (Typical) bind more tightly to D2 receptors and are not
"kicked off" when excess Dopamine is around. This characteristic makes them more likely to
cause: Extrapyramidal Symptoms (dyskinesias and dystonic reactions, tardive dyskinesia,
pseudoparkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome)
Less severe neurotransmitter side effects of Atypical Antipsychotics include: ORTHOSTATIC
HYPOTENSION (Alpha-1 receptor inhibition), ANTICHOLINERGIC SIDE EFFECTS (muscarinic
receptor inhibition), and SEDATION (H1 receptor inhibition).
Metabolic side effects of Atypical Antipsychotics include: Weight gain, dyslipidemia,
hyperglycemia, and increased cardiovascular risk
These two Atypical Antipsychotics tend to cause the most weight gain: clozapine and
olanzapine
This Atypical Antipsychotic has the least impact on weight gain: aripiprazole
Two serious medication specific side effects of clozapine include: Seizures and
Agranulocytosis (leading to frequent and overwhelming infections)
These two labs must be monitored regularly with use of clozapine: WBC and ANC
and Answers | 2025 | Drug Mechanisms, Side Effects, and Indications
Less severe neurotransmitter side effects of Typical Antipsychotics include: ORTHOSTATIC
HYPOTENSION (Alpha-1 receptor inhibition), ANTICHOLINERGIC SIDE EFFECTS (muscarinic
receptor inhibition), and SEDATION (H1 receptor inhibition).
Which Typical Antipsychotics have a stronger sedating effect but less extrapyramidal side
effects? Low potency or High potency Typical Antipsychotics: Low potency
Metabolic side effects of Typical Antipsychotics include: Weight gain, dyslipidemia, and
hyperglycemia
Cardiac side effects of Typical Antipsychotics include: Prolongation of the QT interval
(normal = 0.4-0.44 seconds)
Typical Antipsychotic, chlorpromazine specific side effects: Corneal deposits
Typical Antipsychotic, thioridazine specific side effects: Retinal deposits
Block Dopamine D2 receptors in the Mesolimbic pathway to alleviate positive symptoms of
psychosis (hallucinations, delusions, disorganized thoughts) and block Serotonin 5-HT2A
receptors in the Mesocortical pathway that usually prevent Dopamine release from
dopaminergic neurons, thus increasing mesolimbic dopamine levels and improving negative
symptoms of psychosis (lack of motivation, social withdrawal, and flat affect): Atypical
Antipsychotics
Which type of Antipsychotics are preferred? Typical (first-generation) or Atypical (second
generation): Atypical (second generation)
,Eight common Atypical Antipsychotics: clozapine, olanzapine, quetiapine, paliperidone,
risperidone, lurasidone, ziprasidone, aripiprazole
This Atypical Antipsychotic uniquely partially stimulates D2 and 5-HT1 receptors:
Aripiprazole
Five other indications for Atypical Antipsychotics: Bipolar disorder, OCD, Anxiety,
Depression, Tourette Syndrome
First line agent for Acute Mania: Atypical Antipsychotics
Because they also block D2 receptors in the tuberoinfundibular pathway Atypical Antipsychotics
can cause: Hyperprolactinemia
Hyperprolactinemia caused by Atypical Antipsychotics blocking D2 receptors in the
tuberoinfundibular pathway can result in these three side effects: Oligomenorrhea,
Galactorrhea, and Gynecomastia
Because of its effect on blocking dopamine receptors in the tuberoinfundibular pathway, this
Atypical Antipsychotic is the most likely to cause Hyperprolactinemia (oligomennorhea,
galactorrhea, and gynecomastia): risperidone
Atypical Antipsychotics also block Dopamine receptors in the Nigrostriatal pathway and can
cause these symptoms: Extrapyramidal symptoms (dyskinesias and dystonic reactions,
tardive dyskinesia, pseudoparkinsonism, akinesia, akathisia, and neuroleptic malignant
syndrome)
Acute extrapyramidal symptoms include: Dystonia, Akathisia, and Pseudoparkinsonism
, Tardive (delayed) extrapyramidal symptoms include: Tardive Dyskinesia and Neuroleptic
Malignant Syndrome
This generation of Antipsychotics binds more loosely to D2 receptors and can get "kicked off' if
there is a lot of Dopamine around resulting in less extrapyramidal symptoms: Second-
Generation Antipsychotics (Atypical)
14. First generation Antipsychotics (Typical) bind more tightly to D2 receptors and are not
"kicked off" when excess Dopamine is around. This characteristic makes them more likely to
cause: Extrapyramidal Symptoms (dyskinesias and dystonic reactions, tardive dyskinesia,
pseudoparkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome)
Less severe neurotransmitter side effects of Atypical Antipsychotics include: ORTHOSTATIC
HYPOTENSION (Alpha-1 receptor inhibition), ANTICHOLINERGIC SIDE EFFECTS (muscarinic
receptor inhibition), and SEDATION (H1 receptor inhibition).
Metabolic side effects of Atypical Antipsychotics include: Weight gain, dyslipidemia,
hyperglycemia, and increased cardiovascular risk
These two Atypical Antipsychotics tend to cause the most weight gain: clozapine and
olanzapine
This Atypical Antipsychotic has the least impact on weight gain: aripiprazole
Two serious medication specific side effects of clozapine include: Seizures and
Agranulocytosis (leading to frequent and overwhelming infections)
These two labs must be monitored regularly with use of clozapine: WBC and ANC
