Term
| What is thought to be the underlying abnormality of psychoses? |
|
Definition
| excess dopamine activity in the central nervous system |
|
|
Term
| What is the evidence for the hypothesis that dopamine causes psychosis? |
|
Definition
| drugs that block dopamine receptors are therapeutic in alleviating psychotic symptoms and sympathomimetics drugs which release dopamine (amphetamine) can induce psychosis |
|
|
Term
| How are most antipsychotics administered? |
|
Definition
| orally (IM for certain drugs) |
|
|
Term
| What percent of antipsychotics are bound to plasma proteins? |
|
Definition
|
|
Term
| T/F antipsychotics are in general subject to an extensive "first pass" heapatic metabolism |
|
Definition
|
|
Term
| What are the half-lives of antipsychotics like? |
|
Definition
| generally long halfe lives (chlorpromazine t1/2=30 hours) |
|
|
Term
| What percent of psychotic patients respond to typical antipsychotics? |
|
Definition
|
|
Term
| Aministration of antipsychotics leads to characteristic physical and psychological effects known as _______. |
|
Definition
|
|
Term
| What are the symptoms of neuroleptic syndrome? |
|
Definition
| sedation, emotional quieting, psychomotor slowing, affective indifference |
|
|
Term
| What are the MOA of phenothiazines? |
|
Definition
| predominately dopamine type 2 antagonists |
|
|
Term
| What are the three types of phenothiazines? |
|
Definition
| aliphatics, piperidines, piperazines |
|
|
Term
| What is the MOA of the aliphatics? |
|
Definition
| low affinity D2 antagonists that pose an increased risk for autonomic side effects |
|
|
Term
| Name some drugs that are aliphatics. |
|
Definition
| chlorpromazine, promazine, triflouropromazine |
|
|
Term
| Name the least effective aliphatic? |
|
Definition
|
|
Term
| What is the MOA of piperdines? |
|
Definition
| when compared to aliphatics these drugs have a higher affinity for the D2 receptor; however these drugs now have a black box warning on the labeling because they can produce a quinidine-like effect on the heart |
|
|
Term
|
Definition
| mesoridazine and thioridazine |
|
|
Term
| What is the MOA of piperazines? |
|
Definition
| high affinity D2 antagonists that pose an increased risk for extrapyramidal side effects; least sedating of the D2 antagonists |
|
|
Term
| What class of drugs are the least sedating of the D2 antagonists? |
|
Definition
|
|
Term
|
Definition
| fluphenazine, perphenazine, triflouperazine |
|
|
Term
| What is another name for haloperidol? |
|
Definition
|
|
Term
| What is the MOA of haloperidol? |
|
Definition
| high to intermediate affinity for the D2 receptor and tehrefore poses increased risk of extrapyramidal side effects; decanoate formulation available |
|
|
Term
|
Definition
| chlorprothixene and thithixene |
|
|
Term
| What is the MOA of the thioxanthenes? |
|
Definition
|
|
Term
| Name the three broad clases of typical antipsychotics. |
|
Definition
| phenothiazines, butyrophenone, thioxanthenes |
|
|
Term
| What's different about the second generation antipsychotics? |
|
Definition
| only weakly antidopaminergic so this reduces the potential for tardive dyskinesia and drug-induced parkinsonism |
|
|
Term
| What are dibenzodiazepines? |
|
Definition
| second generation antizychotics that are heterocyclic compounds with extrordinarily mixed receptor binding profiles |
|
|
Term
| Name some dibenzodiazepines. |
|
Definition
| clozapine, loxapine, olanzapine |
|
|
Term
| What is clozapine especially useful for? |
|
Definition
| helps with negative antipsychotic symptoms |
|
|
Term
| What are the side effects of clozapine? |
|
Definition
| agranulocytosis, cardiovascular complications such as myocarditis and cardiomyopathy from chronic treatment |
|
|
Term
| If a patient is experiencing agranulocytosis with clozapine, you can switch them to another dibenzodiazepine without that effect, namely ______. |
|
Definition
|
|
Term
| What are the sieffects of olanzipine? |
|
Definition
| case reports have described incidents of sleepwalking |
|
|
Term
| What is the MOA of benzisoxazole? |
|
Definition
| relatively selective 5-HT2A receptor antagonists, but at higher doses have ahloperidol like effects |
|
|
Term
|
Definition
| risperidone, paliperidone, ziprasidone |
|
|
Term
| What is teh primary active metabolite of risperidone? |
|
Definition
|
|
Term
| Name the heterocyclic antipsychotics that do not fit into a category. |
|
Definition
| molindone, pimozide, quetiapine |
|
|
Term
| What is the MOA of aripiprazole? |
|
Definition
| partial dopamine receptor agonist |
|
|
Term
| Why might a partial dopamine agonist be a better treatment than a dopamine antagonist? |
|
Definition
| you reduce the incidence of neurolepsis, parkinsonism-like effects and tardive dyskinesias |
|
|
Term
| What other receptors are affected by antipsychotics besides dopamine receptors? |
|
Definition
| many antipsychotics can block peripheral muscarinic receptors, alpha0-adrenergic receptors, and histmaine-1 rectpros |
|
|
Term
| T/F Many antipsychotics can result in weight gain |
|
Definition
|
|
Term
| Which antipsychotic is often used as an antiemetic? How does it work as an antiemetic? |
|
Definition
| promethazine (because of its antihistaminic effects) |
|
|
Term
| T/F DA plays a substantial role in the chemoreceptor trigger zone. |
|
Definition
|
|
Term
|
Definition
| unpleasant, subjective responses often characterized as "nervous energy" |
|
|
Term
| T/F Akathisias strongly contribute to noncompliance of antipsychotics. |
|
Definition
|
|
Term
|
Definition
| distinct absence of movement |
|
|
Term
| T/F Tardive dyskinesiasa can occur after taking only a few doses of antipsychotics. |
|
Definition
| false; symptoms develop after extended periods of time on antipsychotic drug therapy |
|
|
Term
| What percent of patients taking antipsychotic drug therapy get neuroleptic malignant syndrome? |
|
Definition
|
|
Term
| What percent of patients who get neuroleptic malignant syndrome end up dying from it? |
|
Definition
|
|
Term
| T/F Neuroleptic malignant syndrome can occur at therapeutic doses. |
|
Definition
|
|
Term
| How long after starting to take antipsychotic meds can you develop neuroleptic malignant syndrome? |
|
Definition
| within hours of starting treatment to months of treatment |
|
|
Term
| What are the symptoms of neuroleptic malignant syndrome? |
|
Definition
| muscular rigidity, impaired breathing or ventilation, autonomic hyperactivity, extremely high temperatures |
|
|
Term
| What kinds of endocrine abnormalities can be caused by antipsychotics? |
|
Definition
| increased serum prolactin, which can lead to amenorrhea, dysmenorrhea, and gynecomastia |
|
|
Term
| What are the cardiovascular effects of taking antipsychotics? |
|
Definition
|
|
Term
| What are the two most common drug interactions with antipsychotics? |
|
Definition
| the potentiation of CNS depressants such as alcohol, an interaction with OTC meds such as antihistamines |
|
|
Term
| What are contraindications for "typical antipsychotic therapy"? |
|
Definition
| blood dyscrasias, parkinsonism, chronic alcoholism, liver disease |
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