Term
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Definition
| disorder of the mind with delusions, hallucinations, disordered thinking |
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Term
| What is markedly disrupted with schiz? |
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Definition
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Term
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Definition
| young adults- "dementia precox" as oppposed to senile dementia |
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Term
| What are the 3 Hypotheses of Schiz? |
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Definition
| Dopamine, serotonin, and glutamate hypothesis. mainly first 2 |
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Term
| Based on the Dopamine Hypothesis, what is the "seat of the mind?" |
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Definition
|
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Term
| What is the neurotranmsitter change with Schiz? |
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Definition
|
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Term
| What is the aim of treatment with Schiz? |
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Definition
| the Dopamine receptor is blocked, instead of reuptake |
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Term
| What Dopamine receptors work via Gi? |
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Definition
|
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Term
| What Dopamine receptors work via Gs? |
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Definition
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Term
| What Serotonin recepotr has involvement in Schiz and what G protein does it work by? |
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Definition
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Term
| What 2 receptors play a role in Schiz? |
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Definition
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Term
| Do D1,3,4,5 blockers affect schizophrenia? |
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Definition
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Term
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Definition
| caudate/putamen, nucleus accumbens, an olfactory tubercle |
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Term
| What is the effect of D2 stimulation |
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Definition
| decreaseed cAMP, blocks Ca channels, opens K channels. D2 Block treats schizophrenia. |
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Term
| What Dopamine receptors are involved in Nigrostriatal system? |
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Definition
|
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Term
| What disease is a/w Decreased Dopamine? |
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Definition
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Term
| What Dopamine recepotrs are found in the Mesolimbic System? |
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Definition
|
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Term
| what are the functions affected by the Mesolimbic System? |
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Definition
| Food, Sex, and Drug Abuse |
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Term
| Does Mesolimbic D2 block treat schizophrenia? |
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Definition
|
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Term
| What Dopamine Receptors are found in the Mesocortical System? |
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Definition
|
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Term
| What functions are carried by the Mesocortical System? |
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Definition
| short term memory, planning, strategic thinking, and problem solving |
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Term
| What is the function of the tuberoinfundibular system? |
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Definition
| arises in arcuate nuclei and periventricular neurons, and release dopamine into pituitary portal circulation. |
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Term
| What is the effect of Dopamine on pituitary? |
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Definition
| decreased prolactin secretion |
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Term
| What is the effect of antipsychotics on pituitary? |
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Definition
| by blocking Dopamine, they increase prolactin secretion- galactorrhea |
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Term
| What is the medullary-periventricular pathway? |
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Definition
| a Dopaminergic system associated with the motor nucleus of the vagus. very unclear. Eating disorders are involved with this. |
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Term
| What is the Incertohypothalamic pathway involved in? |
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Definition
| Motivational phase of copulatory behavior. |
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Term
| What are the 6 Dopaminergic Systems in the CNS? |
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Definition
| Nigrostriatal System, Mesolimbic System, Mesocortical System, Tuberoinfundibular System, Medullary Periventricular Pathwya, Incertohypothalamic Pathway. |
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Term
| What is the effect of Dopamine on hypothalamic-pituitary endocrine system? |
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Definition
| inhibits Prolactin secretion, which normally directly acts on target tissues |
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Term
| What are the 2 uses of D-Amphetamine? |
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Definition
| 1.Anorexigenic- weight loss and 2-ADHD |
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Term
| What effect of D-amphetamine and Levodopa serves as evidence for the Dopaminergic Hypothesis of Pscyhosis? |
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Definition
| Both achieve the same effect as Dopamine and both produce Psychosis |
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Term
| What is a drug that blocks dopamine packaging? And its anti-dopamine effect blocks psychosis |
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Definition
| Reserpine; treats psychosis so it serves as evidence that dopamine is involved |
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Term
| What is a 5HT2a agonist that produces hallucinations? |
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Definition
| LSD- Lysergic acid diethylamide |
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Term
| Atypical antipsychotics have what MOA? |
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Definition
|
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Term
| What is the basis of the Glutamate Hypothesis? |
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Definition
| PCP, Ketamine, and some other NMDA antagonists produce positive and negative symptoms of Psychosis/Schiz. |
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Term
| What are the positive symptoms of Schiz/psychosis? |
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Definition
| things they normally dont have that surface with Schiz: delusions, hallucinations, illusions, dpersonalization, disorganized speech, formal thought disorders, grossly disorganized/catotonic behavior |
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Term
| What is the mechanism behind the casue of Positive Symptoms of Schizophrenia? |
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Definition
| increased D2 Dopaminergic activity (decreased cAMP in the Mesolimbic system) |
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Term
| are positive symptoms alleviated with antipsychotics? |
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Definition
| yes, pharmacotherapy is effective against Positive Symptoms with all antipsychotics |
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Term
| what are negative sympotms of Schiz/Psychosis? |
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Definition
| deficits of normal function: apathy, asociality, alogia, anhedonia, anergia, avoliton |
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Term
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Definition
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Term
| What is the mechanism behind the negative symptoms? |
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Definition
| decreased D1 activity (decreased cAMP in mesocortical system). May be mediated by increased 5HT2a agonism |
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Term
| What drugs work on the negative symptoms of psychosis? |
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Definition
| Pharmacotherapy is less effective with classical antipsychotics. Atypical (2nd generation) drugs work though |
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Term
| What is a synonym for antipsychotic meds that produce extrapyramidal symptoms? |
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Definition
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Term
| What drug calss dissociate antipsyhotic effect and Extrapyramidal Symptoms? |
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Definition
| atypical drugs/2nd generation |
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Term
| What symptoms of Schiz/Psychosis do the atypical drgus treat? |
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Definition
| both positve and negative |
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Term
| are adverse effects of atypical drugs more or less than first generation? |
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Definition
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Term
| is treatment of Schiz/Psychosis started with atypical or first generation? |
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Definition
|
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Term
| All the antipsychotics have some effect on what 2 receptors? |
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Definition
|
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Term
| what other receptors are acted on by antipsychotics? |
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Definition
| alpha 1, H1, and M1. H1>M1 |
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Term
| Is there a relationship of the action of drug dosage and efficacy for D1 receptors? |
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Definition
| No, but there is a linear relationship for D2 action |
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Term
| What are the impt atypical antipsychotics? |
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Definition
| Clozapine, Quetiapine, Olanzapine, Aripiprazole, Risperiodne. In order of potency |
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Term
| What are the 4 important 1st generation antipsychotics? |
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Definition
| Chlorpromazine, Thioridazine, Fluphenazine, Haloperidol. In increasing potency |
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Term
| Which 1st generation can be used IM? |
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Definition
Flupehnazine-Decanoate can be given IM.
Decanoate ester produces a long lasting (up to 3 wks) parenteral drug for compliance in maintenance therapy |
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Term
| What are the adverse autonomic effects of antipsychotic drugs? |
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Definition
| M block: loss of accomodation, dry mouth, difficulty urinating, constipation. alpha 1 block: orthostatic hypotension, impotence, failure to ejaculate |
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Term
| What are the adverse CNS effects of Antipsychotics caused by D block? |
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Definition
| parkinson's syndrome, Akathisia, dystonias |
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Term
| What Adverse CNS effect of antipsychotics results from D-Hypersensitivity? |
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Definition
|
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Term
| What adverse CNS effect results from M block? |
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Definition
|
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Term
| What endocrine adverse effects result from Antipsychotic D block? |
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Definition
| Amenorrhea/galactorrhea, infertility, impotence |
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Term
| What adverse effect of Antipsychotics results form H1 and 5HT2 block? |
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Definition
|
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Term
| What are specific side effects of Chlorpromazine? |
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Definition
| photosensitivity, retinopathy, hyperpigmentation |
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Term
| What is the specific side effect of Thioridazine? |
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Definition
|
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Term
| What is the specific side effect of Haloperidol? |
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Definition
|
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Term
| What is the atypical antipsychotic with the least side effects? |
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Definition
|
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Term
| What are the 4 extrapyramidal symptoms? |
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Definition
| Tardive dyskinesia (chorea-like), akathisia (restlessness), acute dystonia (spastic), Parkinsons Syndrome |
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Term
| When does Tardive Dyskinesia occur? |
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Definition
| can be many years after treatment; can be predisposed by smoking, DMellitus |
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Term
| What is an impt sign of Tardive Dyskinesia? |
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Definition
|
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Term
| What is a desire to be in constant motion? |
|
Definition
| Akathisia; can be accompanied by suicide thoughts, insomnia |
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Term
| What increases incidence of akathisia? |
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Definition
| cigarette smoking in women |
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Term
| What drugs are used to treat Akathisia? |
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Definition
| Trihesyphenidyl and Benztropine mesylate. ( Anti-parkinson Drugs) |
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Term
| What are acute dystonias? |
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Definition
| bizarre muscle spasms of head neck and tongue such as torticollis |
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Term
| What drugs treate Acute Dystonias? |
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Definition
| Diphenhydramine, Benztropine mesylate |
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Term
| What patients are susceptible to extrapyramidal side effects? |
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Definition
|
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Term
| What is the difference between Parkinsons Syndrome and Dz? |
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Definition
| receptor antagonism with the syndrome as opposed to decreased Dopamine with the disease. the syndrome is also reversible. |
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Term
| What is a partial D2 agonist that is a dopamine stabilizer? |
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Definition
|
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Term
| Why is Aripiprazole a PARTIAL D2 agonist? |
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Definition
| it functions as an antagonsit or agonist, depedning on the levels of Dopamine at the receptors |
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|
Term
| What is the MOA of CLozapine? |
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Definition
| inverse agonist of 5HT2A- blocks consitutive activity |
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Term
| What are the side effects of Clozapine? |
|
Definition
| seizures, agranulocytosis, myocarditis, blurry vision. Agranulocytosis risk requires WBC counts |
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Term
| When is Clozapine contraindicated? |
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Definition
| Heart Disease becasue of risk of Myocardiits |
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Term
| What is the unique anti-M effect of Clozapine? |
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Definition
| paradoxical increase in salivary secretion |
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Term
| What is the important side effect of Quetiapine? |
|
Definition
| Cataract and lens change; need to have eye exam every 6 months |
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Term
| What is the important side effect of Ziprasidone? |
|
Definition
| Arrhythmia. QT prolongation; ECG indicated in these patients |
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Term
| What is the imporant side effect of Olanzapine? |
|
Definition
| weight gain and related new onset type 2 Diabetes |
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Term
| What is the impt side effect of Prisperidone? |
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Definition
|
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Term
| What is an uncommon potentially fatal reaction to neuroleptic/antipsychotic drugs? |
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Definition
| neuroleptic Malignant Syndrome |
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Term
| What are the features of Neuroleptic Malignant Syndrome? |
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Definition
| HTN, tachycardia, hyperthermia, Mxl rigidity, stupor, Elevated CK, myoglobinemia, Nephrotoxicity |
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Term
| What is the Pathogenesis of Neuroleptic Malignant Syndrome? |
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Definition
| increased Ca2+ release from SR leading to the increased contractility, hyperthermia, rigidity, rhabdomyolysis. D2 receptor block in the hypothalamus, Nigrostriatum, and Spinal Cord lead to rigidity, tremor, and increased Temperature set point |
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Term
| What 2 drugs are used to treat Neuroleptic Malignant Syndrome? |
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Definition
| Dantrolene and Bromocriptine |
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Term
| What is the basis of Dantrolene use to treat Neuroleptic Malignant Syndrome? |
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Definition
| inhibits Ca2+ entry in skeletal myocytes |
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Term
| What is the basis of Bromocriptine use for Neuroleptic Malignant Syndrome? |
|
Definition
| Ergot Derivative D2 agonist |
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Term
|
Definition
| Receptor Blockade effects of Antipsychotics |
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