Term
| When does schizophrenia usually present |
|
Definition
| Late adolescence to adulthood |
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|
Term
| What are positive symptoms Schizophrenia |
|
Definition
Hallucinations
Delusions
Aggressive behavior |
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|
Term
| What are Negative symptoms Schizophrenia |
|
Definition
Lack of speech
difficult emotional expression
withdrawal |
|
|
Term
| What are cognitive symptoms Schizophrenia |
|
Definition
Difficult concentration and memory
Problems executive decision making |
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Term
| Some complications w/ Schizophrenia |
|
Definition
High suicide rate
Homelessness
Poor compliance w/ drug therapy |
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Term
| Typical Antipsych examples |
|
Definition
Chlorpromazine
Haloperidol |
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Term
| Typical Antipsych mechanism of action |
|
Definition
Dopamine especially D2 receptor blocker
especially in mesocortical and mesolimbic area |
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Term
| Typical Antipsych, other receptor binding |
|
Definition
HAMS:
Histamine
a1 adrenergic
muscarinic
serotonin |
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|
Term
| Typical Antipsychs- 2 limitations |
|
Definition
1/3 don't respond, "treatment refractory"
small amount of improvement only in negt. and cognitive symps |
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Term
|
Definition
1. EPS
2. Hyperprolactemia
3. Sedating |
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Term
| Atypical antipsychs definition |
|
Definition
| reduced cause EPS and Hyperprolactemia |
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Term
| Atypical antipsychs characterized by |
|
Definition
1. weak D2 dopamine receptor blocker
2. Serotonin 2A (5HT 2A) receptor antagonism |
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|
Term
| How do atypical antipsychs partially rescue dopamine transmission |
|
Definition
blocks D2 receptors in striatum and serotonin receptors
so more dopamine released from nigostriatal neurons
Less EPS |
|
|
Term
| Bad SE with atypical antipsychs |
|
Definition
|
|
Term
| Examples atypical antipsychs |
|
Definition
1. clozapine
2. olanzapine
3. quetiapine
4. risperidone
5. ziprasidone
6. aripiprazole |
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|
Term
| How atypical antipsychs work |
|
Definition
| all have different mechanism of action |
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Term
| How select which antipsych for pts? |
|
Definition
| More based on anticipated SEs than effectiveness |
|
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Term
| What else can use antipsychs for? |
|
Definition
acute psychosis
schizoaffective disorder
Acute manic episode in bipolar
tourette's
huntington's
autistic disorders |
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|
Term
| SEs of Dopamine antagonists |
|
Definition
-Positive symptoms- mesocortical and mesolimbic
-Parkinson like symptoms- Nigrostriatal pathway,EPS
-Hyperprolactemia- tuberoinfundibular, amenorrhea, galactorrhea, impotence, infertility |
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|
Term
| SEs of muscarinic antagonists |
|
Definition
dry mouth, urinary retention, blurred vision
cognitive defects
Anti-EPS (tx parkinson's) |
|
|
Term
| SEs of a1 adrenergic antagonist |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| satiety blockade (weight gain) |
|
|
Term
|
Definition
1. Parkinsonism
2. Tardive dyskinesia
3. Neuroleptic malignant syndrome |
|
|
Term
|
Definition
-Parkinson's Disease
-Tx anti-muscarinics (except L-DOPA) |
|
|
Term
| Tardive Dyskinesia symptoms |
|
Definition
-Stereotyped, repetitive involuntary choreoathetoid movements of face, hands, eyelids, extremities, trunk
-Can be irreversible in adults, most important concern long term antipsych use
-Unknown mechanism
-No Tx |
|
|
Term
| Neuroleptic malignant syndrome |
|
Definition
-Life threatening
-Marked muscle rigidity, fever, leukocytosis
-mechanism: believe from extensive rapid blockade of postsynaptic dopamine receptors
-Tx: immediately stop medication, give dopamine agonist and muscle relaxant |
|
|
Term
|
Definition
-prototype neurolyptic drug
-inexpensive
-Anti-muscarinic and anti-alpha adrenergic |
|
|
Term
|
Definition
Many SE's including autonomic
-Highly sedative |
|
|
Term
|
Definition
-inexpensive
-potent
-less autonomic SEs |
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|
Term
|
Definition
| severe EPS and Hyperprolactemia |
|
|
Term
|
Definition
-Most efficacious
-Less EPS (better compliance)
-Only for pts resistant to typical drugs
-must monitor WBCs |
|
|
Term
|
Definition
-Small chance of agranulocytosis - very dangerous
-Weight gain, sedation, hyperlipidemia
-LOWER SEIZURE THRESHOLD |
|
|
Term
|
Definition
-2nd most efficacious
-one of most prescribed
-Strong Histamine H1 blocker |
|
|
Term
|
Definition
-Sedation
-Metabolic Syndrome
-LOWERS SEIZURE THRESHOLD |
|
|
Term
|
Definition
-similar structure to clozapine
-Strong Histamine H1 receptor antagonist |
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|
Term
|
Definition
|
|
Term
|
Definition
-Strongest D2 receptor blockert of atypicals
-less anti-muscarinic |
|
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Term
|
Definition
| -EPS and Hyperprolactemia at high doses |
|
|
Term
|
Definition
| Less affinity for muscarinic, Histamine H1, and alpha 1 adrenergic |
|
|
Term
|
Definition
-Less sedation, weight gain, and postural hypotension
Contraindicated for Heart problems- prolongs QT interval |
|
|
Term
|
Definition
D2 receptor Partial agonist- high affinity but only 30% activity
-Serotonin 5HT 2A antagonist |
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Term
|
Definition
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