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17 Cards in this Set
- Front
- Back
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D2 receptor antagonists exert their therapeutic benefit primarily by blocking DA transmission in the __________ tract. This decreases the ________ (positive or negative) symptoms of scz.
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mesolimbic, positive (ex. hallucinations)
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What receptor do typical antipsychotics block? (main effect)
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dopamine 2
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What receptors do typical antipsychotics block that lead to unwanted side effects? What are these side effects?
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muscarinic (M1): blurry vision, dry mouth, conspitation, urinary retention
histaminic (H1): sedation, weight gain and alpha-1: orthostatic hypotension |
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What is akasthesia?
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subjective feeling of restless in the lower extremities
**can treat with beta blockers |
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What side effects does a D2 receptor blockade have on the three dopamine pathways that it is not targeting? 1. nigrostriatal, mesocortical, tuberoinfundibular
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1. nigrostriatal: extrapyramidal symptoms (dystonia, parkinsonism, akathsia)
2. mesocortical: worsening of negative symptoms (alogia, affective flattening, apathy) 3. tuberoinfundibular: hyperprolactinemia (infertility, decreased bone density) |
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What are some symptoms of Neuroleptic Malignant Syndrome? What is the appropriate treatment?
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muscle rigidity, fever, autnomic instability, elevated WBC, elevated CPK
treatment: stop antipsychotic, supportive treatment |
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What is tardive dyskinesia?
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involuntary choreoathetoid moveents of the face, trunk, or extremities
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_______ and ________ are high potency typical antipsychotics. ___________ is low potency.
terms: haloperidol, chlorpromazine, fluphenazine |
high potency: haloperidol, fluphenazine
low: chlorproazine |
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What two receptors do atypical antipsychotics block?
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D2 and 5HT2A
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Which neurotransmitter binds to a 5HT2A receptor?
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serotonin
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What is the normal effect of serotonin on dopamine release?
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serotonin attenuates dopaine release
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True or False: The effects of combined 5HT and DA antagonism (via an atypical antipsychotic) results in a smaller DA blockade in the mesocortical, nigrostriatal and tuberoinfundibular pathways.
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True.
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What is the major side effect of atypical antipsychotics?
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metabolic syndrome
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What is the most effective antipsychotic?
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Clozapine
**dirty drug, hits a lot of receptors |
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Approximately ______ percent of scz patients discontinued their medication due to ineffectiveness or side effects.
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75
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What are some psychosocial approaches to treatment?
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family education/therapy, CBT, supported employent, assertive community treatment, social skills training
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What effect does an atypical antipsychotic have on the mesocortical pathway?
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Normally, serotonin at the 5HT2A receptor decreases dopamine activity (which is already too low in scz patients).
An atypical antipsychotic would inhibit the inhibition of dopamine by serotonin--> Less DA blockade |
