Diaz - Week 7

Front 1

Name the four classes of antipsychotic meds

Back 1

1. Traditional phenothiazines
2. Butyrophenone - Haldol
3. dibenzodiazepine - Clozapine
4. Newer ones

Front 2

Name some traditional antipsychotics (6)

Back 2

-Chlorpromazine (Thorazine)
-Trifluoperazine (Stelazine)
-Fluphenazine (Prolixin)
-Prochloroperazine (compazine)
-Thioridazine (Mellaril)
-Haloperidol (Haldol)

Front 3

Name some newer anti-psychotics

Back 3

-Clozapine (clozaril)
-Risperadone (Risperdal)
-Quetiapine (Seroquel)
-Olanzapine (Zyprexa)
-Apripiprazole (Abilify)

Front 4

How can the antipsychotic drugs be administered?

(1 enteral, 1 Parenteral)

Back 4

Orally, or IM (intramuscular)

Front 5

What is the half life range of antipsychotics in general?

Back 5

10 to 20 hours

Front 6

What is the common dosing procedure followed with antipsychos?

Back 6

Once a day, at bedtime

Front 7

How was chloropromazine first discovered?

Back 7

by a frenchie experimenting with histamines and he saw that it induced "artificial hibernation" (loss interest in external stimuli but normal consciousness retained)

Front 8

What is the shared mechanism of action of all antipsychos?

Back 8

block dopamine receptors

Front 9

What is the relationship of DA receptor blocking ability and treatment of psychoses?

Back 9

positive correlation

Front 10

Other than DA receptors, what other receptors do antipsychotics block?

Back 10

Acetylcholine receptors

Front 11

How do the antipsychos affect the peripheral nervous system

Back 11

1. block ACh receptors
2. block alpha-adrenergic receptors

Front 12

what DA system is the pathway involved in motor behavior?

Back 12

Nigro-striatal dopamine pathway

Front 13

what DA systems are involved in emotional behavior and are the target of antipsycho meds?

Back 13

meso-limbic and meso-cortical systems

Front 14

what DA system is involved in hormone regulation?

Back 14

tubero-infundibular system

Front 15

The D2a and D2b receptors are the principle site of action for which group/s of antipsychotics?

Back 15

Phenothiazines and the butyrophenones

Front 16

Where are the two D2 receptors found?

Back 16

Cerebral cortex, limbic structures involved with emotion, striatum which is involved with motor behavior

Front 17

Where are the D3 receptors found?

Back 17

Cerbral cortex, limbic areas,

BUT NOT IN THE MOTOR AREAS LIKE STRIATUM

Front 18

What is the mechanism of action of Clozapine?

Back 18

blocks D3, D4 receptors and weakly blocks D2's

also binds to serotonin and histamine receptors

Front 19

What are the physiological effects of antipsychotics?

(think about which receptors are blocked...)

Back 19

-Dry mouth, constipation, and blurred vission
-Beta-adrenergic receptor blocking results in: increased heart rate, decrease in blood pressure, postural hypotension, and peripheral vasodilation which causes mild hypothermia.

Front 20

What are the behavioral consequences of antipsychos?

Back 20

tranquilized state induced, without loss of conciousness. In other words, an indifference to the immediate environment.

Most profound: relief of psychotic symptoms

Front 21

which psychotic symptoms are shown to be relieved with antipsychos?

Back 21

hallucinations, acute delusions, hostility, flat affect, and general withdrawal.

-May also alleviate the primary "core" symptoms like thought disorder and paranoia.

Front 22

To what effects of the antipsychotics does tolerance develop?

Back 22

Sedation;

cross-tolerance develops between antipsychotics

Front 23

To what effect of antipsychotics does tolerance not develop?

Back 23

the antipsychotic effect!

Front 24

what are the withdrawal effects of antipsychotics

Back 24

Virutally none

-some muscle discomfort..

Front 25

How easy/difficult is it to die from antipsychotics?

Back 25

Quite difficult because these are very safe. a single dose of 10,000 mg of chlorpromazine did not result in death.

Front 26

what is a rare reaction that can occur to antipsychotic medications?

Back 26

agranulocytosis ( a severe decrease in white blood cells)

Front 27

What is the risk of hematological effects Clozapine?

Back 27

2% risk, compared to other anti psychotics are 1 in three or four thousand.

Front 28

What is the most significant adverse effect of antipsychos?

Back 28

abnormal motor behaviors which begin soon after treatment begins. about 90 percent incidence

Front 29

Name the four most common toxic reactions:

Back 29

1. Acute Dystonia
2. Akathisia
3. Parkinson's Disease
4. Tardive Dyskinesia

Front 30

Explain Acute Dystonia or Dystonic reactions.

when is risk highest for developing dystonia?

Back 30

dystonia - sustained muscle contraction, usually results in jaw spasms.

Within the first five days

Front 31

-Explain Akathesia.
-Incidence rate is?
-Occurs within __ to ___ days after the onset of antipsychotic medication.

Back 31

-restlessness. most common motor abnormality
-20%
-5 to 40

Front 32

Explain the Parkinson syndrome which occurs with antipsycho use.

-Expressed within __ to ___ days

Back 32

Parkinsons symptoms appear: akinesia or bradykinesia, rigidity and tremor at rest.

- 5; 30

Front 33

Explain Tardive Dyskinesia

Back 33

Disorder involving involuntary abnormal movements typically of the tongue and mouth, like lip smacking and pursing, and darting tongue out of mouth.
-the longer the exposure to antipsychotics, the higher the risk for developing tardive dyskinesia

Front 34

What is the dopamine theory of schizophrenia?

Back 34

Purposes that schizophrenia is caused by overactive DA systems.

Front 35

Name the benefits (3) of Clozapine, the most significant advance since initial development of antipsychotic meds.

Back 35

-patients who are unresponsive to other meds are usually responsive to clozapine.
-reported to be more effective than competing antipsychotics
-fewer motor side-effects and lower risk for tardive diskinesia

Front 36

How does Clozapine effect DA receptors?

Back 36

Blocks activity of D3 and D4, but not so much D2a/b

Front 37

What non-DA receptors are known to be blocked by Clozapine?

Back 37

-Serotonin - 5HT2 and 5HT1c receptors
-muscarinic and ACh receptors
-histamine receptors

Front 38

What is the key argument posing challenge to the DA theory of psychoses

-Name some drugs involved:
----what other receptor do all of these meds block?

Back 38

Other meds which block serotonic receptors also provide clinical relief!


-Risperdal, Seroquel, Abilify, Zyprexa
-------they all block histamine receptors

Front 39

Name the three classes of antidepressants:

Back 39

1. "traditional" meds like the original Tricyclic antidepressants (TCAs) and MAOIs
2. Hetero-cyclic antidepressants
3. Newest generation

Front 40

what are the two subclasses of TCAs? and what are some drugs in those classes?

Back 40

A. nortriptyline (Aventyl, Pamelor)
protriptyline (Vivactyl, Triptyl)
B. imipramine (Tofranil, Janimine)
amitriptyline (Elavil, Endep),
clomipramine (Anafranil)

Front 41

Explain the mechanism of action of the TCAs

Back 41

block the reuptake of Serotonin (5HT) more efficiently than they block the reuptake of norepinephrine

OR

Vice versa