M2-C2-L55 --> Antipsychotics

Front 1

What is the major theory behind the Dopamine Hypothesis of schizophrenia?

Back 1

Excess of dopaminergic neurotransmission

Front 2

Dopamine DEPLETING agensts (reserpine) does what?

Back 2

Improve psychotic phase

Front 3

Dopamine receptor blockers (antagonists) do what?

Back 3

Improve psychosis symptoms

Front 4

Dopamine agonists (L-Dopa, cocaine) do what?

Back 4

Induce psychotic symptoms

Front 5

All typical antipsychotic drugs are what kind of drugs? What do they especially affect?

Back 5

Dopamine receptor antagonists.

D2 dopamine receptors

Front 6

What side effects can be seen by blocking dopamine receptors in the basal ganglia?

Back 6

Extrapyramidal side effects

Front 7

What is the site of action (systems) for antipsychotic effects of neuroleptic drugs?

Back 7

Mesolimbic/mesocortical system

Front 8

Antipsychotics increase what hormone?

Back 8

Prolactin

Front 9

Blocking dopamine receptors in the Chemoreceptor Trigger Zone (CTZ) does what?

Back 9

Protection against nausea and emesis. (anti-emetic action)

Front 10

Antipsychotic effects on the kidney do what? via what?

Back 10

Diuretic action

via blocking antidiuretic hormone

Front 11

What is the superior combo of drugs in treating a particular symptom complex?

Back 11

No such thing as a superior drug or combo.

However, atypical antipsychotics (e.g.- clozapine) is preferred in order to decrease extrapyramidal side effects

Front 12

The right antipsychotic drugs to use is dependent on what? x2

Back 12

Which side effects to avoid.

MD experience

Front 13

Potent neuroleptics:

- Decrease what effects?
- Increase what effects?

Back 13

Autonomic effects

Extrapyramidal effects

Front 14

Why is it hard to OD on antipsychotics?

Back 14

High therapeutic index

Front 15

Muscarinic receptor blockade causes what symptoms? x4

Back 15

Constipation
Urinary retention
Dry mouth
Loss of accomodation

Front 16

Alpha-adrenergic blockade causes what symptoms? x3

Back 16

Orthostatic hypOtention

Impotence
Failure to ejaculate

Front 17

Dopamine receptor blockade in the basal ganglia leads to what symptoms? x3

Back 17

Parkinsonian syndrome

Akathisia

Dytonia

Front 18

Dopamine receptor supersensitivity causes what?

Back 18

Tardive Dyskinesia

Front 19

Toxic-confusional state is caused by what physiological mechanism induced by antipsychotics?

Back 19

Blockade of muscarinic receptors

Front 20

Hyperprolacteremia is caused by what mechanism where?

What are the results? x4

Back 20

Dopamine receptor blockade in the endocrine system (hypothalamus/pituitary)

Amenorrhea
Galactorrhea
Infertility
Impotence

Front 21

Therapeutic doses of antipsychotics can cause which of the following:

a.) hyperthermia
b.) hypothermia
c.) both
d.) none of the above

Back 21

c.) both hyperthermia and hypothermia

Front 22

Tolerance develops typically to what physiological blockade?

Back 22

Antimuscarinic

Front 23

What are the four extrapyramidal syndromes that appear concomitantly with antipsychotic adminitration?

Back 23

1. Acute dystonia
2. Parkinsonian syndrome
3. Neuroleptic Malignant syndrome.
4. Akathisia

Front 24

What are the two extrapyramidal syndromes that appear following prolonged treatment with antipsychotics?

Back 24

1. Tardive Dyskinesia
2. Withdrawal-Emergent syndrome

Front 25

Acute dystonia can be somewhat resolved with what?

Back 25

Anticholinergic antiparkinsonian agents

Front 26

Parkinsonian syndrome can be somewhat resolved with what?

Back 26

Anticholinergic antiparkinsonian agents.

Front 27

Describe neuroleptic malignant syndrome. x4

Back 27

Stupor
Catatonia
Autonomic instability
Myoglobinemia

Front 28

T/F - Neuroleptic malignant syndrome can be resolved with antiparkinsonian agents.

Back 28

False

Front 29

What is the treatment for neuroleptic malignant syndrome? x3

Back 29

Immediate attention due to high mortality rate

Cessation of neuroleptics
Supportive care
Dantrolene

Front 30

Akathisia can be resolved by what? x3

Back 30

1. Reduce neuroleptics
2. Antianxiety drugs
3. Propanolol

Front 31

What is the treatment for Tardive Dyskinesia?

Back 31

No adequate therapy.

Best approach is preventative

Front 32

Clozapine is an example of what?

Back 32

Atypical antipsychotic

Front 33

Clozapine is associated with an increased incidence of what? x2

Back 33

Agranulocytosis

Seizures

Front 34

Describe Tardive Dyskinesia.

Back 34

1. Lip sucking/smacking
2. Lateral jaw movements
3. Darting of tongue
4. Choreiform movements
5. Dystonic athetoid movements

Front 35

T/F - Tardive Dyskinesia is nocturnal.

Back 35

False. Symptoms disappear during sleep

Front 36

With Tardive Dyskinesia:

- effect by using increased neuroleptics
- effect by using antiparkinsonian agents

Back 36

Will mask symptoms (DON'T USE)

Worsen symptoms (DON'T USE)

Front 37

Withdrawal Emergent Dyskinesias can be resolved how? How long will resolve take?

Back 37

Anticholinergic antiparkinson's agents.

Rapid resolve

Front 38

What is the best way to treat all Extrapyramidal side effects.

Back 38

Prevention