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40 Cards in this Set
- Front
- Back
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what are the 4 NT changes that can undergo in Schizophrenia
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Nigrostriatal
Mesolimbic Mesocortical Tuberoinfundibular |
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match the following
extrapyramidal system, movement Nigrostriatal Mesolimbic Mesocortical Tuberoinfundibular |
nigrostriatal
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match the following
memory, stimulus processing, motivational behavior Nigrostriatal Mesolimbic Mesocortical Tuberoinfundibular |
mesolimbic
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match the following
cognition, communication, social functioning, response to stress Nigrostriatal Mesolimbic Mesocortical Tuberoinfundibular |
mesocortical
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match the following
regulates prolactin release Nigrostriatal Mesolimbic Mesocortical Tuberoinfundibular |
tuberinfundibular
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match the following
low dopamine levels = high dopmaine levels = parkinsons, schizophrenia |
low = parkinsons
high = schizophrenia |
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what is GABA's effect on Dopamine
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GABA inhibits Dopamine release
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what happens in the 1st episode of schizophrenia
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withdrawn, suspicious, peculiar behavior
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what happens with acute episodes of schizophrenia
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lose touch with reality
brain creates false reality |
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what is the DSM 4 criteria for schizophrenia
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2 or more of the following during a 1 month period:
dellusions, hallucinations, disorganized speech, grossly disorganized, negative symptoms(alogia, avolition) |
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negative or positive symptoms are cause by
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negative symptoms = too little dopamine
positive symptoms = too much dopamine |
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what are persistent symptoms of schizophrenia
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fixed hallucinations
fixed delusions poor insight, judgement |
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what is the main scale used in schizophrenia monitoring
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positive and negative syndrome scale (PANSS)
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when is ECT used
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when pt doesn't respond to antipsychotics
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what is the potency of chlorpromazine, fluphenazine, haloperidol, thioridazine, thiothixene
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thioridazine 100mg low
chlorpromazine 100 mg low thiothixene 4 mg high fluphenazine 2mg high haloperidol 2mg high |
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what is the MOA of atypical antipsychotics
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Dopamine 2 Rc antagonist
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what are the antipsychotics that can be given as depot injections for noncompliant pts
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fluphenazine
haloperidol risperidone |
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what are the 1st 3 stages of Schizo tx
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stage 1 - atypical antipsychotic monotherapy for 12 weeks
stage 2 use a different SGA/FGA from stage 1 stage 3 use clozapine for 6 months and monitor for agranulocytosis |
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long acting antipsychotics are used in what kind of pt
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non compliant pts
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why do you stabilize pts on oral agent when using long acting antipsychotics
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done to test pt tolerance
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how often are the following injected
Haloperidol Fluphenazine Risperidone |
Haloperidol - once monthly
Fluphenazine - weekly Risperidone - every 2 weeks |
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what are the main SE of chlorpromazine
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sedation
anticholinergic orthostasis |
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what antipsychotic also causes cholestatic jaundice
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chlorpromazine
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what antipsychotics cause metabolic syndrome
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clozapine
olanzapine |
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what antipsychotics cause increase in prolactin
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haloperidol
risperdone (especially) |
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what are the SE of haloperidol
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EPS
increase prolactin levels |
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what is the best way to treat tardive dyskinesia
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switch from FGA to clozapine
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what are cardinal features of Neuroleptic Malignant Syndrome
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fever > 38C
altered conciousness rigidity autonomic dysfunction |
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what is the treatment for Neuroleptic Malignant Syndrome
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supportive therapy: cool blankets, fluids
bromocriptine (DA agonist), dantrolene |
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what are symptoms of hyperprolactinemia
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galactorrhea
amenorrhea sexual dysfunction |
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how do you treat hyperprolactenemia
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decrease dose
dopamine agonist (bromocriptine, amantadine) |
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what antipsychotic causes agranulocytosis
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clozapine
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what antipsychotics cause metabolic syndrome
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olanzapine
clozapine |
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what is metabolic syndrome
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3 of more: abdominal obesity, dyslipidemia, HTN, increase FBS
weight gain (low potency APD) |
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what antipsychotics cause cardiac problems
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thioridazine
ziprasidone |
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what are the cardiac SE of antipsychotic use
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QT interval changes
monitor QTc > 500 or changes in QT interval |
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what are the 1st line agents for tx of schizo
robert always questioned our zoo |
risperdone
olanzapine quetiapine ziprasidone aripiprazole |
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what are good adjunctive agents for EPS symptoms
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anticholinergics
BZD propranolol |
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what can be used to treat pt with coexisting agitation/excitment
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PO/.IM BZD PRN
or PO/IM antipsychotic PRN -nonresponder use the other |
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what can be used to treat pt with coexisting insomnia
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BZD PRN
or Zolpidem PRN nonresponder - trazodone |
