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80 Cards in this Set
- Front
- Back
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what are 4 positive symptoms of schizophrenia?
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delusions
hallucinations disorganized speech catatonia |
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what are 4 negative symptoms of schizophrenia?
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affective flattening
alogia avolition anhedonia |
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what are 3 cognitive symptoms of schizophrenia?
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attention deficits
loss of memory diminished executive function |
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what are 3 mood symptoms of schizophrenia?
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dysphoria
suicidality hopelessness |
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what is the hypothesized cause of schizophrenia?
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overactivity of dopamine in the mesolimbic pathway
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what are 3 drugs that will induce psychosis?
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amphetamines
cocaine L-DOPA |
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how will amphetamines induce pscyhosis?
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increase presynaptic release of dopamine
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how will cocaine induce psychosis?
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inhibits presynaptic dopamine reuptake
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how will L-DOPA induce psychosis?
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increases dopamine availability
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how do the cognative symptoms of schizophrenia limit the dopamine hypothesis?
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because these symptoms are associated with decreased, not increased, dopamine in the prefrontal cortex
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what are 2 drugs that can induce psychosis without increasing dopamine?
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LSD (5HT2 agonist)
MNDA (ketamine) |
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what are the 2 pathways affected in schizophrenia?
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mesolimbic
mesocortical |
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what leads to the positive symptoms in schizophrenia?
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excess D2 receptor activation in the mesolimbic pathway
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what leads to the negative symptoms in schizophrenia?
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excess 5HT2A activation in the mesolimbic and mesocortical pathways
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what will reduced glutamate in the pathways lead to?
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the opposite effect of dopamine
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what is the acute phase of treatment?
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goal is to treat the postitive symptoms
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what is the stabilization phase of treatment? (3)
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goal is to minimize the occurrence of another acute episode (so must use a strong D2 blocker)
get the patient compliant involve the family |
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what is the stable phase of treatment? (2)
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goal is to ensure complaince and improve the quality of life
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how should you administer drugs during the acute phase of treatment?
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IM
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what causes EPS?
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blockade of dopamine receptors in the nigrostriatal pathway
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who do acute EPS tend to be worse in?
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younger patients
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how soon will acute EPS be seen?
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within days
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what are 3 acute EPS?
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acute dystonia
parkinson's like symptoms akathisia |
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what is procyclidine?
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an anticholinergic drug to treat acute EPS
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what is orphenadrine?
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an anticholinergic drug to treat acute EPS
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what is benzatropine?
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an anticholinergic drug to treat acute EPS
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what is diphenhydramine?
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an anticholinergic drug to treat acute EPS
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how can you treat acute EPS medically?
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anticholinergic drugs
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what are 2 chronic EPS?
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tardive dyskinesia and dystonia
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what may temporarily relieve chronic EPS?
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increasing the dose or using a more potent D2 blocker
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what causes neuroendocrine side effects?
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blockade of dopamine receptors in the tuberoinfundibular pathway which removes tonic dopamine mediated inhibtion of prolactin levels from the anterior pituitary
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what will hyperprolacintemia lead to? (3)
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galactorrhea
amenorrhea infertility in some |
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how can you prevent neuroendocrine symptoms?
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using smaller doses of typicals or switching to atypicals
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what will be the side effects from blocking muscarinic receptors? (5)
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dry mouth
difficulty urinating constipation blurred vision confusion |
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what will be the side effects from blocking alpha-adrenoreceptors?
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orthostatic hypotension --> tachycardia
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what will be the side effects from blocking histamine receptors?
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sedation
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what are 3 adverse effects common to both typicals and atypicals?
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cardiac arrhythmias
seizures weight gain |
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what is neuroleptic malignant syndrome?
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resembles a form of parkinsoniam with autonomic instability, elevated serum creatine kinase, rhabdomyalasis, and potential kidney failure
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what are 2 rare but serious side effects of antipsychotics?
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neuroleptic malignant syndrome
hypersensitivity |
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what is the MOA of typical antipsychotics?
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potent D2 receptor blockers
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what causes neuroendocrine side effects?
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blockade of dopamine receptors in the tuberoinfundibular pathway which removes tonic dopamine mediated inhibtion of prolactin levels from the anterior pituitary
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what will hyperprolacintemia lead to? (3)
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galactorrhea
amenorrhea infertility in some |
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how can you prevent neuroendocrine symptoms?
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using smaller doses of typicals or switching to atypicals
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what will be the side effects from blocking muscarinic receptors? (5)
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dry mouth
difficulty urinating constipation blurred vision confusion |
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what will be the side effects from blocking alpha-adrenoreceptors?
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orthostatic hypotension --> tachycardia
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what will be the side effects from blocking histamine receptors?
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sedation
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what are 3 adverse effects common to both typicals and atypicals?
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cardiac arrhythmias
seizures weight gain |
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what is neuroleptic malignant syndrome?
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resembles a form of parkinsoniam with autonomic instability, elevated serum creatine kinase, rhabdomyalasis, and potential kidney failure
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what are 2 rare but serious side effects of antipsychotics?
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neuroleptic malignant syndrome
hypersensitivity |
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what is the MOA of typical antipsychotics?
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potent D2 receptor blockers
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what is chlorpromazine?
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a typical antipsychotic
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what is fluphenazine?
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a typical antipsychotic
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what is haloperidol?
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a typical antipsychotic
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what are 3 typical antipsychotics?
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chloropromazine
fluphenazine haloperidol |
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what are 4 adverse effects of haloperidol?
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EPS
hyperprolactinermia seizures weight gain |
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what are 3 advantages of haloperidol?
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very little sedation
low antimuscarinic effects little orthostatic hypotension |
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what is the MOA of atypicals?
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5HT2a blockers and less potent D2 blockers
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what are 6 general side effects of atypicals?
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anti-cholinergic
anti-alpha adrenergic anti-histaminergic weight gain neuroleptic malginant syndrome hypersensitivity |
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what is clozapine?
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the only atypical antipsychotic that is useful in treatment of resistant groups
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when can you use clozapine? (3)
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if the patient is unresponsive to 2 other neuroleptics
if the patient has tardive dyskinesia if the patient has severe EPS |
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why is the use of clozapine restricted?
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due to fatal neutropenia in some
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what is mandatory with clozapine?
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CBC monitoring
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what are 3 adverse effects of clozapine?
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hyper-salivation
cardiac arrhythmias seizures |
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what is olanzapine?
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most commonly used atypical during a psychotic break (superior to haloperidol)
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what are 3 adverse effects of olanzapine?
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EPS at high doses
more weight gain seizures |
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when will EPS present with olanzapine?
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at doses of 25-30mg
therapeutic dose is 10mg |
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what is risperidone?
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the most commonly prescribed antipsychotic next to olanzapine and haloperidol for acute breaks
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what is the MOA of risperidone?
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blocks 5-HT receptors with more affinity
blocks D2 receptors with more affinity |
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what are 2 adverse effects of risperidone and at what dose will they occur?
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EPS/neuroendocrine effects
weight gain occur at doses higher than 8mg |
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what is quetiapine?
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an atypical antipsychotic commonly used to treat parkinson's patients
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what is an advantage of quetiapine?
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less potential for exacerbating parkinson's because it blocks D1, D4, and 5HT, not D2 receptors
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what are 2 adverse effects of quetiapine?
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somnolence
postural hypotention |
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what is a benefit of ziprasidone?
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less weight gain
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what is ziprasidone?
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a newer generation atypical
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what is an adverse effect of ziprasidone?
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it can cause cardiac arrhythmias in patients with a baseline risk (incl taking diuretics that prolong the QT interval)
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what is aripiprazole?
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a newer generation atypical
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what is the MOA of aripiprazole?
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blocks 5HT1A receptors in addition to 5HT2A
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what can aripiprazole also be used to treat?
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adjuvant in depression
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what is a benefit of aripiprazole?
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less weight gain
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what is an adverse effect of aripiprazole?
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black box warning for risk of death in senile patients
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