Pharm Q8 Exam 10: Anti-Psychotics

Front 1

Schiz:
morbitity
onset
suicide
hospital

Back 1

-1%
-adolescence
-10% of schiz
-30% of hospitalizations are due to schiz

Front 2

schiz:
+ symp
- symp

Back 2

+: delusions, hallucinations, disorganized speech or posture, catatonia
-: non-psycho periods. reduced emotion, poverty of speech, apathy

Front 3

schiz:
prodromal signs

Back 3

(before psych episode)
-social isolaiton
-bad hygiene

Front 4

schiz subtypes (3)

Back 4

paranoid: delusions of persecution but speech is ok
catatonic: mutism, abnormal postures
disorganized: disorganized speech and behavior

Front 5

neurobiological correlates of schiz (3)

Back 5

-low blood flow to caudate nucleus and frontal lobes
-small hippocampus
-big ventricles

Front 6

caudate nucleus responsible for

Back 6

-voluntary movement

Front 7

DISC1

Back 7

-codes for proteins involved in brain signalling
-are crazy unorganized in medial temporal lobes of schiz pts

Front 8

_______ affinity is directly correlated with efficacy

Back 8

-D2 (dopamine) receptor binding

Front 9

reserpine and psycho implications

Back 9

-old antihtn drug
-downs brain dopamine (affinity for D2 recept)
-found to have anti-psycho effects

Front 10

amphetamines and psycho implications

Back 10

-cause release of dopamine
-can induce psychotic-like episodes

Front 11

chlorpromazine

Back 11

-dopamine blocker
-original antipsych drug
-high D2 affinity and efficacy

Front 12

anti-psychs:
aka
effective in ___% of pts
mech

Back 12

-neuroleptics
-70%
-all are dopamine receptor antagonists

Front 13

anti-psychs:
how long to work

Back 13

-dopamine is blocked hrs after admin
-however, effect takes weeks
-don't know why, but dop is apparently being modified in body

Front 14

neuroleptics:
aka
relapse
better at tx'ing

Back 14

-anti-psychs
-2/3 of pt w/in 1 yr (who stop meds)
-positive symp

Front 15

______ receptor blocking drugs for schiz can work w/in hours of admin. Currently in dev

Back 15

-leutamate

Front 16

classic generic anti-psych drugs (2)

Back 16

-chlorpromazine
-haloperidol

Front 17

important atypical psych drug

Back 17

-clozapine

Front 18

major typical antipsych (6)

Back 18

-chlorpromazine (Thorazine) (low potency)
-Fluphenazine (Permitil, Prolixin) (high p.)
-haloperidol (Haldol) (high p.)
-pimozide (Orap) (high p.)
-thioridazine (Mellaril) (low p.)
-thiothixene (Navane) (high p.)

Front 19

Major atypical antipsychs (6)

Back 19

-aripiprazole (Abilify)
-clozapine (Clozaril)
-olanzapine (Zyprexa)
-quetiapine (Seroquel)
-risperidone (Risperdal)
-ziprasidone (Geodon)

Front 20

typical antipsych:
mech (2)
effect (3)

Back 20

-D1/D2 rec ant in CNS
-D2 block to mesocortical, mesolimbic areas (blocking midbrain->limbic system, which leads to ...-->)
-...reduction in disorderd thought, hallucinations, etc
-requires several weeks to work
-good for + symp, not so good for -

Front 21

SE of classical antipsych:
mech

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1. D2 block of nigrostriatal syst
-extra-pyramidal symptoms:
parkinson-like symptoms
2. D2 block tubero-infundibular sys (hypothal-> pituitary) -> lots of hormones are secreted, messes with sex things

Front 22

dystonia
akathisia
dyskinesia

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(all side effects of classical antipsych)
-m. spasms
-m. restlessness
-twitches, twisting

Front 23

Dental concerns for classical antipsychs

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-postural hypotn (alpha-adrenoceptor block)
-dry mouth, blurred vision, urinary retention (muscarinic block)
-sedation (H1 recep block)
-EPS (D2 block)

Front 24

Atypical antipsych:
mech (2)
effect (3)

Back 24

-weaker D2 antag, stronger D1, D4
-also block 5-HT1A/2A (serotonin)
-fewer EPS
-good for + and - sympt
-more effective : . now 1st line drug

Front 25

clozapine SE

Back 25

-agranulocytosis (1%)

Front 26

SE of chlorpromazine, haloperidol, flupentixol

Back 26

Know this!!
-neuroleptic malignant syndrome (low risk)
-m. rigidity, fever, delirium, etc.

Front 27

what antipsych have risk of neuroleptic malig syndrom (3)

Back 27

Know this!!
-chlorpromazine
-haloperidol
-flupentixol

Front 28

DA antags also have an _____ effect

Back 28

-anti-emetic

Front 29

antipsych:
if pt is newly medicated and is ______, consult doc b/c ______

Back 29

-drooling
-dose might be too high

Front 30

antipsych prototype
also strong ______ blocker
potency
SEs

Back 30

-chlorpromazine
-alpha 1 blocker
-low
-hypotns, sedation, antichol
(like all low potency agents)

Front 31

anti-psych:
high potency agents (5) likely to induce

Back 31

-haloperidol
-fluphenazine
-pimozide
-thiothixene
-trifluoperazine
-EPS

Front 32

antipsychs SEs (3)

Back 32

-weight gain
-hyperglycemia
-diabetes