Pharmacology

Front 1

Paranoid Schizophrenia
Symptoms?

Back 1

Positive symptoms (drug responsive): delusions, thought disturbances, hallucinations
Negative (drug resistant):
apathy, withdrawal.

Tends twds negative ultimately.

Front 2

Paranoid Schizophrenia
Typical drugs?

Back 2

BUT/PHE/THI/XAN

Butyrophenones, Phenothiazine, Thioxanthines,

The latter two are analogs and act in a similar way, the fromer has fewer autonomic effects and is more potent.

Front 3

Paranoid Schizophrenia
Thioxanthines
example and effects?

Back 3

e.g. Thiathixene.

effects same as below

Front 4

Paranoid Schizophrenia
Phenothiazines
examples and effects?

Back 4

e.g. Flu-phen-azine, Chlor-prom-azine
Antipsychotic effects, motor effects, sedation, hypotension

Front 5

Paranoid Schizophrenia
Butyrophenones
examples and effects?

Back 5

HALO-DROP-DUMP
e.g. halo-peridol, dro-peridol, dumperidone (not butyrophenone per se but derived from it)
Antipsychotic effects, motor effects

Notes: Droperidol with Fentanyl = neuroleptanalgesic (Sedation)
Domperidone peripheral action only, anti-emetic (Think Dump kind of puking)

Front 6

Paranoid Schizophrenia
SEs of Typicals

Back 6

Sedation, Orthostatic hypotension, Parkinsonism and Dytonia (extrapyramidal effects), Akathisia (restless leg), Dry mouth, pseudopregnancy (prolactin), lower seizure threshold, tardive dyskinesia, dermatitis and photosensitivity, jaundice

Front 7

Paranoid Schizophrenia
Typicals
Mech? site of action?

Back 7

Post synaptic blockade of D2 dopaminergic transmission

1. Mesolimbic system (Nucleus Accumben) -> anti-psychotic (desirable)
2. Medulla (CTZ) -> anti-emetic (desirable)
3. Basal ganglia -> extrapyramidal effects (adverse)
4. Hypothalamus -> pseudo-pregnancy (adverse)

sedation, hypotension effects likely unrelated to dopaminergic

Front 8

Paranoid Schizophrenia
Atypical (NEW) drugs
Def?

Back 8

Anti-psychotic effects with less adverse extrapyramidal motor effects and pro-lactin effects (except risperidone)

Front 9

Paranoid Schizophrenia
Atypicals
examples?

Back 9

risperidone, Cloz-apine, Olanz-apine, Quet-apine (Olana's, cloz quet niice)

Front 10

Paranoid Schizophrenia
Atypicals
Mech?
SEs?

Back 10

blocks D-2 receptors and 5HT-2 receptors (unknown effects)

STILL, may cause tardive dyskinesia

Front 11

Anti-psychotics
Dentist warnings?

Back 11

Opiods with local like lidocaine can lead to status epilepticus and death. Low seizure threshold.