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30 Cards in this Set

  • Front
  • Back
What is the definition of schizophrenia?
• psychotic disorders characterized by a mix of symptoms
• symptoms involve perception, ideations, reality, cognition, emotions, behavior and attention (divided into positive & negative symptoms)
List examples of negative symptoms
• anhedonia
• alogia
• amotivation
• blunted affect
• poor grooming
• poor social skills
• poverty of speech (can't make a sentence)
List examples of positive symptoms
• agitation
• delusions
• hallucinations
• illusions delusions
• ideas of reference
• insomnia
• paranoia
What are some theoretical causes of schizophrenia?
• Transmethylated hypothesis: symptoms arise from the endogenous production or abnormal accumulation of methylated substrates

• Dopamine hypothesis: symptoms arise from abnormal mesocortical (Negative) and/or mesolimbic (Positive) dopaminergic activity
What are the 4 major dopamine tracts?
• Mesolimbic: increases dopamine
• Mesocortical: decreased dopamine
• Nigrostriatal: extra-pyramidal symptoms from dopamine blockade
• Tuberinfundibular: if blocked will increase prolactin
What different types of schizophrenia?
• catatonic
• disorganized
• paranoid
• residual
• undifferentiated
What is the definition of a delusion?
erroneous beliefs involving misinterpretation of reality and are relatively resistant ot evidence that refutes them (fixed delusion)
What is the definition of a hallucination?
• perceptual abnormalaties that can involve any sensory system
• auditory is very common
Name and describe the 4 phases of schizophrenia?
• Prodromal phase: start of symptoms
• Acute phase: full-blown symptoms
• Stabilization phase: acute symptoms decrease
• Stable phase: symptoms markedly decline
What is MOA of the antipsychotics?
antagonist at dopamine-2 receptors
List the 4 general categories of antipsychotics
• conventional phenothiazines
• butyrophenone
• atypical
• others
Give examples of conventional phenothiazines
• Chlorpromazine (Thorazine)*
• Fluphenazine (Prolixen)*
• Medoridazine
• Perphanazine (Trilfon)*
• Thiroridazine
• Trifluperazine

* most common phenothiazides
Give an example of a butyrophenone
Haloperidol (Haldol)
List examples of atypical antipsychotics
• Aripiprazole (Ablify)
• Clozapine (Cloazapine)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)
What drug is best at controlling schizophrenia, but has many adverse effects?
Clozapine (Clozaril)
Which antipsychotic drugs have the highest incidence of EPS side effects?
• Fluphenazine (Prolixin)
• Haloperidol (Haldol)

* patient on long term Haldol will be given Cogentin or Benadryl to counteract the EPS affects
Which antipsychotic drug has the highest incidence of sedation and decreased BP as side effects?
Chlorpromazine (Thorazine)
What lab is required for a patient taking Clozapine (Cloazaril)?
• patients on Clozapine (Clozaril) require a CBC every two weeks
• Clozapine can cause agranulocytosis
What are neurologic effects of typical antipsychotic agents?
• Parkinsonism: bradykinesia, rigidity, tremor, or akinesia (treated with ACH agents like diphenhydramine or benzotropine

• Dyskinesia: spasms of muscle groups (Tx: ACH)

• Akathisias: somatic restlessness & inability to stay calm (TX: lipophilic beta blocker like propanolol and ACH agents)

• Tardive Dyskinesias: from long-term therapy (at least 6 months) of antipsychotics
What are characteristics of Neuroleptic Malignant Sydrome?
• serious complication, common with high potency drugs
• causes autonomic system dysfunction
How do patients with neuroleptic malignant syndrome present?
• agitation
• confusion
• fever
• labile blood pressure
• sweating
• tachycardia
What is the treatment for neuroleptic malignant syndrome?
• must discontinue agent & give supportive therapy
• Bromocriptine (PO) & Dantrolene (IV or PO) may be used
What are some endocrine/libido side effects of antipsychotic agents?
• galactorrhea & menstrual changes as a result of hyperprolactinemia
• sexual dysfunction
• weight gain
What are characteristics of atypical antipsychotics?
• have decreased EPS, decreased incidence of tardive dyskinesias, and improved efficacy

• also block 5-HT2, which may improve activity for negative symptoms and reduce EPS

• many use these agents as first line
What are characteristics of Clozapine (Clozaril)?
• less potent dopamine blocker than typical antipsychotics and is a 5-HT2 antagonists
• not associated with EPS or tardive dyskinesia & may lead to improvement of negative symptoms
What are side effects of Clozapine (Clozaril)?
• Agranulocytosis (must have CBC every 2 weeks)
• Fever
• Rapid Heart Rate
• Sedation
• Weight gain
What is the dosage and ADE of Risperidone (Risperdal)?
• Dose: 1-16 mg (in divided doses)
• ADE: some orthostatis, sedation (above 10 mg/day will see EPS)
What is the dosage and ADE of Olanzapine (Zyprexa)?
• Dose: 5-20 mg/day
• ADE: sedation, ACH, orthostasis (like Clozapine w/out side effect profile)
What is the dosage of ADE of Quetiapine (Seroquel)?
• Dose: 100-800 mg/day
• ADE: headache, low EPS incidence, moderate sedation, possible cataracts, weight gain
What is a common, but unapproved, use of Quetiapine (Seroquel)?
used for hypnotic/sedative effects