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93 Cards in this Set
- Front
- Back
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What are the positive symptoms of schizophrenia? what are they due to?
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hallucinations
bizzare behavior, thought disorders Due to increases dopaminergic activity |
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What are the negative symptoms of schizophrenia?
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loss of function
blunted emotions lack of affect* |
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What seems to be the main cause of schizophrenia?
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excessive dopaminergic activity
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What is the main role of the nigrostriatal system?
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this is used in control of posture and voluntary movements
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What is the problem in Parkinsons?
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a decrease in dopamine activity from the nigrostriatal system
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What are *extrapyramidal symptoms*
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these are parkinsons like symptoms caused by drugs
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What is the mesolimbic-mesocortical system associated with?
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higher mental functions and emotions
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what do imbalances is the mesolimbic-mesocortical systems cause?
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this causes psychosis
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What does the pituitary secrete?
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prolactin (among other things)
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How do antipsychotics classically work?
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these block D2 subtype of dopamine receptors
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What is correlated with blocking the "positive" schizophrenia symptoms?
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how well a drug blocks the D2 receptor
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What do New antipsychotics act on?
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these block 5-HT2a receptors.
these work better against negative symptoms |
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What receptors do 'classical' antipsychotics act on?
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D2, alpha, and histamine
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What are 'high potency' antipsychotics mostly specific for?
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dopamine receptors
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What do classical antipsychotics do in the limbic system? results?
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these block D2-
this decreases fear, hostility, agitation, allucinations and dellusions |
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How do classical antipsychotics effect the sedation state or schizophrenic pts?
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these have a "neuroleptic" effect- aka a decrease in arousal/motility
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How do classical antipsychotics affect vomiting?
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these are antiemetic- they block dopamine in the chemoreceptor trigger zone
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How safe are classical antipsychotics?
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these are fairly safe, and have a high therapeutic index
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How bad are the side effects of antipsychotics?
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these are unpleasant- and usually leads to the pts to stop taking them (plus...they are crazy so that might be why)
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What are the extrapyramidal side effects of antipsychotics?***
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Akathisia (anxiety, restlessness, rocking, pacing)
Dystonia (involuntary spasms, sustained abnormal postures) Parkisons like symptoms |
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How do you treat the extrapyramidal effects of antipsychotics?
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you treat with anitcholincergic drugs
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What causes tardive dyskinesia?
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this is caused by long term antipsychotic therapy
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What drugs are LESS likely to cause tardive dyskenesia?
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Clozapine (Clozaril) and olanzapine (zyprexa)
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How do antipsychotics affect appetite and temperature?
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it suppresses both
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How do antipsychotics affect weight?
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these cause weight gain
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How do antipsychotics affect prolactin?
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these increase the release of prolactin (because DA inhibits it).
this causes amenorrhea, lactation, decreased libido, and infertility in women (same kinds of symptoms in men as well) |
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What are the autonomic effects of antipsychotics?
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these are like TCA's - blocking M, A, and H receptors.
hypotension, and vagal blockade |
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How do antipsychotics affect seizures?
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these can cause seizures, must be used with caution in epileptics
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what is neuroleptic malignant syndrome?
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this is a life threatening condition, cause by antipsychotics. -
muscle rigidity, catatonia, altered BP/HR |
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How do you treat neuroleptic malignant syndrome?
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Dantrolene- a muscle relaxant.
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What type of drug is chlorpromazine?
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Thorazine is a phenothiazine
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What does chlorpromazine treat? (4 major things)
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Thorazine is used to treat Schizophrenia
Nausea/vomiting-pre anestesia (compazine) Alcohollic hallucinations (from drug abuse) psychotic episodes in mania |
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How is chlorpromazine absorbed?
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this is erratically absorbed orally
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what is the metabolism of chlorpromazine like?
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this has a slow metabolism in the liver. 24-48 hour half life
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What receptor types does chlorpromazine block as side effects?
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anticholinergic
alpha receptor block |
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how does chlorpromazie affect the heart?
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this is negative ionotropic
and caused long QT |
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what are chlorpromazine's neruo side effects?
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this lowers the seizure threshold
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how does chlorpromazine affect the kidneys?
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this may produce renal deposits
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What receptor type does Haloperidol block?**
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D2 ONLY
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When is haldol usually given?
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this is usually given to treat acute psychotic situations
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What is the major drawback of using haldol?
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this is the most likely drug to cause extrapyramidal symptoms (dyskenias, and such)
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What receptors does Clozapine bind to?
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D4 and 5-HT2a
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What are the extra pyramidal effects of clozapine like?
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these are minimal
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Other than D4 and 5-HT2a, what receptors does clozapine block?
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this blocks M, H, and a1 receptors
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What serious side effect can clozapine have on the blood?
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this can cause agraunlocytosis
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What receptors does Olanzapine block?
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Zyprex blocks D4 and 5-HT2a
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other than D4 and 5-HT2a what does Olanzapine (zyprexa) block?
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this blocks M
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What is Olanzapine used to treat?
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zyprexa treats bipolar disorder
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What are the main side effects of Olanzapine?
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zyprexa cause weight gain, hyperglycemia and type 2 diabeties
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What is the first line drug for treating pyschosis?
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risperidone
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What does risperidone block?
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this blocks 5-HT2a, alpha receptors
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How does risperidone affect the basal ganglia?
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this enhances DA transmission in basal ganglia
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What is the major side effect of risperidone?
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this causes long QT
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What receptors does Ziprasidone block?
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Geodon blocks D2 and 5HT-2a
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other than antipsychotic, what other activity does ziprasidone (geodon)have?
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this has some antidepressant activity
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What are the major side effects of Ziprasidone (Geodon)
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LONG QT
sedation Hyperprolactinemia caution with seizure history |
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What is Quetiapine?
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Seroquel is an atypical antipyschotic
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What are the common side effects of Quetiapine?
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seroquel causes-
weight gain, drowsiness, xerostomia |
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What kind of drug is Pimozide?
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Orap is an atypical antipsychotic
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What is Pimozide used to treat?
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Orap treats tourettes syndrome
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What are the side effects of Pimozide (Orap)?
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this causes extrapyramidal effects
and ECG changes |
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Whats the most important side effect of Ziprasidone (geodon)
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may cause hyperprolactinemia
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What type of drug is Aripiprazole?
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Abilify is a dopamine system stabilizer
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Does aripirazole affect prolactin, or the QT interval?
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it does NOT affect prolactin OR the QT interval***
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What is aripiprazole used to treat?
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abilify treats drug resistant depression
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What are the major side effects od aripiprazole?
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abilify can:
orthostatic hypotension (like all antipsychotics it seems0 sedation slows esophagus motility* few extrapyramidal effects |
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How does Carbamazepine (Tegretol) affect antipsychotics?
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this increases their metabolism speed
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How does smoking affect antipsychotics?
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this increases their metabolism as well
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What is the most common drug to treat bipolar disorder?
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Lithium! (eskalith)
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How does lithium work?
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this may increase Ach release
decreased IP3/DAG production May uncouple G proteins |
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What is the optimal concentration range for lithium?
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.6-1.2 mEq/L
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how do you dose lithium?
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by measuring the serum lithium concentration
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How is lithium excreted? what does it compete with?
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this has renal excretion, and it competes with sodium for reabsorption***
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How does low sodium affect lithium?
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this will increase serum lithlium levels, due to more of it being reabsorbed
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What two types of drugs decrease lithium clearance?
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Thiazide diruetics
NSAIDs |
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What are the major side effects of lithium?
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Decreased thyroid function*
Renal effects, increase H2O loss* Weight gain |
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How do you treat lithium toxicity?
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dialysis and saline
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How toxic is lithium?
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very
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What level is mild lithium toxicity? signs?
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2.0 mEq/L
nausea, vomiting, diarrhea muscle weakness fine tremor |
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What level is severe lithium toxicity? signs?
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2.5mEq/L
confusions hyperreflexia clonic-tonic twitching renal failure mental confusion gross tremor |
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How do antidepressants and lithium interact?
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these increase mania in some people
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What does Valproic Acid treat?
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Depakene- this is used as a mood stabilizer
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How effective is valproic acid?
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this is as good or better than lithium
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how fast does valproic acid work?
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this has a rapid onset
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What are the main side effects of valproic acid?
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GI upset
weight gain |
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What type of drug is Carbamazepine?
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Tegretol is an antipsychotic
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What are the major side effects of Carbamazepine?
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Tegtrol-
CNS toxicity Rashes Hematologic effects **Stevens Johnson syndrome** |
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What does Lamotrigine (lamictal) do?
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this is an anticonvulsant used to treat bipolar disorder
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What are the side effects of Lamotrigine (Lamictal)
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rash
but NO weight gain* |
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What is Topiramates side effect?
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this causes weight loss**
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What is Gabapentin used for?
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neurontin is used for neurological pain
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What are the side effects of Gabapentin?
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drowsiness and weight gain
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Can you take gabapentin during pregnancy?
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no you should not
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