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35 Cards in this Set
- Front
- Back
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Symptom of behavior/thinking that breaks from reality and impairs a patients's fxing and causes them distress |
Psychosis |
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5 Positive symptoms of psychosis? |
Hallucinations, Delusions, Disorganized Behavior/Speech (impulsivity, bizarre appearance, catatonia, agitation), Paranoia, Formal Thought Disorder |
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4 Negative Symptoms of psychosis? |
*Absence of normal behaviors - 4 A's* 1) Apathy/Avolution (lack of interest) 2) Alogia (absense of speech) 3) Anhydonia (inability to take pleasure in things) 4) Affect flat |
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(+) Symptoms of psychosis for less than 1 month with full return to pre-morbid fxing afterwards |
Brief Psychotic Disorder |
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2+/5 (+) symptoms for at 6+ months with at least one of symptoms being one of the 3 core symptoms: delusions, hallucinations, disorganized speech |
Schizophrenia |
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2+/5 (+) symptoms for 1-6 months with at least one of symptoms being one of the 3 core symptoms: delusions, hallucinations, disorganized speech |
Schizophreniform Disorder |
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Schizophrenia + concurrent mood disorder |
Schizoaffective Disorder |
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1+ months of delusional symptoms only |
Delusional Disorder |
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What % of Schizophrenic pts will commit suicide? |
50% |
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What schizophrenic patients have the best and worst outcomes? |
Best = female schizoaffective or paranoid type
Worst = insidious, early onset, (-) symp, and disorganized type |
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What is the general sequelae of schizophrenic patients in the residual stages of the disorder? |
1/4 fully recover 3/4 return to prodrome stage (never recover) |
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Dopa Hypoth. states that increased activity of ____ receptors in the cortex and ____ receptors in the limbic/striatum tracts cause schizophrenia |
D1 and D5 D2-4
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How do 5-HT levels vary in schizophrenics? What receptors are abnormal? |
decreased 5-HT levels (leads to less inhibition of Dopa neurons)
5-HT1,2a,3 |
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How do hallucinogens cause psychosis? |
block NMDA (glutamate) receptors |
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increased family stress w/ contraindication b/w verbal communication and nonverbal metacommunication leads to greater risk of development and relapse of schizophrenia |
Double Blind Hypothesis |
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Hypothesis that schizophrenic pts fall from higher socioeconomic status and generally stay at this lower level |
Downward Drift Hypothesis |
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What is the neurotransmitter cause of positive and negative symptoms in schizophrenia? |
(+) = too much Dopa in N. Accumbens
(-) = too little Dopa in prefrontal cortex |
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What are the 5 effects of Anti-psychotic meds? |
1) Increases Prolactin 2) Antipsychotic Effect 3) Decreases N/V 4) Decreases Temp regulation 5) Decreases Seizure threshold (*PANTS*)
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D2 receptors in what areas of the brain causes the following effects:
a) Anti-Psych Effect b) Motor SE c) Galactorrhea d) Decreased N/V |
a) mesolimbic/cortical b) negrostrial c) tuberoinfundibular d) chemotrigger zone |
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What receptor do the Typical/1st gen. anti-psychotics target? |
D2 antagonists |
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What are the High potency Typical/1st gen. anti-psychotics? |
(Try to Fly HIGH)
Trifluoperazine Fluphenazine Haloperidol |
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What are the Low potency Typical/1st gen. anti-psychotics? |
(Cheating Thieves are LOW)
Chlorpromazine Thioridazine |
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What is the clinical use for Typical/1st gen. anti-psychotics? |
*Schizophrenia w/ mainly + symp*
psychosis, Tourette's, Huntington's |
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What are the main SE seen in high potency Typical/1st gen. anti-psychotics?
What Rx can treat these SE? |
Extrapyramidal Symptoms (dyskinesias + Parkinson-like symptoms)
Trx w/ Benzotropine and Trihexylphenidyl |
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What the main SE's seen in Low potency Typical/1st gen. anti-psychotics? |
Non-neuronal SE:
- Anti-cholinergic = dry mouth, constipation - Alpha1-Blockade = hypotension - Anti-Histamine = Sedation |
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What is the evolution of extrapyramidal SE seen in high potency Typical/1st gen. anti-psychotics? |
1) 1-5 days = Acute dystonia (facial mm spasms, torticallis) 2) 5-60 days = Akathisia (motor restlessness) 3) weeks = NMS 4) long-term use = Tardive dyskinesia (non-treatable oral-facial chorea) |
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Fever, Encephalopathy, Vitals unstable, Enzymes increased (myoglobinemia), Ridgidity of muscles, potentially fatal!
*FEVER* |
Neuroleptic Malignant Syndrome (NMS)
- Stop typical anti-psych Rx and start Dantrolene (mm relaxer) and Bromocriptene (D2 agonists) |
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How can you treat the acute dystonia seen w/ high potency typical anti-psych. meds? |
Anti-Parkinson Drugs (expect L-Dopa) |
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What are the atypical Anti-psych. Drugs? |
(It's ATYPICAL for Old Closets to Quietly Risper from A to Z)
Olanzapine Closapine Quietapine Risperidone Aripriprazole Ziprasidone |
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Which atypical Anti-psych. drugs cause weight gain, worsening of lipids, and increased risk of DM? |
Olanzapine & Closapine
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Which atypical Anti-psych. drug is the best tolerated and most efficacious? |
Olanzapine |
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What do the majority of atypical Anti-psych. drugs target? What drug is also a partial D2 agonist? |
5-HT2a receptor anatagonists
*Aripiprazole |
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What atypical Anti-psych. drug may cause prolonged QT intervals? |
Ziprasidone |
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What atypical Anti-psych. drug must you monitor closely for agranulocytosis? |
Closapine |
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What is main benefit of atypical Anti-psych. drugs? |
Less extrapyramidal symptoms and thus less risk of irreversible tardive dyskinesias (other than that efficacy is similar to 1st gen. antipsych's) |
