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51 Cards in this Set

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  • Back
What are the symptoms of Active Schizphrenia?
Delusions, Hallucinations, Disordered thinking, Bizarre behavior, violence
What are the symptoms of Passive Schizophrenia?
Withdrawal from interaction with people
No emotional response
How many people are affected with schizophrenia in the US?
2 million
Approximately how many people in the US are being treated for schizphrenia
only half
When does schizohrenia usually start
in adolescents or early adulthood
What is the suicide rate for people with schizophrenia
about 10%
What is the cause of schizophrenia
There is a genetic compenent that is found with twin studies and higher incidences in families

there is also an environmental component
What is the pathophysiology of schizophrenia
either too many dopamine receptors or they are too sensitive
What is the 1st anti-psychotic drug?
Chlorpromazine
What are the low potency typical antipsychotic agents?
thioridizine and chlorpromazine
What is the mechanism of the low potency typical anti-psychotics?
block dopamine1(DA1) and dopamine2(DA2) receptors
What is the mechanism of action of thioridizine?
block dopamine1(DA1) and dopamine2(DA2) receptors
What is the mechanism of action of chlorpromazine?
block dopamine1(DA1) and dopamine2(DA2) receptors
What are the side affects of thioridizine?
sedation and some extrapyramidal effects
What are the side effects of chlorpromazine?
sedation and some extrapyramidal effects
What are the high potency typical anti-psychotic agents?
trifluoperazine and haloperidol
What is the difference between low potency and high potency anti-psychotic agents
They have more extra pyramidal effects then sedation
What is the mechanism of trifluoperazine?
Work on DA1 and DA2
What is the mechanism of haloperidol
Work on DA1 and DA2
What are the atypical anti-psychotics
clozapine, olanzapine, riperidone, aripirazole
What is the mechanism of action of the atypical anti-psychotics?
Act on DA2 and serotonin receptors
What is the mechanism of action of clozapine?
Act on DA2 and serotonin receptors
What is the mechanism of action of olanzapine?
Act on DA2 and serotonin receptors
What is the mechanism of action of riperidone
block DA2 and serotonin receptors
What is the difference between the atypical and the typical anti-psychotics?
fewer side affects and the atypical may work better with negative side affects
What long is the onset of the typical anti-psychotic drugs?
All take as least several days to work and several weeks to have a full affect
What is the distribution of the typical anti-psychotic drugs?
They are highly lipid soluble and tightly bound to circulating proteins in the blood and may be possible to discontinue use and still see metabolites in the blood 18 months later
What other receptors might the typical anti-psychotic drugs work on?
histamine, norepi, serotonin
Where are the sites of action for the typical anti-psychotic drugs in the CNS and what will the effects of each be?
Cortical Sites- will lower intellectual function

Basal Ganglion - will cause extrapyramidal effects

Hypothalmus - will alter hormone function

Chemoreceptor trigger zone

Anti-emetics - prevent nausea
What are the two sites major sites of action for the typical anti-psychotic drugs
CNS and autonomic
What affects do the typical anti-psychotics drugs have in the autonomic system
Anti-cholineurgic and antihistamine
What percentage of patients will have extra pyramidal effects if they take typical anti-psychotics?
40%
What are dystonias?
Movement of the head neck and face
What do extrapyramidal effects consist of?
Bradykinesia, tremors, kinesia, dystonias, ocucogynic crisis and akathisia
What is a ocuogynic crsis?
A fixed stare
What is akathisia
need for constant movement
What are the extrapyamidal effects of the typical anti-psychotic drugs treated with
an anti-cholineurgic drug - benztropine
Why does sedation occur when one uses typical anti-psychotics?
Due to the anti-histamine affects of the autonomic nervous system
Why does postural hypotension occur when administration of typical anti-psychotics
Due to a alpha 1 blockade
What are the alterations in the visual systems that can occur with typical anti-psychotics?
diplopia, photophobia, glaucoma, dry eye, blurry vision, irreversible pigmentation of lens, sclera and conj
Why is the glaucoma worsened when one takes a typical anti-psychotic agent?
Due to the anti-cholinergic effects
What endocrine disturbances occur with typical anti-psychotics
increase in prolactin
What is neuroleptic malignant syndrome?
high fever, high blood pressure and msucle rigidity
What are the side effects of typical anti-psychotic drugs?
extrapyramidal effects, sedation, postural hypotension, hypersensitivity reaction, alterations in the visual system, Endocrine disturbances, Neuroleptic malignant syndrome, dysphoria
What will the typical antipsychotic drugs interact with
Any other CNS drug including alcohol
What other uses do the typical anti-psychotic drugs have besides schizophrenia
treatment of prolonged hiccups
treatment of tourettes
Motion sickness by decreasing nausea
What are the differences between the typical and the atypical anti-psychotics?
All have fewer extrapyramidal effects, fewer hormonal effects but can cause sedation, weight gain and associated with diabetes and agranulocytosis
What are the negative side effects of atypical anti-psychotics not seen with typical anti-psychotics
more sedation, weight gain, they are associated with diabetes and agranulocytosis
What are the atypical anti-psychotics?
clozapine, aripiprazole, risperdone, olanzapine
What is the trade name of aripirazole?
abilify
What is apripirazole used to treat
Can be used as an atypical anti-psychotic to treat schizophrena or to treat bipolar disorder