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15 Cards in this Set
- Front
- Back
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discuss the general classifications of primary psychoses
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-Schizophrenia
-Acute psychosis -Affective psychosis (bipolar, psychotic depression) -Isolated Delusions |
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describe the pathophys of psychosis
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hypothesis: DA hyperactivity (in limbic system)
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how is intellectual function affected by antipsychotics?
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it isn't affected
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what are the actions of antipsychotics on DA neurotransmission
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DA receptor antagonists, mostly at D2 (D2 normally reduces cAMP)
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how can antipsychotics lead to gonadal steroid deficiency?
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blocking DA leads to hyperprolactinemia, which inhibits GnRH, decreasing LH and FSH
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other than EPS, how are antipsychotics' SE mediated?
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inhibition of various receptors:
-Muscarinic antagonism, like atropine -alpha1 antagonism - hypotension -H1 antagonism - sedation, low affect |
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list a typical progression of EPS due to antipsychotics:
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-acute dystonia (spasms), rapid onset
-days/month after: Parkinsonism (akinesia) -1 month after: akathisia (restlessness - urge to move) -months/years after: tardive dyskinesia (involuntary mvmts, usually perioral) |
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list prototype typical antipsychotics; atypical
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haloperidol, chlorpromazine
atypical: Clozapine |
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what is EPS
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ExtraPyramidal Symptoms due to DA blockade, mostly on nigrostriatal pathways - leads to Parkinsons-like Sx.
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what is NMS
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neuroleptic malignant syndrome. basically severe Parkinsonism Sx's. Rigidity, autonomic instabilities (high body temp set point = hyperpyrexia)
Tx by removing antipsychotics, give Dantrolene. |
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what are the advantages to atypical antipsychotics? what is the prototype?
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clozapine. vs typicals, they also get negative symptoms; less likely for EPS SEs, less likely for hyperprolactinemia
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how do a typical antipsychotic's potency, EPS risk, and anti-muscarinic risk relate?
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high potency = high EPS risk = low antimuscarinic risk.
interestingly, - remember that high EPS symptoms are treated with antimuscarinic drugs |
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a pt on clozapine hasn't seen his Dr for months and came down with a systemic fungal infection. what probably led to this?
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clozapine can cause agranulocytosis. WBC counts must be monitored weekly.
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are antipsychotics absorbed well? lipophilic? Vd?
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all can be given oral. atypicals absorb better. very lipophilic. high Vd. distribute to brain easily.
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what are other uses for antipsychotics, besides for Schizophrenia?
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tourette's, huntington's, acute mania (Bipolar Disorder)
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