725 Quiz 2 Flashcards by Emily Hochwald

Stressed induced _______________ damage the ______________ and the __________ and increases the synaptic connectivity in the __________________ .

glucocorticoids; hippocampus; PFC; amygdala

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Decreased 5HT1A binding in the raphe nuclei is associated with what two mental DOs?

Panic & social anxiety

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Stress induces a cyclical interaction of what three things that influence each other?

bodily response; ineffective behavior; upsetting thoughts

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Patients with GAD have an enlarged and hyperactive __________ and too little inhibitory control by the ______ .

amygdala; PFC

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GABA agonists increases ___________ which reduces anxiety symptoms.

inhibition

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First line tx of GAD? Alternative tx?

SSRIs and SNRIs; buspirone, BDZs, pregabalin and gabapentin

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Is there a genetic component to panic disorder? Also, what two brain areas are reduced in volume?

yes; amygdala and hippocampus

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1st line tx of phobias?

behavior therapy, exposure therapy specifically

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During a panic attack, _________ activity is increased in the _______ , _______________, and the ______ and there is a reduction in the ________ .

neural; amygdala, cingulate cortex, and the insula; PFC

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Social anxiety is also known as social _________ .

phobia

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In social anxiety DO, activity in the _____________ is ___________.

amygdala; increased

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What are the medication treatments for social anxiety DO? The non-medication tx?

SSRIs, SNRIs, and CBT

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In PTSD there can be a __________ of emotional responses for many years after the original event.

numbing

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Tx for nightmare r/t PTSD; what is the precaution/SE and why?

Prazosin (Minipress); orthostatic hypotension due to interfering w/sympathetic nervous system with inhibition of vasoconstriction of the peripheral vessels

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Minipress is an _____________ antagonist which blocks ________ ___________, thus reducing ________ . It basically blocks an overactive _____________ __________ system.

alpha -1; NE receptors; NE; sympathetic nervous

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Minipress helps reduce the ____________ and __________ of _____________ .

frequency and severity; nightmares

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Name three short-acting BDZs (the Ox rides his Tri-cycle in Mid-line for hours), what are they typically used for and what is there half-life range?

triazolam; oxazepam; midazolam; sedation in ICU; 1-12 hours

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Name four intermediate-acting BDZs (LACT) and what is their half-life range?

lorazepam, alprazolam, clonazepam, and temazepam (Restoril); 12-24 hours

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Name two long-acting BDZs (DC) and there half-life?

diazepam; chlordiazepoxide; 24 hours

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Buspirone is a ________ _________ __________ at the __________ receptor.

serotonin partial agonist; 5HT1A

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Antihistamines are sedating and are used to treat ___________ and ____________ .

anxiety and insomnia;

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Antihistamines help induce sleep but can decrease the quality of the _______ ___________ .

sleep cycle

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Hydroxyzine is a first generation antihistamine, and is selective for the ____ receptor and is a weak ___________ .

H1; anticholinergic

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Gabapentin works as an ___________ at __________-_____ ___________ channels, leading to ____________ __________ firing and acts _____________ .

inhibitor at voltage-gated calcium channels; decreased neuronal firing; quickly

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Pregabalin is similar to gabapentin but it reaches __________ faster and is more ______________ .

peak; bioavailable

Propranolol is a beta blocker and should not be rx'd to people with ___________ ; when taken prn, it should be given ___________ before a performance.

asthma; 60 minutes

Per the __________ theory, positive symptoms are the result of ___________ in the ______________ dopamine pathway.

Dopamine; overactivity; mesolimbic

The cognitive impairments and negative symptoms of schizophrenia are suggested to be caused by a dysfunction in what pathway?

mesocortical pathway

FGA are proposed to (mechanism of action)?

block D2 receptors

Antagonism of D2 receptors in this pathway is associated with increased risk of EPS.

Nigrostriatal pathway

D2 blockage increases prolactin levels by reducing the associated D2 effect of the prolactin-inhibiting factor thus promoting release in the pituitary gland by what pathway?

Tuberoinfundibular pathway

Mesolimbic pathway includes what two structures?

VTA and nucleus accumbens

The nigrostriatal includes what two structures?

substantia nigra and basal ganglia

The mesocortical pathway includes what two structures?

VTA and PFC

Name three 1st generation antipsychotics and their potency (HFC).

haloperidol (high), fluphenazine (Prolixin, high), chlorpromazine (Thorazine, low)

Olanzapine two major SEs and what can be used for the for one of the side effects?

sedation and weight gain; samidorphan (like naltrexone) reduces cravings

Quetiapine is highly ____________ and has strong __________ properties which make it helpful for _________ DOs.

sedating; serotonergic; mood

Clozapine is used for tx-resistant __________ and improves __________ symptoms but has the dangerous SE of _____________ and the ________ must be monitored closely.

schizophrenia; negative; agranulocytosis; CBC/ANC

Risperidone is _________ sedating than some other antipsychotics but has a much higher rate of ____________ and ___________ .

less; hyperprolactinemia and gynecomastia

Paliperidone (Invega) has the same primary active metabolite as _____________; it has an injection form that can be given _________, _________, or __________ a year.

risperidone; monthly, quarterly, twice

Ziprasidone (Geodon) has a risk of _______ ___________.

QTc prolongation

Lurasidone must be taken with >350 calories of food and is helpful in treating BPAD ______________ .

depression

IIoperidone (Fanapt) is only __________ effective and can cause ___________ ______________ .

mildly; orthostatic hypotension

Aripiprazole is approved for adjunctive tx of ______ and _________ DO.

MDD; BPAD

Brexpiprazole (Rexulti) is approved for adjunctive tx of ____ and ______________ .

MDD; schizophrenia

Cariprazine (VraylarP is approved for adjunctive tx of ________ , ______, and BPAD _________ and ________ episodes.

MDD, schizophrenia, depression and mixed

Because DA plays a role in attention and concentration...

people taking antipsychotics report their ability to focus is IMPAIRED

Dopamine antagonists are known to cause what serious SE?

EPS

Antipsychotics cause ____________ and interact with other receptors: (5)

5HT2a, 5HT2c; muscarinic AcH, a1 NE, H1

Four types of EPS? PAAT

parkinsonism, acute dystonia, akathisia, tardive dyskinesia

Acute dystonia causes sustained and painful involuntary ___________ and often involves the __________ and ________ .

contractions; face and neck

Akathisia causes a constant feeling of _______________ and/or ____________ of muscles.

restlessness; jitteriness

Parkinsonism causes _____________, ___________, __________, postural ___________, and a ____________ gait.

bradykinesia, tremor, rigidity, postural instability, shuffling gait

What does bradykinesia looks like?

decreased movements and/or trouble initiating movements

Treatment for acute dystonia?

anticholinergics (Benadryl or benzatropine which is Cogentin)

Treatment for Akathisia?

Lowering or stopping med and/or starting Inderal, a benzodiazepine, or an anticholinergic

Treatment for parkinsonism?

Changing med to less potent or stopping antipsychotics completely

What does tardive dyskinesia look like?

constant involuntary rhythmic movements that is often irreversible

What new medications can treat TD with reduced severity?

Ingrezza and Austedo

What are the symptoms of neuroleptic malignant syndrome? (FEVER)

fever, encephalopathy, VS instability, elevated WBC/CPK, and rigidity

What are the tx's for neuroleptic malignant syndrome?

stop med, cooling measures, and use of dantrolene or bromocriptine

What does dantrolene do and how?

blocks postsynaptic AcH receptors and lessens excitation-contraction of muscles

What does bromocriptine do and how?

D2 agonist; helps overcome D2 blockade

The amygdala forms __________ memories and enhances _____ _____ memory consolidation in the ___________.

emotional; long term; hippocampus

_____ added by cortisol mediates the formation and reconsolidation of traumatic memories.

Stress can increase phasic burst _______ of select cells in the ____ causing increased release of ___ .

firing; VTA; DA