Anti-Psychotic Drugs Flashcards
How does the mesolimbic pathway contribute to symptoms of disease?
Positive symptoms
Place where cocaine and amphetamine hpgereate psychosis
What are the four dopaminergic systems?
- Mesolimbic (VTA –> nucleus accumbens)
- Mesocortical (VTA –> frontal and limbic cortex)
- Nigrostriatal (SN –> basal nuclei)
- Tuberoinfundibular (hypothalamus –> Anterior pituitary)
How does the mescortical pathway contribute to symptoms of a disease?
Proposed area of negative symptoms (possibly cognitive also)
Increase 5-HT inhibits DA release here
How does the Nigrostriatal pathway contribute to symptoms of a disease?
Therapeutic blocking results in Parkinsonism like syndrome
How does the tuberoinfundibular pathways contribute to symptoms of a disease?
Less prolactin (DA inhibits prolactin release)
Blocking this leads to galactorrhea, amenorrhea, sexual dysfunction
How does each dopaminergic pathway contribute to the adverse side effects after treatment with an anti-psychotic?
- Mesolimbic -
- Mesocortical - worsening neg effects with D2 only blockage
- Nigrostriatal - Parkinsonism
- Tuberoinfundibular - galactorrhea, amenorrhea, sexual dysfunction
How does the proposed mechanism of FGA antipsychotic drugs account for both the therapeutic and extrapyramidal effects of this class of drugs?
Therapeutic:
Extrapyramidal:
How does the proposed mechanism of SGA antipsychotic drugs account for clinical improvement in both positive and negative symptoms?
Positive:
Negative:
Compare and contrast the early and late onset symptoms of toxicity seen with some antipsychotic drugs.
A
What are the most common adverse effects of FGA?
- Parkinsonism
- worse neg symptoms
What are the most common adverse effects of SGA?
Clozapine - agranulocytosis (death)
- weight gain (clozapine and olanzapine)
- increased risk for type 2 diabetes mellitus
- increased LDL - myocarditis and cardiomyopathies
What are the three classes of symptoms of schizophrenia?
Positive (gain): delusions, disorganized speech, weird behavior, catatonic, auditory hallucinations
Negative (lost): lack of emotions, social isolation, flat affect, alogia (speaking), cannot keep friends
Cognitive: disorganized thinking, slow thinking, poor concentration, poor memory, diff integrating thoughts and feelings into behavior
What symptoms of schizophrenia respond to meds?
Positive (not really negative)
What is the Goldilocks principle of dopaminergic dysfunction?
- up DA, limbic –> psychosis
- down DA, striatum –> Parkinsonism
How do you treat psychosis?
Block D 2 receptors
