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Pharm III Unit 1 > Anti-Psychotic Drugs and Mood Stabilizers > Flashcards

Anti-Psychotic Drugs and Mood Stabilizers Flashcards

1
Q

Brain scan of a schizophrenic pt shows

A

Progressive gray matter loss

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2
Q

Hypothesis of schizophrenia

A
  1. Greater amount of DA receptors, 2. Serotonin receptors (–>DA transmission) altered, 3. Glutamate
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3
Q

Positive symptoms

A

Hallucination (auditory and visual) & delusions, catatonic behavior, disorganized speech and thinking

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4
Q

Cause of positive sxs

A

Over-active dopamine pathway in limbic system (mesolimbic)

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5
Q

Negative sxs

A

Affective behavior, apathetic, withdrawn, anti-social, lack of motivation, depressed

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6
Q

Cause of negative sxs

A

Under-active dopamine pathways in frontal cortex (Mesocortical)

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7
Q

Mesolimbic

A

VTA to limbic (emotion)

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8
Q

Mesocortical

A

VTA to frontal cortex (cognition; emotion)

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9
Q

Nigrostraital

A

SN to striatum (motor)

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10
Q

Tuberoinfundibular

A

Hypothalamus to pituitary (Prolactin)

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11
Q

DA D2 receptors distrubtion

A

Mesolimbic region

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12
Q

DA D4 receptors distribution

A

Mesocortical area

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13
Q

Classical antipsychotic

A

Block DA D2 receptors; target the mesolimbic system; alleviate positive sxs

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14
Q

Atypical antipsychotic

A

Block 5HT2A & DA receptor; target mesocortical and mesolimbic system; alleviate both negative and positive sxs; DOC!!

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15
Q

In addiction to their primary receptor blocking mechanism, what else do they block?

A

Muscarinic, alpha-adrenergic, and histamine receptors in brain and periphery

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16
Q

Antipsychotic with antiemetic property

A

Prochloroperazine

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17
Q

Antipsychotic side effects

A

Decrease seizure threshold; endocrine (wt gain, increased prolactin); autonomic (anticholinergic, alpha-adrenergic, histamine); dental (xerostomia and bruxism); EPS; Tardive dyskinesia, neuroleptic malignant syndrome

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18
Q

Antipsychotic EPS

A

Parkinson’s like, imbalance of striatal DA and ACh

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19
Q

Degree of EPS depend on

A

Anticholinergic activity (more anticholinergic, less EPS)

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20
Q

How to restore ACh/DA balance

A

Treat w/ anticholinergic (Benztropine)

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21
Q

More EPS: Classical vs. Atypical

A

Classical

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22
Q

Drugs least likely to cause tardive dyskinesia

A

Clozpine and olanzapine

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23
Q

Antipsychotic drug interactions

A

Anticholinergic, sedative-hypnotics, TCAs, drugs that induce CYP450s

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24
Q

Classical antipsychotic drugs (4)

A

Chloropromazine, Prochlorperazine, Fluphenazine, Haperidol

25
Q

Classical antipsych with high anticholinergic effects (low EPS)

A

Chloropromazine

26
Q

SE: retinal deposits “browning of vision”

A

Chloropromazine

27
Q

“Vitamin H”

A

Haloperidol

28
Q

Antipysch that works right away!!

A

Haloperidol (may be injected)

29
Q

Antipsych with no anticholinergic activity (high risk of EPS)

A

Haloperidol

30
Q

Antipsychotic: drug of last choice due to agranulocytosis

A

Clozapine

31
Q

SE: Hyperglycemia, type II DM

A

Olanzapine

32
Q

DOC for psychosis

A

Risperidone

33
Q

No significant effect on DA neurotransmission in NS pathway

A

Risperidone

34
Q

SE: prolongs QT interval

A

Ziprasidone

35
Q

Do not give ziprasidone to pts w/

A

hx of seizure

36
Q

Antipsych with some antidepressant activity

A

Ziprasidone

37
Q

Antipsych that does not elevate prolactin

A

Quetiapine

38
Q

Dopamine system stabilizer

A

Arpiprazole

39
Q

SE: decreases esophageal motility

A

Arpiprazole

40
Q

Used in treatment of depression associated with bipolar disorder

A

Olanzapine, Lurasidone

41
Q

Bipolar affective disorder caused by

A

a lack of GABAergic activity

42
Q

DOC of bipolar disorder

A

Lithium

43
Q

Lithium absorption

A

by proximal tubule in kidney

44
Q

Li competes w/ ___ for reabsorption

A

Na+ (must monitor!)

45
Q

Li increases results in

A

Hyponatremia

46
Q

Na+ decreases results in

A

Li toxicity

47
Q

SE: Diabetes insipidus (by inhibiting ADH –> increase thirst and UO)

A

Lithium

48
Q

Tx for diabetse insipidus

A

amiloride

49
Q

Lithium therapeutic window

A

small

50
Q

Lithium can cause mania if added with

A

antidepressants

51
Q

Li clearance increases w/

A

diuretics

52
Q

NSAIDs + Lithium

A

increase Li toxicity (decrease clearance, increase uptake)

53
Q

LIthium + benzos & antipsychotics

A

SAFE

54
Q

Used for rapid cycling manic/depressive phases

A

Valproic acid, gabapentin

55
Q

SI: surgical bleeding (dental)

A

Valproic acid

56
Q

Drugs NOT given to pregnant ladies with bipolar (teratogenic

A

Valproic acid, Lithium

57
Q

Used for refractory bipolar disorder

A

Carbamazepine

58
Q

Tardive dyskinease

A

Choreiform; uncontrollable, jerky movements of face and limits

59
Q

Neuroletpic malignant syndrome

A

muscle rigidity, hyperprexia, changes in BP and heart rate

Pharm III Unit 1 (9 decks)

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