anti psychotics Flashcards
what is schizophrenia?
disturbance in reasoning, cognition, delusions, hallucinations, behavior, emotions, thoughts, and reality
when is the onset of schizophrenia?
late teens-adult
what is psychosis?
lacking the ability to test reality
what can drugs or l-dopa cause?
psychosis
is schizophrenia polygenic?
yes
is schizophrenia heterogenic?
yes
is there an environmental component in schizophrenia?
yes
what are delusions?
false beliefs
what are hallucinations?
abnormal sensation
do affected or unaffected individuals experience positive symptoms?
affected
do affected or unaffected individuals experience neg. symptoms?
unaffected
what are negative symptoms?
decrease in emotion, speech, interests and drive
what are positive symptoms?
hallucinations, delusions, disorganized speech/behavior
is the cerebral cortex thin or thin in schizophrenia?
thin
what happens to the cortical grey matter volume?
decreases
what happens to the lateral ventricles?
increase
what two things can happen to dopa after reuptake into the cell?
degraded or repackaged
where is the mesolimbic?
VTA to NAc
where is the mesocortical?
VTA to frontal cortex
where is the nigrostriatal?
substantia nigra to striatum
what is the mesolimbic role?
reward
what is the mesocortical role?
cognition
what is the nigrostriatal role?
extrapyramidal
is the mesolimbic responsible for an increase or decrease in dopa?
increase
are the results of the mesolimbic + or – symptoms?
pos.
is the mesolimbic hyperactive or hypoactive in psychosis?
hyper
is the mesocortical responsible for an increase or decrease in dopa?
decrease
are the results of the mesocortical + or – symptoms?
neg.
is the mesocortical hyperactive or hypoactive in psychosis?
hypo
what happens to the flow of blood to the prefrontal cortex in hypoactive state?
decrease
if you block the mesolimbic positive symptoms, what happens to the mesocortical?
you get an increase in negative symptoms from the hypoactive mesocortical
how can you block positive symptoms?
dopa antagonist
what is an example of a dopa antagonist?
chlorpromazine
what do the multiple dopa receptor distributions contribute to?
drug interactions
what can target + without negative symptoms?
5HT (LSD and hallucinogens)
are antipsychotics lipophilic or phobic?
lipophilic
what is the MOA of glutamate?
psychomimetic NMDA receptor antagonist (PCP & ketamine)
what generation are known as typical antipsychotics?
1st
what generation are sedating?
1st
what generation has EPS?
1st
what generation has high D2 antagonism?
1st
do first generations have high or low 5HT2a action?
low
(8) what are the 1st gen antipsychotics?
thiothixene
thioridazine
perphenazine
trifluoperazine
fluphenazine
chlorpromazine
loxapine
haloperidol
other than being a first gen antipsychotic, what does chlorpromazine do?
antihistamine
which gen has low EPS?
2nd
which gen has low D2 antagonism?
2nd
which gen has higher 5HT2a antagonism?
2nd
which gen has metabolic AEs?
2nd
(6) what are the 2nd gen antipsychotics?
arpiprazole
brexpiprazole
clozapine
quetiapine
ziprasidone
cariprazine
what is arpiprazole MOA?
partial D2/5HT2a/5HT1a agonist
what is brexpiprazole MOA?
partial D2/5HT1a agonist
what is cariprazine MOA?
partial D2/D3 agonist
what is clozapine MOA?
5HT1a agonist
what is quetiapine MOA?
5HT1a agonist
what is ziprasidone MOA?
5Ht1a agonist
what do ziprasidone, quetiapine, and clozapine all do?
increase dopa release in prefrontal cortex
for a mesolimbic that is hyperactive you would…
D2 block (dec. positive symptom)
for a mesocortical that is hypoactive a D2 block would…
worsen neg. symptoms
for the nigrostriatal D2 block would…
cause parkinsons
for the hypothalamic a D2 block would…
cause hyperprolactinemia
which gen is known as atypical?
2nd
which gen antagonizes alpha1, H1, and M1?
both
which gen antagonizes 5HT2a> D2?
2nd
which gen can be a 5HT1a agonist?
2nd
is lumateperone atypical or typical?
atypical
what is the MOA of lumateperone?
moderate D1,D2,D4 activity and a 5HT2a antagonist
what is the MOA of pimozide
D2 antagonist
what is the MOA of pimavanserin?
inverse 5HT2a agonist
