Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Anti-Psychotics > Flashcards

Anti-Psychotics Flashcards

1
Q

Define Psychosis

A
  • Derangement of personality
  • Loss of contact with reality
  • Delusions
  • Hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

All disorders in this class (schizophrenia spectrum and psychotic disorder) share some form of the syndrome psychosis with abnormalities in one or more domains

A
  • delusions,
  • hallucinations,
  • disorganized thinking,
  • abnormal motor behavior and negative symptoms.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How prevelant is schizophrenia

A

seen in 1.1% US adults

*60% adults with schizophrenia use healthcare system in 12 month period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

You need to have two or more symptoms in 1 month period to be dx with schizophrenia, at least one is a core positive which is:

A

Delusions, hallucinatins, disorganized speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the negative or a other symptoms seen in schzophrenia

A 
Grossly disorganized or catatonic behavior
Negative Symptoms
– Blunted affect
– Lack of spontaneity
– Poor abstract thinking 
– Poverty of thought
– Social withdrawal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain dopamine synthesis and it’s role in schizophrenia

A

Schizophrenia results from hyperactivity of dopaminergic neurons or their receptors, particularly those with terminals in limbic areas of the brain.
*All effective antipsychotics interact with dopamine system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dopamine pathway
ORiginates in A10
key for arousal, memory, stimulus processing, locomotor activity, MOTIVATIONAL behavior
Domapine hyperactivity here–> Positive symptoms

A

Mesolimbic tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dopamine pathway
Originates in A10
Key for Cognition, communication, social activity
Diminished dopaminergic activity–> negative symptoms

A

Mesocortical Tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Originates in A9, see Doamine blockade that increaes EPS

( Blockade 5-HT2a and see decreased EPS, and parkinsonism

A

Nigrostriatal pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

dopamine blockade here leads to increased prolactin release

A

Tuberoinfundibular tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does body regulate dopamie release

A

Have reuptake by DAT
D2/D3 receptor on pre-syaptic neuron senses level of DA and can inhibit release
MAO breaks it down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What Dopamine receptors have a role in guanyl or adenylyl cyclase ACTIVATION and increase IP3 and Ca channels

A

Ca activation is seen in the D1 and D5 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What dopamine receptors have role in guanyly or adenyly cylcase INHIBITION of IP3 channels and k channels

A

D2, D3, D4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

We see strong correlation of clinical potency of drug and affinity for ______

A

Dopamine D2 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the goal of D2 drugs

A

they block the D2 receptor on presynaptic cell to increae DA production and release, cell isn’t getting it’s feedback of having enough dopamine: also have blockages of DA activation on post synaptic side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do Atypical Antipsychotics such as Clozapine and Risperidone work?

A

Block DA receptor AND block 5-HT2 receptors in forebrain with greater potency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clhopromazine, fluphenazine, trifluoperazine and thioridazine are all examples of

A

Typical antipyschotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risperidone, Clozapine and Olanzepin are all examples of

A

Atypical anthpyschotics

19
Q

PharmK of antipyschotics

A

Oral absorption, Lipid soluble, Protein binding = large volume distribution, complex metabolism

20
Q

What therapy has the best outcome for pts with pyschosis

A

Medications and Social therapy

21
Q

Antipyschotics:
o Typical drugs differ only in_____.
o The negative symptoms of schizophrenia are not well treated by the ____ agents.
o_____ drugs, in addition to treating positive symptoms, may be more effective in treating negative symptoms.

A

potency
older typical
Atypical

22
Q

What three actions do we see in antipyschotic drugs

A

decreased psychotic behavior, sedation, extrapyramidal effects

23
Q

What side effects do we owrry about with antipyschotics?

A

o Dystonias
o Parkinsonism Early Reactions - more with typicals
o Akathisia
o Tardive dyskinesia – Late reaction may be less frequent with atypicals

24
Q

Pt comes in with spasm of tongue, neck and back. You find out she was put on antipsychotics receltnly. What is the appx timefrine she’s been on the drugs and what is she experiencing?

A

Acute Dystonia

happens 1-5 days after starting antipyschotics

25
Q

Pt comes to clinic complaining of rigidity and feels like he’s drooling more. You note he has a masked face and cogwheeling during your physical exam. He states he started taking clozapine recently. What rxn is he experiencing and apx how long would you guess he’s been on drugs?

A

Parkinsonism

5-30 days post starting meds

26
Q

You are checking on a pysch pt you started on risperidone. She seemed very aggitated during your visit and kept moving around. How long ago did you start risperidone, what’s going on

A

pt has Akathisia: is an EPS seen about 5-60 days post starting antipychotics

27
Q

What is a long term complication that can result from taking antipyschotics

A

Tardivve dyskenisia; months to years and see oral-facial dyskinesias and choreoathetoid movements

28
Q

What are some other side effects of antipyschotics

A
  • Anticholinergic ‐ dry mouth, blurred vision, urinary retention
  • Orthostatic hypotension
  • Neuroendocrine effects - result of dopamine receptor blockade
  • Allergic and idiosyncratic effects - liver, blood and cutaneous
29
Q

What antipyschotic causes cardiac effects

A

Thioridazine

30
Q

What pts do we need to be aware of before starting them on antipyschotics?

A

people with seizure disorders: you see decreased seizure threshold

31
Q

What antipyschotics is weight gain prevelant in?

A

Weight gain -Diabetes related events are more common with atypicals, particularly olanzapine, risperidone, clozapine and quetiapine

32
Q

A potentially lethal hypodopaminergic side effect of antipsychotic drugs.
• Hyperthermia, Parkinson‐like symptoms (muscular rigidity and tremor), mutism and possible death.

A

Neuroleptic Malignant Syndrome

33
Q

How do you cure Neuroleptic malignant syndrome

A

Treatment includes cooling and hydration, bromocriptine and dantrolene

34
Q

Original antipsychotics: low to medium potency, sedative, pronounced anticholinergic effects

A

Phenothiazines

35
Q

Chlorpromazine, Triflupromazine and Vesprin are examples of

A

Phenothiazines

36
Q

What are my typical antipyschotics that are low potency, sedatving with less extrapyramidal effects. Its a piperidine side chain

A

Thioridazine

37
Q

What type of drug are Trifluoperazine and Fluphenazine and what is their profile

A

Typical antipyschotics; have piperazine side chain

High potency, less sedative but more EPS

38
Q

Typical Antipyschotic drugs from Thioxanthine

  • non-nitrogen contaning
  • similar to penothiazines
A

Clorprothixene, Thiothixene

39
Q

Haloperidol is a

A

Typical antipyschotic

high potency, less sedating, pronounced anthicholinergic effects

40
Q

Pimozide is a

A

Typical antipyschotic

41
Q

Potent neuoleptic, lots of sides, can tx Tourettes and used secondary to Haloperidol

A

Pimozide

42
Q

Why did we create Atypical antipyschotics

A
  • Need for better antipsychotic drugs
  • More acceptable side-effect profile
  • More efficacious in treating negative symptoms of schizophrenia
43
Q
  1. Clozapine (Clozaril®
  2. Olanzapine (Zyprexa)
  3. Risperidone (Risperdal)
  4. Quetiapine (Seroquel
  5. Aripiprazole (Abilify)
  6. Ziprasidone (Geodon)
  7. Asenapine (Saphris)
  8. Iloperidone (Fanapt)
  9. Lurasidone (Latuda)
  10. Paliperidone (Invega®)
A

List of Atypical Antipyschotics

44
Q

What are the benefits of Atypical antipyschotics over typicals

A

Lower incidence of extrapyramidal symptoms, lower Tardive, impoveds negative sypmptoms, improvement of + symptoms in pts that typicals didn’t work

Psychiatry (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions