Anti-Pyschotics

Question 1

Chlorpromazine (Thorazine); Haloperidol (Haldol)

Answer 1

• 1st generation anti-pyschotic
• Block D2 receptors everywhere in brain, leads to extrapyramidal symptoms and other adverse effects (muscarinic, adrenergic, histaminergic)
• Most effective against positive symptoms
• Risk for tardive dyskinesia

Question 2

Clozapine (Clozaril)

Answer 2

• 2nd generation antipsychotic (effective for positive and negative symptoms)
• No Parkinson-like symptoms
• Risk for AGRANULOCYTOSIS!
• Block D2 receptors AND 5HT receptors
• Gold standard 2nd gen, never something you start with though. Need to watch WBC
• Weight gain
• Myocarditis and cardiomyopathies

Question 3

Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Aripiprazole (Abilify)

Answer 3

• 2nd gen antipsychotic (effective for positive and negative symptoms)
• No agranulocytosis, but not as effective as clozapine
• block D2 receptors AND 5HT receptors

Adverse effects:

• Weight gain (clozapine and olanzapine)
• Increase in type 2 diabetes, change drug if patient gains more than 5% weight.
• Myocarditis and cardiomyopathies

Question 4

Proposed area of the brain that mediates the positive symptoms of schizophrenia.

Answer 4

Mesolimbic pathway

-block D2 DA receptors, decrease positive symptoms

Question 5

Proposed area of brain that mediates the negative (and cognitive?) symptoms of schizophrenia.

Answer 5

Mesocortical pathway
-decreasing DA levels or activity may produce or worsen negative symptoms..BLOCK 5HT receptors (increase 5HT inhibits DA release)

Question 6

Area of brain that regulates posture and voluntary movement, FGAs block DA receptors here, resulting in Parkinsonism-like syndrome.

Answer 6

Nigrostriatal pathway

Question 7

Runs from hypothalamus to anterior pituitary. With FGAs, female patients may experience Galactorrhea, amenorrhea, sexual dysfunction. DA inhibits prolactin here.

Answer 7

Tuberoinfundibular pathway