Antiphsychotics Flashcards
What are the characteristics of psychosis?
impaired behavior
inability to think coherently or comprehend reality
Inability to understand disturbance
-delusions and hallucinations may present
What are some of positive symptoms of schizophrenia?
Delusions
hallucinations
Catatonic–> stupor or near unconsciousness (daze)
Disorganized speech and behavior
What are some negative symptoms of schizophrenia?
Lack of emotion or interest Social isolation Affective flattening Alogia (difficulty speaking Inability to keep friends
What is psychosis due to?
Hyperactive Da system
What symptoms is related to the dopamine?
Positive symptoms
What is the MOA of First Generation Antipsychotics?
Block D2 receptors in the limbic system
- treats positive symptoms
- doesn’t help with negative symptoms actually seems to make them worse
What does Serotonin to the DA?
It inhibits its releases
- thus FGA which increased the ratio of 5HT to DA by decreasing DA inhibit even more DA via inhibition of 5HT
What is EPSE?
Extrapyramidal side effects
- Drug induced movement disorders
- Dystonia, akathisa, parkinsonism
- Tardive dyskinesia
What are the dopaminergic pathways?
- Mesolimbic
- Mesocortical
- Nigrostriatal
- Tuberoinfundibular
What is the Mesolimbic pathway?
Runs from Tegmentum to Nucleus accumbens
- Medicates POSITVE symptoms
- where FDA’s work
- where positive symptoms of chronic drugs acts
What is the meoscortical pathway?
Runs from Tegmentum to the Frontal and limbic cortex
- Mediates NEGATIVE symptoms
- Decrease in DA make - signs worse
What is the nigrostriatal pathway?
Runs from the Substantia Nigra to he Basal nuclei
- Area the regulates posture and voluntary movement
- Blocking of D2 here causes Parkinsonisum like syndromes
- EPSE
- thought to be a disruption in the balance between ACe and DA (fine motor control)
What is the Tuberoinfundibular pathway?
Runs from the hypothalamus to the Ant. Pituitary
- DA inhibits prolactin
- Blocking of D2 leads to:
- —Galactorrhea, amenorrhea, ED, Hypogonadism and infertility
What are the FGA’s?
Chlorpromazine (Thorazine)
Halperidol (Haldol)
Thioridazine (Mallaril)
Fluphenzine (Prolixin)
What are the SGA’s?
Clozapine (Clozaril) (agranulocytosis) Risperidone (Risperdal)- EPSE and HoTN Olanzapine (Zyprexa)- Weight gain Quetiapine (Seroquel)- HoTN Ziprasidone (Geodon)- Qt longation Ariprazole (Abilify) - long 1/2 life
