Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology- Test 4 > Antipsychotic Agents > Flashcards

Antipsychotic Agents Flashcards

1
Q

What are the positive symptoms of Schizophrenia?

A

(1) hallucinations
(2) delusions
(3) aggressive behaviors

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

What are the negative symptoms of Schizophrenia?

A

(1) lack of speech or emotional expression

(2) social withdrawal

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

What are the cognitive symptoms of Schizophrenia?

A

(1) Difficulties with concentration and memory

(2) Executive decision making abilities

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

What is the prevalence of Schizophrenia? When does it present?

A
  • 1% of population over 18 years old

- typically presents in early adulthood or late adolescence

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

T/F Schizophrenia has a weak genetic component.

A

FALSE; strong genetic component (identical twin 48% concurrence rate; fraternal 17%, parent 10%) with multiple genes involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the cost to society for Schizophrenia?

A

Large, >$65 billion overall/year, 1/3 mental health beds used

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

What is the suicide risk for Schizophrenia? Amount homeless?

A
  • High suicide risk, 25-50% of patients attempt suicide, and 5-10% succeed; mortality rate higher than the general population
  • 1/3 homeless are Schizophrenic (200,000 people)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T/F Schizophrenia is one of the most challenging diseases in terms of drug compliance.

A

TRUE

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

What is the relapse rate with drug compliant patients? How many are non-compliant?

A

20-40% relapse rate; >80% non-compliant

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

T/F The shorter the first untreated period, the worse the outcome.

A

FALSE; the longer the first untreated period, the worse the outcome

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

What is the first antipsychotic drug? What is its mechanism of action?

A

Chlorpromazine; sedative

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

Does Chlorpromazine treat positive symptoms, negative symptoms, cognitive symptoms?

A

Preferentially treats psychotic symptoms (especially positive symptoms) while leaving patients relatively conscious (leaves alone the negative symptoms)

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

T/F Chlorpromazine is more sedating that newer atypical antipsychotic drugs.

A

TRUE

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

What are the classifications of TYPICAL antipsychotics?

A

(1) Phenotiazines: Chlorpromazine

(2) Butyrophenones: Haloperidol

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

What is the mechanism of action for TYPICAL antipsychotics?

A

(1) Blocking dopamine receptors (especially D2) in mesocortical and mesolimbic pathways

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

What is the dopamine hypothesis?

A

(1) Both amphetamine and cocaine blocks reuptake of dopamine and foster psychotic symptoms
(2) Antipsychotics block dopamine D2 receptors

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

T/F Clinical properties of antipsychotic drugs correlate well with affinities of D1 and D2 receptors. (typical antipsychotics)

A

FALSE; D2 and not D1

18
Q

What is HAMS referring to regarding typical antipsychotics?

A
  • Histamine, alpha-1 adrenergic, muscarinic-cholinergic, and serotonin
  • Typical antipsychotics have affinities for these receptors as well (they have their own unique receptor binding profile)
19
Q

What are common problems concerning TYPICAl antipsychotics? (3)

A

(1) Persistent symptoms in ~30% of patients (“treatment refractory”)
(2) Only modest improvement of negative cognitive symptoms
(3) Side effects include extrapyramidal symptoms (EPS) and Hyperprolaceinemia due to D2 blockade in tuberoinfundibular system

20
Q

T/F Drugs such as Haloperidol produce EPS which causes a drug-induced Parkinsonism.

A

TRUE

21
Q

How are ATYPICAL antipsychotics defined? How are they pharmacologically characteried?

A
  • defined by reduced tendency to cause EPS (and hyperprolactinemia)
  • Pharmacologically characteried by
    ~ relatively weak D2 receptor blocking activity
    ~ serotonin 2A (5-HT2A) receptor antagonism
22
Q

What is a more common side effect of ATYPICAL antipsychotics?

A

Metabolic syndrome (weight gain, hyperlipidemia, hyperglycemia)

23
Q

What are the atypical antipsychotic drugs? (5)

A

(1) Apripiprazole
(2) Ziprasidone
(3) Olanzapine
(4) Risperidone
(5) Clozapine

24
Q

What is the selection of antipsychotics based upon?

A

Anticipated side effects rather than therapeutic expectancy (+ or - symptoms)

25
Q

What is the time course for antipsychotics?

A

from 48 hours for some acute symptoms to several weeks for hospitalized patients

26
Q

What are antipsychotics also indicated for?

A

(1) Schizoaffective disorder
(2) Manic phase in bipolar disorder
(3) Tourette’s syndrome
(4) Huntington’s disease
(5) autistic disorders

27
Q

What are the 3 effects of EPS?

A

(1) Parkinsonism
(2) Tardive Dyskinesia
(3) Neuroleptic Malignant Syndrome

28
Q

T/F Treatment for EPS Parkinsonism includes L-DOPA.

A

FALSE; never should L-DOPA be used; you will use anti-muscarinic drugs (benztropine)

29
Q

T/F There is no adequate treatment for Tardive dyskinesia.

A

TRUE

30
Q

What is Tardive dyskinesia?

A
  • Stereotyped, repetitive involuntary, choreoathetoid movements of the face, eyelids, mouth, tongue, extremities, trunk
  • can be irreversible in adults, most important problem with long term use (20-50%)
31
Q

What is the treatment for Neuroleptic malignant syndrome? Is this life threatening?

A
  • Immediate discontinuation of the drug
  • dopamine receptor agonist (bromocriptine) and muscle relaxant (diazepam or dantrolene)
  • Yes
  • symptoms include fever, muscle rigidity, leukocytosis, autonomic instability
32
Q

Why does Chlorpromazine have many side effects?

A

(especially autonomic)

  • due to relatively high muscarinic and alpha-1 adrenergic receptor blocking activity
  • highly sedative
33
Q

Does Haloperidol have more or less autonomic side effects?

A

LESS; sever EPS and hyperprolactinemia

34
Q

Which drug is the most efficacious among the antipsychotics? When is this drug used?

A

Clozapine; only used for patients resistant to typical antipsychotics

35
Q

What are the side effects of Clozapine?

A
  • 1-2% of patients develop agranulocytosis

- weight gain, sedation, hyperlipedemia, lowering seizure threshold

36
Q

T/F Strict blood monitoring is necessary for Clozapine?

A

TRUE, because of the agranulocytosis

37
Q

What drugs are widely regarded as the second most effective atypical antispsychotic drugs? What are their mechanism of action?

A

(1) Olanzapine- relatively strong histamine receptor antagonism (H1)
(2) Risperidone- most potent D2 receptor blocker; much less potent anti-muscarinic activity

38
Q

T/F Apripirazole is associated with EPS and hyperprolactinemia at higher doses.

A

FALSE; Risperidone is because it is a D2 blocker

39
Q

What drugs lower seizing threshold?

A

(1) Olanzapine

(2) Clozapine

40
Q

Which drug is structurally similar to clozapine?

A

Quetiapine (strong H1 receptor antagonism)

- associated with weight gain, sedation

41
Q

Which drug is minimally sedating? What is it’s mechanism of action?

A

Aripiprazole; partial D2 agonist (high affinity for D2 receptors but has ~30% of intrinsic activity of dopamine)
- 5-HT2A antagonist

42
Q

What does Ziprasidone do? What does it have a low affinity to?

A
  • prolonges QTc interaval (not indicated for patients with heart problems)
  • low affinity for muscarinic, alpha-1 and H1 receptors (less sedation, less postural hypotension, less weight gain)

Pharmacology- Test 4 (11 decks)

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