antipsychotic medications

Question 1

what are the acute extra-pyramidal side effects of anti-psychotics

Answer 1

1) ACUTE DYSTONIA
- spasms(e.g torticollis, oculogyric crisis and tongue protusion)
- managed with anticholinergics
2) PARKINSONISM
-tremor, rigidity, bradykinesia
-managed with anticholinergics
3) AKATHISIA
- restlessness
-managed with sedatives or medication changes

Question 2

There are several areas where dopamine neurons are concentrated. Which are these areas

Answer 2

largest are substantia nigra and ventral tegmental areas in the midbrain. Other areas include the hypothalamus, olfactory bulb and retina

Question 3

Several major dopamine pathways carry dopamine from areas of concentration to other parts of the brain

Answer 3

1)mesostriatal and nigrostriatal pathways which stretches from the substantia nigra to the striatum(caudate and putamen)
mesolimbic pathway stretches from ventral tegmental area to the nucleus accumbens and other limbic structures
and mesocortical pathway which stretches from the ventral tegmental area throughout the cerebral cortex

Question 4

mesolimbic pathway and how it affects sp

Answer 4

motivation, emotion and reward
overactive mesolimbic pathway cause positive symptoms in schizophrenia, increase level of dopamine from vta to na. This pathway is the intended site of action of antipsychotics

Question 5

mesocortical pathway and how it affects sp

Answer 5

controls for cognition and executive function
in SP there is decrease in level of dopamine from VTA to cortex causes negative symptoms of SP (anhedonia, flat affect, poverty of speech). Antipsychotics don’t
have great efficacy
at improving the
functioning of this
pathway

Question 6

nigrostriatal pathway and affect on SP

Answer 6

stimulation of movement - intricate involvement of basal ganglia. Starts in the substantia nigra project to striatum (caudate and putamen). Normal levels in SP. Antipsychotic use affect this pathway due to decrease level of dopamine. DA antagonism in this
pathway causes extra-
pyramidal side-effects. Cause parkinsonism: cogwheel rigidity, shuffling gait, resting tremor

Question 7

What does antipsychotics do

Answer 7

they decrease the level of dopamine