Antipsychotics Flashcards
how do pre synaptic serotonin receptors impact dopamine?
decrease synaptic dopamine
what happens when we block post synaptic dopamine receptors?
movement disorders
(seen in typical antipsychotics)
what happens when we block dopamine and serotonin receptors
increase synaptic dopamine
competition between drug and dopamine
reduced motor side effects
possible etiologies of schizophrenia
neurodevelopmental
genetics
environmental
gene - environment interactions
neurodevelopment-environment interactions
which receptor mediator of hallucinations
5HT2a
which agents were originally identified as 5HT agonists
LSD and mescaline
5HT2a receptors modulate what
glutamate release and NMDA receptors
dopamine release
5HT2a ____ are beneficial in schizophrenia
antagonists
what is glutamate
major excitatory neurotransmitter
whats part of the glutamate theory that exacerbates psychosis and cognition
ketamine and phencyclidine which are noncompetitive inhibitors of NMDA receptors
patients with schizophrenia have increased _____ receptor density
D2
which region responsible for motor side effects (EPS)
basal ganglia
which region is primary therapeutic effects
mesolimbic
which region has hypofunction in schizoprenia
mesocortical
which region helps anti-emetic
medulla
when do we see EPS symptoms?
early, days/weeks
drug therapy for EPS
anticholinergics (benztropine, trihexphenidyl, akineton)
benadryl
amantadine
propranolol
how do EPS side effects happen?
since we blocking inhibitory and D2, we get excess excitatory so we need anticholinergic
when may tardive dyskinesia occur?
late, months to years
is tardive dyskinesia reversible
no
irreversible
treatment of tardive dyskinesia
prevention
phenothiazine structure
clozapine
olanzapine
loxapine
risperidone
