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Pharmacology > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Define psychotic disorders

A

Mental illnesses characterized by psychotic symptoms such as loss of touch with reality

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2
Q

What are some common psychotic disorders

A

Schizophrenia, schizoaffective disorder, delusional disorder, substance-induced psychosis, mood disorders with psychotic features, dementia with psychotic features

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3
Q

What characterizes schizophrenia

A

Disturbances of thought and perception along with emotional and behavioral disturbances causing significant impairment in socio-occupational functioning

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4
Q

What is the typical feature of schizophrenia

A

Loss of touch with reality

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5
Q

What is the onset period for schizophrenia

A

Adolescence or early adulthood

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6
Q

What are the major clusters of schizophrenia symptoms

A

Positive symptoms negative symptoms cognitive symptoms

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7
Q

What are positive symptoms of schizophrenia

A

Delusions, hallucinations, formal thought disorder, grossly disorganized or abnormal behavior, catatonia

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8
Q

What are negative symptoms of schizophrenia

A

Affective flattening, anhedonia, alogia, avolition, asociality

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9
Q

What are cognitive symptoms of schizophrenia

A

Impaired attention working memory and executive function

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10
Q

What is the dopamine hypothesis of schizophrenia

A

Symptoms arise from hyperactivity of dopaminergic pathways in the brain

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11
Q

What evidence supports the dopamine hypothesis

A

Reserpine has antipsychotic actions amphetamine can induce psychosis antipsychotics block DA-receptor agonists

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12
Q

What is the glutamate hypothesis of schizophrenia

A

Psychotic symptoms induced by NMDA receptor antagonists like ketamine and phencyclidine

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13
Q

What is the serotonin hypothesis of schizophrenia

A

Schizophrenia-like symptoms induced by LSD, many atypical antipsychotics block 5-HT receptors

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14
Q

What are first-generation antipsychotics FGAs

A

Typical classical or conventional antipsychotics

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15
Q

What are second-generation antipsychotics SGAs

A

Atypical antipsychotics with less risk of extrapyramidal symptoms

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16
Q

Name some phenothiazine FGAs

A

Chlorpromazine thioridazine fluphenazine perphenazine trifluoperazine

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17
Q

Name some butyrophenone FGAs

A

Haloperidol droperidol

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18
Q

What are the effects of FGAs on behavior

A

Reduced hallucinations and delusions, quieting of agitated patients, sedation, decreased spontaneous activity

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19
Q

What are anti-emetic effects of FGAs

A

Blockade of CTZ via DA/5-HT blockade blocks emesis induced by various agents

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20
Q

What are some SGAs

A

Clozapine olanzapine quetiapine asenapine zotepine

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21
Q

What is the primary use of antipsychotics

A

Treatment of acute mania schizoaffective disorders psychosis associated with depression or drug intoxication

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22
Q

What are the main adverse effects of antipsychotics

A

Metabolic effects, cardiovascular effects, decreased seizure threshold, jaundice, leukopenia, agranulocytosis, skin reactions, poikilothermia, clozapine-induced sialorrhea

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23
Q

What are the metabolic effects of antipsychotics

A

Weight gain hyperglycemia diabetes mellitus dyslipidemia

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24
Q

Which SGAs have high metabolic risk

A

Clozapine olanzapine

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25
Q

Which SGAs have moderate metabolic risk

A

Risperidone quetiapine

26
Q

Which SGAs have low metabolic risk

A

Ziprasidone aripiprazole lurasidone

27
Q

What are some cardiovascular effects of antipsychotics

A

Orthostatic hypotension, ECG changes, increased risk of sudden cardiac death

28
Q

What is neuroleptic malignant syndrome

A

A severe syndrome characterized by muscular rigidity, altered consciousness, hyperthermia and autonomic dysfunction

29
Q

What is the role of dopamine in the etiology of schizophrenia

A

Hyperactivity of dopaminergic pathways is linked to positive symptoms

30
Q

What are the typical positive symptoms of schizophrenia

A

Delusions and hallucinations

31
Q

What is catatonia

A

A marked decrease in reactivity to the environment including negativism rigidity bizarre postures mutism and stupor

32
Q

What are the anti-emetic properties of FGAs

A

Blockade of CTZ receptors to prevent vomiting

33
Q

What is the significance of D2 receptor blockade in antipsychotics

A

Strong correlation with antipsychotic potency in reducing positive symptoms

34
Q

What are some side effects of antipsychotics related to sexual function

A

Decreased libido arousal and difficulties in erection and ejaculation

35
Q

How do antipsychotics cause sedation and cognitive deficits

A

Through antihistamine H1 activity

36
Q

What are some antimuscarinic side effects of antipsychotics

A

Blurred vision dry mouth constipation urinary retention impaired memory

37
Q

What is the primary treatment for acute psychotic episodes with aggression

A

FGAs due to their sedative effects and availability in injectable forms

38
Q

What are the risks associated with clozapine use

A

Agranulocytosis and metabolic side effects

39
Q

Why is long-term treatment usually initiated with SGAs

A

Due to their lower risk of extrapyramidal symptoms

40
Q

What are some behavioral effects of antipsychotics

A

Reduction in hallucinations and delusions sedation decreased spontaneous activity

41
Q

What is the importance of monitoring blood cell counts in patients on clozapine

A

To detect potential leukopenia and agranulocytosis

42
Q

How do antipsychotics affect temperature regulation

A

They may cause poikilothermia leading to difficulty in maintaining normal body temperature

43
Q

What are some examples of atypical antipsychotics

A

Clozapine olanzapine quetiapine aripiprazole ziprasidone

44
Q

What is the main advantage of SGAs over FGAs

A

Lower risk of extrapyramidal symptoms

45
Q

How do antipsychotics affect seizure threshold

A

Some like chlorpromazine and clozapine decrease the seizure threshold

46
Q

What are the cognitive effects of antipsychotics

A

Impaired attention working memory and executive function

47
Q

How do FGAs and SGAs differ in their receptor binding profiles

A

FGAs primarily block D2 receptors while SGAs have a broader receptor binding profile including 5-HT receptors

48
Q

What is the clinical significance of antipsychotic-induced weight gain

A

It increases the risk for obesity diabetes and cardiovascular diseases

49
Q

What are some strategies to manage antipsychotic side effects

A

Monitoring metabolic parameters, using antipsychotics with lower side effect profiles and dose adjustments

50
Q

What are the primary goals of antipsychotic therapy

A

To reduce symptoms, prevent relapse and improve functional outcomes

51
Q

How do antipsychotics help in schizoaffective disorders

A

By reducing both psychotic and mood symptoms

52
Q

What is the role of benzodiazepines as adjuncts to antipsychotics

A

They help manage agitation and anxiety in acute psychotic episodes

53
Q

What are the risks of long-term antipsychotic use

A

Metabolic syndrome cardiovascular risks and movement disorders

54
Q

How is treatment resistance in schizophrenia managed

A

Through combinations of antipsychotics or use of clozapine

55
Q

What is the significance of depot formulations of antipsychotics

A

They improve compliance in patients with chronic non-compliance issues

56
Q

What are the potential consequences of sudden discontinuation of antipsychotics

A

Relapse of psychotic symptoms and withdrawal effects

57
Q

How do antipsychotics interact with other medications

A

They may interact with drugs metabolized by liver enzymes leading to increased or decreased drug levels

58
Q

What are the indications for antipsychotic use in depression

A

To manage psychotic symptoms or severe agitation

59
Q

How do antipsychotics impact quality of life in schizophrenia patients

A

By reducing symptoms improving social and occupational functioning but may also cause side effects that impact quality of life

60
Q

What are the benefits of early intervention in psychosis

A

Improved long-term outcomes reduced severity of symptoms and better functional recovery

Pharmacology (8 decks)

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