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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
Which SGAs have moderate metabolic risk
Risperidone quetiapine
26
Which SGAs have low metabolic risk
Ziprasidone aripiprazole lurasidone
27
What are some cardiovascular effects of antipsychotics
Orthostatic hypotension, ECG changes, increased risk of sudden cardiac death
28
What is neuroleptic malignant syndrome
A severe syndrome characterized by muscular rigidity, altered consciousness, hyperthermia and autonomic dysfunction
29
What is the role of dopamine in the etiology of schizophrenia
Hyperactivity of dopaminergic pathways is linked to positive symptoms
30
What are the typical positive symptoms of schizophrenia
Delusions and hallucinations
31
What is catatonia
A marked decrease in reactivity to the environment including negativism rigidity bizarre postures mutism and stupor
32
What are the anti-emetic properties of FGAs
Blockade of CTZ receptors to prevent vomiting
33
What is the significance of D2 receptor blockade in antipsychotics
Strong correlation with antipsychotic potency in reducing positive symptoms
34
What are some side effects of antipsychotics related to sexual function
Decreased libido arousal and difficulties in erection and ejaculation
35
How do antipsychotics cause sedation and cognitive deficits
Through antihistamine H1 activity
36
What are some antimuscarinic side effects of antipsychotics
Blurred vision dry mouth constipation urinary retention impaired memory
37
What is the primary treatment for acute psychotic episodes with aggression
FGAs due to their sedative effects and availability in injectable forms
38
What are the risks associated with clozapine use
Agranulocytosis and metabolic side effects
39
Why is long-term treatment usually initiated with SGAs
Due to their lower risk of extrapyramidal symptoms
40
What are some behavioral effects of antipsychotics
Reduction in hallucinations and delusions sedation decreased spontaneous activity
41
What is the importance of monitoring blood cell counts in patients on clozapine
To detect potential leukopenia and agranulocytosis
42
How do antipsychotics affect temperature regulation
They may cause poikilothermia leading to difficulty in maintaining normal body temperature
43
What are some examples of atypical antipsychotics
Clozapine olanzapine quetiapine aripiprazole ziprasidone
44
What is the main advantage of SGAs over FGAs
Lower risk of extrapyramidal symptoms
45
How do antipsychotics affect seizure threshold
Some like chlorpromazine and clozapine decrease the seizure threshold
46
What are the cognitive effects of antipsychotics
Impaired attention working memory and executive function
47
How do FGAs and SGAs differ in their receptor binding profiles
FGAs primarily block D2 receptors while SGAs have a broader receptor binding profile including 5-HT receptors
48
What is the clinical significance of antipsychotic-induced weight gain
It increases the risk for obesity diabetes and cardiovascular diseases
49
What are some strategies to manage antipsychotic side effects
Monitoring metabolic parameters, using antipsychotics with lower side effect profiles and dose adjustments
50
What are the primary goals of antipsychotic therapy
To reduce symptoms, prevent relapse and improve functional outcomes
51
How do antipsychotics help in schizoaffective disorders
By reducing both psychotic and mood symptoms
52
What is the role of benzodiazepines as adjuncts to antipsychotics
They help manage agitation and anxiety in acute psychotic episodes
53
What are the risks of long-term antipsychotic use
Metabolic syndrome cardiovascular risks and movement disorders
54
How is treatment resistance in schizophrenia managed
Through combinations of antipsychotics or use of clozapine
55
What is the significance of depot formulations of antipsychotics
They improve compliance in patients with chronic non-compliance issues
56
What are the potential consequences of sudden discontinuation of antipsychotics
Relapse of psychotic symptoms and withdrawal effects
57
How do antipsychotics interact with other medications
They may interact with drugs metabolized by liver enzymes leading to increased or decreased drug levels
58
What are the indications for antipsychotic use in depression
To manage psychotic symptoms or severe agitation
59
How do antipsychotics impact quality of life in schizophrenia patients
By reducing symptoms improving social and occupational functioning but may also cause side effects that impact quality of life
60
What are the benefits of early intervention in psychosis
Improved long-term outcomes reduced severity of symptoms and better functional recovery

Pharmacology (8 decks)

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