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Block 3 > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What 4 characteristics are seen in a period of psychosis?

A

Delusion

Disrupted thought patterns

Hallucination

Lack of self-awareness

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2
Q

What are the 5 main domains of symptoms seen in schizophrenia?

A

Positive symptoms

Negative symptoms

Cognitive symptoms

Aggressive symptoms

Anxiety/depression

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3
Q

How is Sx diagnosed?

A

Disturbances to have been longer than 6 months

OR

At least 1 month with 2 of the classic symptoms of delusions, hallucinations, disorganised/catatonic behaviour or negative symptoms

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4
Q

What are the 4 main negative symptoms of Sx?

A

Affective blunting – reduction in good and bad moods

Anhedonia – lack of joy

Alogia – lack, or paucity, of speech

Avolition – apathy, lack of motivation

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5
Q

What is the main treatment course for Sx?

A

Combination of pharmacological and psychological therapies

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6
Q

What is the main problem for patients taking antipsychotics?

A

Adherence

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7
Q

Describe Neuroleptic Malignant Syndrome

A

Rapid onset of extreme side effects caused by genetic polymorphism of D2 receptors

Presents within the first few weeks of treatment

Fever, autonomic problems, altered consciousness

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8
Q

What is the treatment for Neuroleptic Malignant Syndrome?

A

Dopamine agonists

Benzodiazepines

Withdrawal of the antipsychotic

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9
Q

What is the mechanism of action of first generation antipsychotics?

A

Antagonism of D2 receptors

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10
Q

Give 2 examples of first generation antipsychotics

A

Haloperidol

Chlorpromazine

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11
Q

What other receptors do first-generations act on?

A

Muscarinic M1

Histamine H1

Alpha-1 adrenergic

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12
Q

What side effects do first generations cause by antagonising M1 receptors?

A

Dry mouth

Constipation

Blurred vision

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13
Q

What side effects do first generations cause by antagonising H1 receptors?

A

Sedation

Weight gain

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14
Q

What side effects do first generations cause by antagonising a1 receptors?

A

Hypotension

Drowsiness

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15
Q

What side effects do first generations cause by antagonising D2 receptors?

A

Rigidity

Slow movements

Prolactin elevation

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16
Q

What side effects are usually seen in first-generation drugs? (broadly speaking)

A

Extrapyramidal symptoms

17
Q

Describe Tardive Dyskinesia

A

Caused by long term use of first-generations

Leads to involuntary movements of the tongue, twisting/grimacing movements of the face and limbs

Usually irreversible

18
Q

Give 3 examples of second-generation antipsychotics

A

Clozapine

Amisulpride

Risperidone

19
Q

Describe the mechanism of action of second-generation antipsychotics

A

5HT2 receptor antagonists

20
Q

What are the benefits/risks seen in second generation?

A

Lower risk of extrapyramidal symptoms

Higher risk of metabolic side effects

21
Q

Constipation, weight gain, dizziness and somnolence are side effects caused by which class of drugs and on which receptor?

A

Antagonism of 5HT receptors

Second-generation antipsychotics

22
Q

Name the 4 main dopamine pathways

A

Mesocortical

Mesolimbic

Nigrostriatal

Tuberohypophyseal

23
Q

Describe the nigrostriatal dopamine pathway

A

Goes from the substantia nigra (midbrain) to the basal ganglia

Involved in fine tuning and control of motor movements

24
Q

Describe the Tuberohypophyseal dopamine pathway

A

Connects the hypothalamus and pituitary gland

Responsible for prolactin release

25
Q

Describe the mesocortical and mesolimbic dopamine pathway

A

Start in ventral tegmental and substantia nigra (midbrain), project to nucleus accumbens in basal forebrain

Mesolimbic then goes to limbic system

Mesocortical goes to cortical regions in prefrontal cortex (cognitive function of personality)

26
Q

Describe Huntington’s disease

A

Autosomal dominant inherited disorder that results in degeneration of the striatum (caudate nucleus and putamen)

Hyperkinetic disorder

27
Q

Describe the relationship between dopamine, D2 receptors, and the indirect pathway

A

Dopamine acting at D2 receptors inhibit the indirect pathway. As this pathway inhibits movement, this results in a net increase of movement

Antagonists of D2 receptors will therefore stop this disinhibition, leading to reduced movement

Block 3 (14 decks)

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