antipsychotics

Question 1

mesocortical

Answer 1

projects from the ventral tegmentum (brain stem) to the cerebral cortex. This pathway is felt to be where the negative symptoms and cognitive disorders (lack of executive function) arise. Problem here for a psychotic patient, is too little dopamine

Question 2

mesolimbic

Answer 2

projects from dopaminergic cell bodies in the ventral tegmentum . This pathway is where the positive symptoms come from (hallucinations, delusions, and thought disorders). Problem here in a psychotic patient is there is too much dopamine.

Question 3

NIGROSTRIATAL-

Answer 3

projects from the dopaminergic cell bodies in the substantia nigra to the basal ganglia. This pathway is involved in movement regulation. Remember that dopamine suppresses acetylcholine activity. Dopamine hypoactivity can cause Parkinsonian movements i.e. rigidity, bradykinesia, tremors), akathisia and dystonia.

Question 4

TUBEROINFUNDIBULAR

Answer 4

projects from the hypothalamus to the anterior pituitary. Remember that dopamine release inhibits/regulates prolactin release. Blocking dopamine in this pathway will predispose your patient to hyperprolactinemia

Question 5

typical antipsychotic

Answer 5

D2 dopamine receptor antagonists

high potency bind to D2 receptor as a result have extra pyramidal side effects

Question 6

low potency typical

Answer 6

less affinitey for D2 receptors but tend to interact with non dopaminergic receptors resulting in more cardiotoxic and anticholinergic adverse effects

Question 7

for exam

Answer 7

atypical are newer and cause weight gain

Question 8

atypicals

Answer 8

serotonin dopamine 2 antagonists

considered atypical in the way they affect dopamineand serotonin neurotransmission in four key dopamine pathways

Question 9

Risperidone (atypical)

Answer 9

functions more like typical antipsychotic at doses greater than 6 mg
increased extrapyramidal side effects
atypical induce hyperprolactinemia
weight gain and sedation

Question 10

olanzapine

Answer 10

weight gain
may cause hypertriglyceridemia
hypercholesterolemia
hyperglycemia
hyperprolactinemia

Question 11

quetiapine

Answer 11

most likely to cause orthosatic hypotension

Question 12

treatment resistance

Answer 12

clozapine
reserved for treatment resistant patients but it works
associated with agranulocytosis
increased risk of seizures
associated with most sedation weight gain
hypertriglyceridemia

Question 13

antipsyhotic adverse effects

Answer 13

tardive dyskinesis
neuroleptic malignant syndrome- characterized by severe muscle ridigity, fever
extrapyramidal side effects: acute dystonia, parkinson syndrome, akathisia.

Question 14

anticholinergics

Answer 14

benztropine

trihexphenidyl

Question 15

dopamine facilitators

Answer 15

amantadine

Question 16

benzodiazepines

Answer 16

use to treat insomnia, parasomnias and anxiety

often used for CNS depressant withdrawals