Antipsychotics

Question 1

Plays key role which argues that psychosis can be explained by changes of these neurotransmitter in brain

Answer 1

Dopamine

Question 2

Pathway hyperactive in schizophrenia

Mediates positive symptoms such as delusions and hallucinations

Answer 2

Mesolimbic

Question 3

Pathway underactive in schizophrenia

Mediates negative psychotic symptoms such as loss of motivation and social withdrawal

Answer 3

Mesocortical

Question 4

Part of EPS
Controls motor function and movement

Deficiency of dopamine in this pathway leads to dystonia and parkinsonian symptoms

Excess of dopamine in this pathway leads to tics and dyskinesia

Answer 4

Nigrostriatal

Question 5

Pathway that controls prolactin secretion

Dopamine in this pathway inhibits prolactin release

Answer 5

Tuberoinfundibular

Question 6

5 primary types of dopamine receptors

Highest density of receptors involved in psychotic disorder

Most clinically relevant

Answer 6

D1-D5

D1 and D2

D2 target of antipsychotics

Question 7

Blocks D2 receptors in all areas of the brain leading to

reduction of positive symptoms (delusion, hallucination)
worsening of negative symptoms (diminished energy, social disengagement)
EPS disorders (tardive dyskinesia, tremors)
increased prolactin (galactorrhea, gynecomastia, sexual dysfunction)

Answer 7

First generation typical antipsychotics

Question 8

High potency first generation anti psychotics

Produce stronger antipsychotic effect at low doses but more EPS and rare increase in prolactin

Answer 8

Haloperidol
Fluphenazine
Prochlorperazine
Trifluoperazine

Question 9

Low potency first gen antipsychotic
Do not bind to D2 receptors as tightly

Results in variety of side effects by blockade of alpha receptor (OH)
Blockade of muscarinic receptors (dry mouth, blurred vision, difficulty of urination)
Blockade of H1 histamine receptor (sedation, weight gain)

Answer 9

Chlorpromazine

Question 10

Blocks both D2 and 5HT2A receptors

Significantly lowers incidence of EPS
Decreases negative symptoms

Also binds to histamine, alpha adrenergic and muscarinic receptors

Answer 10

2nd generation Atypical anti-psychotics

Question 11

2nd gen Atypical antipsychotics

Answer 11

Clozapine
Aripiprazole
Lurasidone
Olanzapine
Quietiapine
Risperidone
Ziprasid

Question 12

Strong affinity for 5HT2C

Causes metabolic side effects

Weight gain
Hyperglycemia
Hyperlipidemia

Answer 12

Clozapine

Olanzapine

Question 13

Strong affinity for H1 receptors

Cause sedation
weight gain

Answer 13

Clozapine
Olanzapine
Quietiapine

Question 14

Strong affinity for a1 adrenergic receptor

Cause OH

Answer 14

Clozapine

Risperidone

Question 15

Strongest affinity for D2 receptor

Atypical antipsychotic with Highest potential to cause EPS and hyperprolactinemia

Answer 15

Risperidone

Question 16

Causes agranulocytosis

Needs period CBC

Answer 16

Clozapine