Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMSP Exam 3 > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What are some indications of antipsychotics?

A
  • Recurrent suicidal behavior

- Hallucinations/Delusions associated with Parkinson Disease psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the dopamine hypothesis?

A
  • Chlorpromazine serendipitously found to have antipsychotic activity
  • Direct/indirect DA-agonists provoke psychotic reactions in non-schizophrenics and exacerbate symptoms in schizophrenics
  • PET studies have revealed alterations in DA-mediated transmission in schizphrenics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are positive symptoms of schizophrenia?

A
  • Hallucinations
  • Delusions
  • Disorganized speech/thinking
  • Agitation
  • Abnormal motor behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the anatomy of the mesolimbic pathway in schizophrenia?

A
  • Projections from the ventral tegmental area to the nucleus accumbens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the physiology of the mesolimbic pathway schizophrenia?

A
  • Motivation
  • Emotions
  • Reward
  • Positive symptoms of schizophrenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the anatomy of the mesocortical pathway in schizophrenia?

A
  • Projections from the ventral tegmental area to the cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the physiology of the mesocortical pathway in schizophrenia?

A
  • Cognition and executive functions

- Emotions and affect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the implications of the mesolimbic pathway in schizophrenia?

A
  • D2 antagonists reduce positive symptoms of schizophrenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the implications of the mesocortical pathway in schizophrenia?

A
  • Hypofunction of the mesocortical pathway might be related to cognitive and negative symptoms in schizophrenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the negative symptoms of schizophrenia?

A
  • Apathy
  • Avolition
  • Alogia
  • Cognitive deficits
  • Social withdrawal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the anatomy of the nigrostriatal pathway and EPS?

A
  • Projections from substantia nigra to striatum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the physiology of the nigrostriatal pathway and EPS?

A
  • Stimulation of purposeful movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the implications of the nigrostriatal pathway and EPS?

A
  • D2 antagonism induces extrapyramidal symptoms (pseudoparkinsonism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the anatomy of the tuberoinfundibular pathway and prolactin release?

A
  • Hypothalamus to infundibular region
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the physiology of the tuberoinfundibular pathway and prolactin release?

A
  • Dopamine is released into the portal circulation connecting the median eminence with the anterior pituitary gland
  • Dopamine tonically inhibits prolactin release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some implications of the tuberoinfundibular pathway and prolactin release?

A
  • D2 antagonism increases prolactin levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the four dopaminergic pathways?

A
  • Mesolimbic pathway
  • Mesocortical pathway
  • Nigrostriatal pathway
  • Tuberoinfundibular pathway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the schizophrenia hypotheses?

A
  • Limits to dopamine hypothesis
    1. Does not account for all cognitive deficits/negative symptoms associated with schizophrenia
    2. Does not fully explain role of other neurotransmitters or other receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  • What is the glutamate disorder hypothesis?
A
  1. NMDA receptor antagonists can manifest select aspects of schizophrenia
  2. Agents that modulate glycine modulatory site NMDA/AMPA receptor reduce some cognitive symptoms of schizophrenia
  3. Cognitive symptoms may be due to low activity of NMDA/AMPA receptor on GABA inhibitor interneurons in prefrontal cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the early-life neurodevelopmental disorder hypothesis?

A
  • Youth/adolescence genetic/environmental impact during pivotal neurodevelopmental stages leads to later-life symptoms and presentation of worsening impacts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do the therapeutic choices start with when treating psychotic disorders?

A
  • Previous dosing history

- Tolerance to known side effects

22
Q

What is the minimum therapy necessary in order to evaluate response to therapy?

A
  • 2-3 weeks

- Max benefit may take several months

23
Q

What is the best for rapid response in treating psychotic disorders?

A
  • Injectable versions

- Acute high doses are not universally beneficial

24
Q

When is favorable prognosis seen in treating psychotic disorders?

A
  • Shorter duration and less severe symptoms of disease prior to diagnosis/treatment]
  • Strong, positive pre-illness functionality
25
Q

What is the MOA of first generation antipsychotics (FGAs)?

A
  • Primarily block dopamine type-2 post synaptic receptors (D2» 5-HT)
26
Q

What else does FGAs do?

A
  • Also block one or more other receptors (primarily inducing SE’s)
    1. Muscarinic
    2. Histaminic
    3. Alpha-adrenergic
    4. D2 receptors in nigrostriatal and tuberoinfundibular
27
Q

What are the muscarinic side effects of FGAs?

A
  • Dry mouth
  • Constipation
  • Urinary retention
  • Blurred vision
  • Sedation
28
Q

What are the alpha adrenergic side effects of FGAs?

A
  • Orthostatic hypotension

- Dizziness/syncope

29
Q

What are the histamine side effects of the FGAs

A
  • Sedation
30
Q

What are some other side effects of FGAs?

A
  • Rick of QT prolongation and seizure activity
31
Q

What are some dopamine associated side effects of FGAs?

A
  • Hyperprolactinemia (amenorrhea/galactorrhea/gynecomastia/decreased libido)
  • Extrapyramidal symptoms/Tardive dyskinesia
32
Q

What are some treatments for extrapyramidal symptoms (EPS)?

A
  1. Anticholinergic agents (benztropine and trihexyphenidyl)

2. Antihistamine agents (diphenhydramine)

33
Q

What are some treatment for tardive dyskinesia (TD)?

A
  1. Selective vesicular monoamine transporter 2 (VMAT2) inhibitors (valbenazine and deutetrabenazine)
34
Q

What is the MOA of second generation antipsychotics (SGAs)?

A
  • Not only block dopamine type 2 post synaptic receptors they also block 5HT
  • They are stronger 5HT blockers than D2
35
Q

What are the four broad categories of SGAs?

A
  1. 5HT-2A/DA receptor antagonists
  2. Partial DA/5HT-1A receptor agonists
  3. Multi-acting receptor target agents
  4. Inverse serotonin agonist/antagonist
36
Q

What are some 5HT-2A/DA receptor antagonist drugs?

A
  • Iloperidone
  • Lurasidone
  • Paliperidone
  • Risperidone
  • Ziprasidone
37
Q

What are some partial DA/5HT-1A receptor agonist drugs?

A
  • Aripiprazole

- Brexpiprazole

38
Q

What are some multi acting receptor target agents?

A
  • Asenapine
  • Clozapine
  • Olanzapine
  • Quetiapine
  • Lumateperone
39
Q

What are some inverse serotonin agonist/antagonists?

A
  • Primavanserion
40
Q

What are some side effects of SGAs?

A
  • Weight gain
  • Metabolic effects
  • QT prolongation/ECG changes
  • Stroke
41
Q

What is monitored during antipsychotic treatment?

A
  • Serum glucose
  • Lipids
  • Weight
  • BP
  • Waist circumference and personal/family histories of metabolic and CV disease (if possible)
42
Q

What are some ways to monitor antipsychotics?

A
  • GASS
  • AIMS
  • BARS
  • SAS
43
Q

What are some rare side effects of SGAs?

A
  • Agranulocytosis (clozapine)
  • Drug reaction with eosinophilia and systemic symptoms (DRESS) (olanzapine)
  • Neuroleptic Malignant Syndrome (NMS)
44
Q

What is the treatment of Neuroleptic Malignant Syndrome?

A
  • Dantrolene (malignant hyperthermia)
45
Q

What may be needed after dose escalation or when switching agents?

A
  • Combination of antipsychotic therapy may be necessary clinically
46
Q

What is the best for acute agitation?

A
  • Injectable and ODT or SL versions
47
Q

What is the best treatment of multi-drug resistant disease of psychotic diseases?

A
  • Clozapine
48
Q

What is critical in treatment of psychotic disorders?

A
  • Adherence
49
Q

How can non-adherence be managed?

A
  • Long acting injectable agents (LAIAs)
50
Q

What are some LAIAs?

A
  • Haloperidol
  • Fluphenazine
  • Risperidone
  • Olanzapine
  • Aripiprazole

NMSP Exam 3 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions