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Pharmacology > Antipsychotics and Antimanic > Flashcards

Antipsychotics and Antimanic Flashcards

1
Q

how does the mesolimbic differ from the mesocortical pathway in terms of positive and negative symptoms

A

mesolimbic- positive symptoms
mesocortical- negative symptoms

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2
Q

how does the nigrostriatal differ from the tuberoinfundibular pathway in terms of schizophrenic symptoms

A

nigrostratal- extrapyramidal symptoms
tuberoinfundibular- hyperprolactinemia

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3
Q

what is the effect of atypical antipsychotics for schizophrenia

A

increase dopamine in mesocortical tract (control negative symptoms)

inhibit activity of mesolimbic path (control positive symptoms)

*controls + and - symptoms

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4
Q

what is the effect of typical antipsychotics for schizophrenia

A

inhibit mesolimbic path activity (controls positive symptoms)

less increase in mesocortical pathway (controls negative symptoms)

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5
Q

do typical or atypical antipsychotics for schizophrenia have more of an impact on the mesocortical tract? Mesolimbic tract

A

atypical= more mesocortical

both inhibit mesolimbic

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6
Q

how do D1 receptors differ from D2 receptors

A

D1 increase cAMP
D2 decreased cAMP

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7
Q

D1 receptors are __ coupled
D2 receptors are __ coupled

A

D1= Gs
D2= Gi or Go

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8
Q

what is the difference between the receptors primarily blocked by typical vs atypical antipsychotics

A

typical antipsychotics block dopamine D2 receptors

atypical antipsychotics block serotonin (5-HT2) receptors

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9
Q

what is an example of a high potency antipsychotic drug

A

haloperidol

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10
Q

atypical antipsychotic drugs control more __ symptoms

typical antipsychotics control more __ symptoms

A

atypical control negative
typical control positive

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11
Q

do atypical or typical antipsychotics produce more extrapyramidal symptoms

A

typical

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12
Q

although one may block a certain predominantly, all antipsychotics block what 2 receptors

A

D2 dopamine
serotonin (5-HT2)

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13
Q

do typical or atypical antipsychotics block muscarinic, alpha1, and histaminergic receptors

A

typical

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14
Q

what body temperature effect is seen with antipsychotic drug use

A

poikilothermic effect- loss of body regulation= body temperature varies with the environment

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15
Q

what are 3 cardiovascular system effects seen with antipsychotic drugs

A

orthostatic hypotension
QT prolongation
ventricular arrhythmia

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16
Q

what is an example of a typical (first generation) antipsychotic drug

A

chlorpromazine

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17
Q

what are 2 adverse effects of antipsychotic use

A

cholestatic jaundice (hypersensitivity reaction)
bone marrow suppression

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18
Q

how does thioridazine differ from chlorpromazine as an antipsychotic

A

more antimuscarinic effects
less extrapyramidal side effect

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19
Q

what are 2 adverse effects of the typical antipsychotic thioridazine

A

pigmentary retinopathy
cardiac arrhythmia

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20
Q

haloperidol is effective in acute schizophrenia to treat __ symptoms

positive or negative

A

positive

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21
Q

is Haloperidol short or long term acting

A

long acting injection

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22
Q

haloperidol has less antimuscarinic effects but its use is limited due to __

A

extrapyramidal symptoms and anticholinergic effects

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23
Q

what are 2 antipsychotics that can be used for Tourette’s syndrome

A

Pimozide
Haloperidol

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24
Q

what effects of typical antipsychotic drugs can tolerance be developed for

A

sedative and hypotensive

not antipsychotic and extrapyramidal

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25
what are 3 adverse effects of antipsychotic use
extrapyramidal symptoms such as: acute muscular dystonia akinesia drug induced pseudo-parkinsonism symptoms
26
how are extrapyramidal symptoms of antipsychotics treated
anticholinergic drugs benztropine, benzhexol
27
chronic toxicity of antipsychotics causes what symptom
tardive dyskinesia
28
what antipsychotic is the only drug to not induce tardive dyskinesia
clozapine
29
does chronic toxicity leading to tadive dyskinesia occur more with typical or atypical antipsychotic use
typical
30
what is the treatment for tardive dyskinesia caused by chronic antipsychotic toxicity
Valbenazine or Deutetrabenazine
31
what is the mechanism of action of Valbenazine or Deutetrabenazine used for management of chronic antipsychotics toxicity
inhibit monoamine transporter 2 and decreases amines
32
what are 5 adverse effects of antipsychotic drugs
hyperprolactinemia weight gain hyperglycemia, insulin resistance, and dyslipidemia-->diabetes retinopathy cardiotoxicity
33
antipsychotic drugs can cause neuroleptic malignant syndrome, especially with what drug
haloperidol
34
what causes neuroleptic malignant syndrome
rapid and excess dopamine receptor blockade
35
what are 3 effects of neuroleptic malignant syndrome caused by antipsychotic drugs
elevation of creatine kinase and liver transaminase autonomic dysfunction altered mental state
36
what drugs can be used for treatment for neuroleptic malignant syndrome
Bromocriptine Amantadine
37
what atypical antipsychotic drug has the greatest risk for developing cardiotoxicity
Ziprasidone
38
antipsychotic drugs causing Parkinson-like symptoms is due to __ while tardive dyskinesia symptoms is due to __
Parkinson- dopamine receptor blockade tardive dyskinesia- supersensitivity of dopamine receptors
39
do typical or atypical antipsychotics have a greater risk for metabolic effects and QT prolongation
atypical
40
is Clozapine an atypical or typical antipsychotic
atypical
41
what is the mechanism of action of Clozapine
blocks 5-HT2 and D4 with higher affinity than D2
42
what is the most effective antipsychotic drug
Clozapine
43
what are 4 adverse effect of Clozapine
agranulocytosis sialorrhea constipation hyperglycemia (diabetes)
44
in what cases is Clozapine used for
drug resistant schizophrenia (due to its adverse effects)
45
what drug is used for the prevention of the manic phase of bipolar disorder
Olanzapine with lithium
46
what drug similar to Clozapine doesn't induce agranulocytosis
Olanzapine
47
what is the mechanism of action of the atypical antipsychotic Risperidone
blocks 5-HT2 receptors
48
what is the preferred antipsychotic drug
Risperidone
49
what are 3 adverse effects of the atypical antipsychotic Risperidone
hyperprolactinemia prolonged QT interval more extrapyramidal symptoms
50
what atypical antipsychotic has the greatest risk for QT prolongation
Ziprasidone
51
what atypical antipsychotic is preferred for schizophrenia with depression
Quetiapine
52
what is the mechanism of action of the atypical antipsychotics Aripiprazole
partial agonist of D2 and 5-HT2 receptors
53
what atypical antipsychotic can be used for maintenance rather than severe psychosis
Aripiprazole
54
what atypical antipsychotic drug increases prolactin
Risperidone
55
what atypical antipsychotic is used for Huntington's chorea
Haloperidol
56
what antipsychotic can be used for intractable hiccups
Clorpromazine
57
what antipsychotic can be used for neuroleptanalgesia (semiconscious and nonreactive state)
Droperidol with fetanyl
58
are typical or atypical drugs more effective in schizophrenia
atypical
59
when giving antipsychotics, there is a potential for more anticholinergic effects if given with __ or __
TCA antiparkinsonian drugs
60
antipsychotic drugs are contradicted in what 3 patients
chronic alcoholics (lowers seizure threshold) mood disorders nursing mothers
61
typical antipsychotics have a higher risk for __ side effects while atypical have a higher risk for __ side effects
neurological metabolic
62
what drug is used in acute mania and bipolar maintenance
lithium
63
what is the mechanism of action of lithium
inhibits inositol monophosphate (decreases inositol concentration) increased BDNF
64
what are 3 adverse effects of lithium
nephrogenic diabetes insipidus hypothyroidism increased leukocytes
65
lithium is contradicted in what patients
pregnant/breastfeeding
66
lithium has high drug interaction with what 3 classes of drugs
diuretics NSAIDS neuroleptics
67
effect of diuretic use with lithium
increased plasma lithium
68
effect of NSAID use with lithium
enhances lithium toxicity by decreasing its clearance
69
lithium is the preferred drug for what 3 conditions
bipolar affective disorder prevention of acute manic episodes depression in bipolar
70
what 2 drugs are alternatives for lithium in acute mania
Carbamazepine Valproate
71
how does Valproate stabilize mood
inhibits histone deacetylase which increases BDNF

Pharmacology (16 decks)

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