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PHARM 203 (Final) > Antipsychotics (General) > Flashcards

Antipsychotics (General) Flashcards

1
Q

Psychosis

A

Abnormal condition of the mind

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2
Q

Schizophrenia (What is it?)

A

Psychiatric Illness (Disorder)

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3
Q

Schizophrenia (Affects Who?)

A

Affects young people
Strong hereditary factor

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4
Q

Schizophrenia (Positive Symptoms)

A

Excess/Distortion of normal behaviour:
- Delusions
- Hallucinations
- Thought Disorder: Wild thoughts, delusions

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5
Q

Schizophrenia (Negative Symptoms)

A

Absence/Loss of normal behaviour
- Withdrawal from social contacts
- Flattening of emotional response
- Inability to enjoy pleasure (Anhedonia)

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6
Q

Schizophrenia (Other Symptoms)

A

Deficits in cognitive function
- Attention
- Memory

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7
Q

Schizophrenia (Positive Symptoms)
- Neurotransmitters Involved

A

Under-activity of glutamate
- Receptor hypofunction (Glu/NMDA Receptor)

Dopamine Dysregulation
- Too much/little in some areas

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8
Q

Schizophrenia (Positive Symptoms)
- Mechanism

A

Overactivation of D2 in mesolimbic pathways

NMDA Receptor Hypofunction
- Not enough activation of GABAergic Neurons –> Not enough inhibition of dopaminergic neurons
–> Too much synthesis and release of dopamine

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9
Q

Schizophrenia (Negative Symptoms)
- Mechanism

A

Decreased activity of D1 dopamine receptors in mesocortical pathway
–> Not enough NMDA receptor activity
–> Too little activation of dopaminergic neurons

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10
Q

What pathways are responsible positive/negative symptoms
- Mesolimbic
- Mesocortical

A

Mesolimbic = Positive Symptoms
Mesocortical = Negative Symptoms

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11
Q

Schizophrenia (Cognitive Symptoms)
- Mechanism

A

NMDA Receptor Hypofunction
–> Affects GABAergic Interneurons altering cortical processing and causing cognitive impairment

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12
Q

Schizophrenia (Treating Positive vs Negative Symptoms)

A

Treatments work better on Positive Symptoms
–> They target D2 Receptors

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13
Q

Antipsychotics (Mechanism of Treatment)

A

Antagonism of D2 Receptors
- Also block many other receptors
–> Can cause good/bad side effects

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14
Q

First Generation Antipsychotics vs
Second Generation Antipsychotics

A

1st Gen:
- D1 Selectivity = D2 Selectivity
- Higher Extrapyramidal Disturbances
- Less Effective Against Negative Symptoms

2nd Gen:
- D2 Selectivity > D1 Selectivity
- Lower Extrapyramidal Disturbances
- Effective Against Negative Symptoms
–> 5-HT2A Antagonism

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15
Q

Antipsychotics
- Extrapyramidal Side Effects

A

Motor Disturbances
- Blocks D2 Receptors in Nigrostriatal Pathway

Parkinson’s Disease (Dystonia)
- Involuntary movements

Irreversible Dyskinesia
- Involuntary movement of face, limbs, tongue

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16
Q

Antipsychotics (Endocrine Effects)

A

Enhanced Prolactin secretion and Galactorrhea
- Blocks D2 Receptor in Tuberohypophyseal Pathway

17
Q

Antipsychotics (Pleasure Effects)

A

Blocks D2 Receptors in Mesolimbic Pathway
- Reduces Pleasure

18
Q

Antipsychotics (Worsening of _ Symptoms)

A

Blocks D2 Receptors in Cortex
- Worsening of Negative Symptoms

19
Q

Antipsychotics can have an effect on other receptors
- Name some examples?

A

Antihistamine: Sedation
mAchR Inhibition:
- Blurred Vision
- Constipation / Urinary Retention
- Dry Mouth
Alpha-Adrenoceptor Block: Low Blood Pressure

20
Q

Antipsychotics (Side Effects)
- Clozapine

A

Leukopenia/Agranulocytosis
- Lowers white blood cell count

21
Q

Antipsychotics (Side Effects)
- Skin

A

Jaundice
Urticarial (Hives) Skin Reaction

22
Q

Antipsychotic Malignant Syndrome

A

Muscle Rigidity
Rapid increase in body temperature
Mental Confusion

23
Q

How can Antipsychotic’s Side Effects be useful?

A

Blocking other unintended receptors can provide beneficial effects

24
Q

Relation between Dopaminergic and Cholinergic Neurons

A

Dopaminergic Neurons can inhibit Cholinergic Neurons
–> Reduces Motor Side Effects

25
Q

How can Antipsychotic’s Side Effects be useful?
- Producing Motor Side Effects

A

Antipsychotic blocks D2 Receptors on Cholinergic Neuron
–> No more inhibition –> Enhanced Ach
–> Produces Motor Side Effect

26
Q

How can Antipsychotic’s Side Effects be useful?
- Reducing Motor Side Effects

A

Antipsychotic blocks mAchR
–> Reduces Motor Side Effects

Antipsychotic blocks mAchR on Dopaminergic Neurons
–> Enhanced Dopamine release
–> Activates D2 Receptor on Cholinergic
–> Reduced Ach
–> Reduced Motor Side Effects

27
Q

How can Antipsychotic’s Side Effects be useful?
- Nigrostriatal Pathway

A

Dopamine Needed for Movement

Antipsychotic Blocks 5-HT2A Receptor
–> Increased Dopamine release
–> Reduces Motor Side Effects

28
Q

How can Antipsychotic’s Side Effects be useful
- Mesocortical Pathway

A

Too Little Dopamine, need more

Antipsychotic Blocks 5-HT2A Receptor
–> Increased Dopamine/Glutamate release
–> Improve Negative Side Effects

29
Q

How can Antipsychotic’s Side Effects be useful?
- Mesolimbic Pathway

A

Too much Dopamine, need less

Antipsychotic Blocks 5-HT2A and D2 Receptors
–> Decrease dopamine function

PHARM 203 (Final) (41 decks)

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