Antipsychotics HY

Question 1

primary mechanism of typical antipsychotic agents

Answer 1

block D2 (dopamine) receptors

-mainly positive symptoms in mesolimbic tract

Question 2

primary mechanism of atypical/newer antipsychotic agents

Answer 2

block 5HT2A receptors (serotonin)

• positive symptoms
• negative symptoms in mesocortical tract

Question 3

consequence of blocking mesolimbic pathway

Answer 3

antipsychotic (positive symptoms)

Question 4

consequence of blocking mesocortical pathway

Answer 4

antipsychotic (negative symptoms)

Question 5

consequence of blocking nigrostriatal pathway

Answer 5

extrapyramidal movements
(block dopamine D2R --> parkinsons)

Question 6

consequence of blocking tuberinfundibular pathway

Answer 6

prolactin release (hyperprolactinemia)

Question 7

common adverse reactions of antipsychotics

Answer 7

• hyperprolactinemia
• orthostasis
• cardiotoxicity
• extrapyramidal syndromes
• acute dystonic reaction
• neuroleptic malignant syndrome
• pregnancy: abnormal motor movements, withdrawal symptoms
• poikilothermia

Question 8

adverse effects of atypical antipsychotics

Answer 8

• increases in weight, blood glucose, and lipids
• orthostasis
• LESS likely to get hyperprolactinemia, EPS
• misc others: somnolence, dizziness, increased LFTs, CYP450 interactions

Question 9

consequence of blocking alpha-1 receptors

Answer 9

orthostasis

Question 10

consequence of blocking histamine-1 receptors

Answer 10

sedation and weight gain

stimulation of appetite

Question 11

consequence of blocking muscarinic receptors

Answer 11

• dry mouth
• blurred vision
• urinary retention
• constipation