Antipsychotics - Lichtblau Flashcards
What does the dopamine hypothesis say about the cause of Schizophrenia?
Hyperproduction of dopamine.
Activity is increased at the D2 receptor
How does haloperidol improve schizophrenia symptoms?
Haloperidol is a first generation drug. It blocks dopamine receptors in the brain
It ONLY reduces positive symptoms of schizophrenia
What is a serious side-effect possibility with long-term, high-dose first generation antipsychotic?
Tardive dyskinesia.
Repetitive involuntary purposeless movements Results of long-term or high-dose use of FGA’s -Examples: Grimace Tongue movements Lip smacking Puckering Pursing lips Eye blinking
(also very small incidence in second generation as well)
*Cade says just remember “the joker” and “Barty Crouch Jr.”
Schizophrenia is interesting because it has 3 different types of symptoms, name the positive, negative, and cognitive symptoms:
Pos: Delusions, hallucinations, disorganized behavior and thinking
Neg: Lack of emotion and interest, flat affect, alogia (difficulty speaking), social probs and isolation
Cog: Slow thinking, poor understanding and memory, difficulty concentrating and expressing oneself
What pathway in the brain is though to mediate the positive symptoms of Schizophrenia:
Mesolimbic pathway
cocaine and amph. can mimic + symptims by affecting this site
Problems in the mesocortical system in a Schizophrenic patient would likely produce what symptoms?
negative symptoms:
ex. flattened affect and lack of motivation
When FGA (1st Gen. Antipsychotics) like haloperidol block dopamine receptors, they run the risk of what SERIOUS side effect?
Parkinsonian-like syndrome
Caused by blocking DA receptors in the striatum in the nigrostriatal pathway
What kind of side affects can female patients experience on FGAs?
Galactorrhea, amenorrhea, sexual dysfunction
This is due to action on the tuberoinfundibular pathway
Advantage and disadvantage of the SGA clozapine and the SGA quetiapine?
Clozapine works well for both positive and negative symptoms BUT has small chance of getting agranulocytosis (acute and dangerous leukocytopenia)
Quetiapine and all the other SGA’s are less dangerous, but just don’t work as well as clozapine
What are all of the SGA’s similar to Clozapine, just safer and not quite as effective?
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Aripiprazole (Abilify)
How do SGAs work?
Why does this decrease some of the negative symptoms seen in FGAs?
They block D2 receptors and 5HT receptors
5HT actually causes DA release in some areas like nigrostriatal, mesocortical, and tuberoinfundibular. This counteracts the DA receptor blockade. Luckily in the mesolimbic system 5HT doesn’t have as much effect, so you get the therapy there without the adverse effects everywhere else seen in FGAs.
What is the most common adverse effect in SGAs leading to noncompliance?
Weight gain
