Antipsychotics&Lithium 1 Flashcards
What are the 6 essentials of diagnosis for schizophrenia?
Social withdrawal, usually slowly progressive; deterioration in personal care
Loose thought associations; often slowed thinking and rapid shifting from topic to topic
Autistic absorption in inner thoughts; frequent sexual or religious preoccupations
Auditory hallucinations, often of a derogatory nature
Delusions, frequently of a persecutory nature
Symptoms of at least 6 months’ duration
Schizophrenic disorders are characterized by what?
a loss of contact with reality
What characterizes a delusional disorder?
persistent delusions with minimal impairment of daily functioning
What characterizes a schizoaffective disorder?
affective symptoms (either a major depressive episode, manic episode, or hypomanic episode) that precede or develop concurrently with psychotic manifestations
What characterizes a schizophreniform disorder?
Symptoms similar to schizophrenic disorders except that the duration of prodromal, acute, and residual symptoms is longer than 1 week but less than 6 months.
What characterizes a brief psychotic disorder?
Result of psychological stress and last less than 1 week
Hypotheses of schizophrenia:
___________ receptor and possibly _______ stimulation was the basis for the hallucinatory effects of LSD and mescaline.
5-HT2A receptor and possibly 5-HT2C stimulation was the basis for the hallucinatory effects of LSD and mescaline.
Hypotheses of Schizophrenia:
_______ receptor blockade is a key factor in the mechanism of action of the main class of atypical antipsychotic drugs
5-HT2A
Hypotheses of Schizophrenia:
Dopamine:
______________ in the central nervous system in the mesolimbic and striatal-frontal system.
Blockade of postsynaptic D2 receptors in the central nervous system in the mesolimbic and striatal-frontal system
Hypotheses of schizophrenia:
Glutamate:
Hypofunction of _________ located on GABAergic interneurons leads to diminished __________ on neuronal function.
Hypotheses of schizophrenia:
Glutamate:
Hypofunction of NMDA receptors located on GABAergic interneurons leads to diminished inhibitory influences on neuronal function.
T/F: Glutamate can lead to hyperstimulation of cortical neurons
True
What type of sx are involved with the mesolimbic dopaminergic pathways?
Positive sx
What type of sx are involved wih the mesocortical dopaminergic pathways?
negative sx
What type of sx are observed with the nigrostriatal dopaminergic pathways?
EPS & Tardive dyskinesia
What type of sx are involved with tuberohypophyseal dopaminergic pathways?
hyperprolactinemia
Suspiciousness
Unusual thought content (delusions)
Hallucinations
Conceptual disorganization
Disorganized speech
Catatonia
These are which sx cluster in schizophrenia?
Positive behavior sx cluster
Affective flattening (blunted)
Alogia (aphasia, “poverty of speech”)
Anhedonia (inability to experience pleasure)
Avolition (decreased motivation)
Withdrawal
Which type of Schizophrenia symptom cluster?
Negative (affect)
Impaired attention
Impaired working memory
Impaired executive function
Which type of schizophrenia sx cluster is this?
Cognitive (Cognition)
What 3 moods do schizophrenic pts feel?
Dysphoria
Suicidality
Hopelessness
Which antipsychotic has the most weight gain?
Chlorpromazine
Which drug has significant QTc prolongation?
Thioridazine
Sublingual only, no food or drink for 10 minutes after administration of the dose
Which 2nd generation antipsychotic?
Asenapine
Due to long half-life, steady-state is not reached for several weeks
Which 2nd generation antipsychotic drug?
Cariprazine
Take with food; ≥350 calories
Which 2nd gen antipsychotic?
Lurasidone
Avoid in first episode because of weight gain
Which drug?
Olanzapine
Dose related weight gain
Which drug?
Quetiapine
Hyperprolactinemia; use in mania
Which drug?
Risperidone
Take with food, ≥500 calories
Which 2nd generation antipsychotic?
Ziprasidone
What are the overall PK of antipsychotics?
Well absorbed
Lipid soluble
Allows entry into the CNS
Extensively bound to plasma proteins
Metabolized by liver enzymes: to active metabolites: CYP2D6 and CYP3A4
Long plasma half-lives
Further prolonged utilizing LAI
Renally eliminated
