Antipsychotics&Lithium 1 Flashcards

1
Q

What are the 6 essentials of diagnosis for schizophrenia?

A

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

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2
Q

Schizophrenic disorders are characterized by what?

A

a loss of contact with reality

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3
Q

What characterizes a delusional disorder?

A

persistent delusions with minimal impairment of daily functioning

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4
Q

What characterizes a schizoaffective disorder?

A

affective symptoms (either a major depressive episode, manic episode, or hypomanic episode) that precede or develop concurrently with psychotic manifestations

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5
Q

What characterizes a schizophreniform disorder?

A

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.

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6
Q

What characterizes a brief psychotic disorder?

A

Result of psychological stress and last less than 1 week

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7
Q

Hypotheses of schizophrenia:

___________ receptor and possibly _______ stimulation was the basis for the hallucinatory effects of LSD and mescaline.

A

5-HT2A receptor and possibly 5-HT2C stimulation was the basis for the hallucinatory effects of LSD and mescaline.

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8
Q

Hypotheses of Schizophrenia:

_______ receptor blockade is a key factor in the mechanism of action of the main class of atypical antipsychotic drugs

A

5-HT2A

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9
Q

Hypotheses of Schizophrenia:

Dopamine:

______________ in the central nervous system in the mesolimbic and striatal-frontal system.

A

Blockade of postsynaptic D2 receptors in the central nervous system in the mesolimbic and striatal-frontal system

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10
Q

Hypotheses of schizophrenia:

Glutamate:

Hypofunction of _________ located on GABAergic interneurons leads to diminished __________ on neuronal function.

A

Hypotheses of schizophrenia:

Glutamate:

Hypofunction of NMDA receptors located on GABAergic interneurons leads to diminished inhibitory influences on neuronal function.

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11
Q

T/F: Glutamate can lead to hyperstimulation of cortical neurons

A

True

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12
Q

What type of sx are involved with the mesolimbic dopaminergic pathways?

A

Positive sx

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13
Q

What type of sx are involved wih the mesocortical dopaminergic pathways?

A

negative sx

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14
Q

What type of sx are observed with the nigrostriatal dopaminergic pathways?

A

EPS & Tardive dyskinesia

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15
Q

What type of sx are involved with tuberohypophyseal dopaminergic pathways?

A

hyperprolactinemia

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16
Q

Suspiciousness

Unusual thought content (delusions)

Hallucinations

Conceptual disorganization

Disorganized speech

Catatonia

These are which sx cluster in schizophrenia?

A

Positive behavior sx cluster

17
Q

Affective flattening (blunted)

Alogia (aphasia, “poverty of speech”)

Anhedonia (inability to experience pleasure)

Avolition (decreased motivation)

Withdrawal

Which type of Schizophrenia symptom cluster?

A

Negative (affect)

18
Q

Impaired attention

Impaired working memory

Impaired executive function

Which type of schizophrenia sx cluster is this?

A

Cognitive (Cognition)

19
Q

What 3 moods do schizophrenic pts feel?

A

Dysphoria

Suicidality

Hopelessness

20
Q

Which antipsychotic has the most weight gain?

A

Chlorpromazine

21
Q

Which drug has significant QTc prolongation?

A

Thioridazine

22
Q

Sublingual only, no food or drink for 10 minutes after administration of the dose

Which 2nd generation antipsychotic?

A

Asenapine

23
Q

Due to long half-life, steady-state is not reached for several weeks

Which 2nd generation antipsychotic drug?

A

Cariprazine

24
Q

Take with food; ≥350 calories

Which 2nd gen antipsychotic?

A

Lurasidone

25
Q

Avoid in first episode because of weight gain

Which drug?

A

Olanzapine

26
Q

Dose related weight gain

Which drug?

A

Quetiapine

27
Q

Hyperprolactinemia; use in mania

Which drug?

A

Risperidone

28
Q

Take with food, ≥500 calories

Which 2nd generation antipsychotic?

A

Ziprasidone

29
Q

What are the overall PK of antipsychotics?

A

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

30
Q
A