Atypical antipsychotics Flashcards
What are the 4 main dopamine pathways and their function?
1) The mesolimbic pathway : Motivation and desire.
2) Mesocortical pathway: Emotions.
3) Nigrostriatal pathway: regulates involuntary movements and coordination.
4) Tuberoinfendibular pathway: dopaminergic inhibition of prolactin secretion.
Activation of dopamine receptor in area postrema triggers ?
Vomiting reflex
The dopamine receptors in medullary peri-ventricular area is involved in ?
Regulating eating behaviour
What are the symptoms of high mesolimbic dopamine level in schizophrenia
It causes positive symptoms such as delusions, hallucinations, and disorganised thoughts.
What are the symptoms of low levels of dopamine in mesocortical pathway in schizophrenia ?
Negative symptoms such as lack of motivation, social withdrawal and flat affect.
Why are atypical antipsychotics the preferred medication in schizophrenia ?
They alleviate positive symptoms by inhibiting D2 receptors in the mesolimbic pathway. They also alleviate negative symptoms by enhancing the dopamine release in the mesocortical pathway by inhibiting the 5-HT2a receptors.
What are the most commonly used atypical anti-psychotics ?
- Clozapine, Olanzapine and Quetiapine.
- Paliperidone and Risperidone
- Lurazidone and Ziprasidone.
- Aripiprazole.
What are the conditions treated using atypical antipsychotics ?
- Schizophrenia and bipolar disorder
- OCD and anxiety
- Depression and Tourette syndrome.
What is the first line agent for the management of acute mania ?
Atypical antipsychotics.
What are the side effects caused by the action of atypical antipsychotics on Tubuloinfendibular pathway ?
Hyperprolactenaemia , oligomenorrhoea, galactorrhoea, and gynacomastia.
Which is the antipsyhcotic most likely to cause hyper-prolactenaemia ?
Risperidone.
How does atypical antipsychotics cause extra pyramidal symptoms ?
Inhibition of dopamine receptors in the nigrostrial pathway.
What are the acute EPSs caused by atypical antipsychotics ?
Dystonia, akathesia and psuedo-parkinsonism.
What is the chronic EPS caused by atypical antipsychotics ?
Tradive dyskinesia.
What is the most dangerous side effect of atypical antipsychotics ?
Neuroleptic malignant syndrome characterised by confusion, muscle rigidity, agitation, seizure and hyperthermia.
What is the complication of neuroleptic malignant syndrome ?
Rhabdomyolysis
What is the management of neuroleptic malignant syndrome?
- For muscle relaxation dandoline.
- for reversing anti-dopaminergic effects bromocreptine ( Dopamine agonist).
Why does atypical antipsychotics cause fewer EPS than typical antipsychotcis ?
As compared to typical anti-psychotics, the atypical ones binds loosely to the dopamine receptors. Therefore, they can be relatively easily displaced from the binding sites by dopamine and dopamenergic drugs. Hence fewer EPS compared to typical anti-psychotics.
What are the other side effects of atypical anti-psychotics ?
- Sedation due to H1 inhibition.
- Orthostatic hpotension due to Alpha 01 inhibition.
- Anti-cholinergic effects due to muscaranic receptor antagonism.
Atypical anti-psychotics can also cause ______
Metabolic syndrome.
What are the atypical anti-psychotics tends to cause weight gain most ?
Clozapine and Olanzapine.
Which is the atypical anti-psychotics tends to cause weight gain the least ?
Aripiprazole.
What are the unique dangerous side effects of clozapine?
Seizures and agranulocytosis therefore blood cells should be monitored weekly.
What is the unique side effect of ziprazidone ?
Prolongation of QT interval.
Osmosis link to atypical anti psychotics ?
https://www.osmosis.org/learn/Atypical_antipsychotics?from=/pa/foundational-sciences/pharmacology-and-pharmacotherapeutics/psychiatry-behavioral-science/antipsychotics
