B3 Eugene

Question 1

Decreasing dopamine ameliorates psychosis

Answer 1

–Blockade of DA receptors treats psychosis
–Inhibition of DA synthesis ameliorates symptoms of schizophrenia
•There is enhanced amphetamine-induced DA release in schizophrenia

Question 2

Conventional antipsychotic drugs

Answer 2

are often subclassified according to their oral milligram potency (high potency or low potency).

Question 3

High-potency neuroleptic drugs

Answer 3

(piperazine phenothiazines, e.g., fluphenazine; and haloperidol) are more likely to produce extrapyramidal reactions

Question 4

Low-potency drugs

Answer 4

(aliphatic phenothiazines, e.g., triflupromazine; piperidine phenothiazines, e.g., thioridazine) are less likely to produce acute extrapyramidal reactions and more likely to produce sedation and postural hypotension.

Question 5

Atypical antipsychotic agents

Answer 5

(e.g., risperidone, olanzapine) have generally replaced the conventional drugs for initial treatment of first-episode patients

Question 6

Clozapine

Answer 6

is reserved for treatment-resistant patients.

Question 7

Mechanism of therapeutic action for neuroleptics

Answer 7

1. The therapeutic action of the conventional antipsychotic drugs is correlated best with antagonist activity at postjunctional dopamine D2-receptors, where dopamine normally inhibits adenylyl cyclase activity.
2. The therapeutic action of the atypical antipsychotic drugs is correlated with antagonist activity at both 5-HT2-receptors and dopamine D2- or D4-receptors. Aripiprazole is a partial agonist at dopamine D2-receptors and, like ziprasidone, also stimulates serotonin 5-HT1A-receptors.
3. The therapeutic action is best correlated with the actions of these drugs in the mesolimbic and mesocortical areas of the CNS.

Question 8

Aripiprazole

Answer 8

Partial Agonist

Question 9

What are the two high-potency Antipsychotic drugs?

Answer 9

Fluphenazine and Haloperidol

Question 10

Which ADR are the high potency antipsychotics more likely to produce?

Answer 10

ExtraPyramidal Reactions

Question 11

Which Low-potency drug is more likely to produce sedation and postural hypotension?

Answer 11

Thioridazine

Question 12

Please name 2 first line Atypical antipsychotic drugs?

Answer 12

Risperidone and Olanzapine

Question 13

Which antipsychotic is reserved for treatment-resistant patients?

Answer 13

Clozapine

Question 14

Thiorizadine, ziprasidone and quetiapine

Answer 14

Long QT interval

Question 15

Increasing dopamine worsens psychosis

Answer 15

–High doses of amphetamine or cocaine can lead to a paranoid psychosis
–Amphetamine will exacerbate an existing schizophrenic state