Chapter 10: Psychopharmacology

Question 1

What are examples of some extrapyramidal reactions and give their meanings.

Specifically choreiform, athetoid, rhythmic

Answer 1

choreiform: jerky movements
athetoid: slow continuous movements
rhythmic: stereotypical movements

Question 2

What are the dopamine tracts?

Answer 2

• mesolimbic/ mesocortical
• nigrostriatal
• tuberoinfundibular

Question 3

Main mechanism of antipsychotics.

Answer 3

DA blockage at the receptor

Question 4

How does blocking DA affect the nigrostriatal pathway?

Answer 4

increases movement disorder

Question 5

How does blocking DA affect the tuberoinfundibular pathway?

Answer 5

increases prolactin (galactorrhea, amenorrhea, gynecomastia)

Question 6

How long does the side effect of dystonia come about after taking antipsychotics?

Answer 6

peaks hours to days

Question 7

Treatment for dystonic reaction associated to taking antipsychotic medications.

Answer 7

anticholinergics: benztropine, trihexyphenidyl, diphenhydramine

Question 8

When does rigidity start after taking antipsychotic meds?

Answer 8

3 weeks after

Question 9

What is the treatment for rigidity after taking antipsychotics?

Answer 9

lower dose or anticholinergics

Question 10

When can tremors develop after taking antipsychotics?

Answer 10

6 weeks

Question 11

What is the treatment for tremors caused by use of antipsychotics?

Answer 11

lower dose or anticholinergics

Question 12

When does the side effect of akathisia come about after use of anticholinergics?

Answer 12

10 weeks

Question 13

What is the treatment for akathisia after using anti-psychotics?

Answer 13

B-blockers, benzodiazepines; lower dose or switch to atypical antipsychotics

Question 14

What is the peak time tardive dyskinesia may develop after use of antipsychotics?

Answer 14

> 3 - 6 months

Question 15

What are the treatment options for tardive dyskinesia caused by antipsychotics?

Answer 15

switch to atypical or clozapine

Question 16

What are the treatment options for NMS?

Answer 16

neuroleptic malignant syndrome: may be lethal; dantrolene or bromocriptine

Question 17

Describe the extrapyramidal symptom and anticholinergic effects levels associated with use of haloperidol. (Also describe if this is a high or low potency drug)

Answer 17

high potency drug so:

increased EPS
low anticholinergic effects

Question 18

Describe the levels of potency, EPS, and anticholinergic effects associated with the drug chlorpromazine.

Answer 18

low potency

EPS levels = low
anticholinergic effects = high

Question 19

MOA trazodone.

Answer 19

5 HT receptor antagonist, alpha 1 blocker

Question 20

MOA mirtazapine.

Answer 20

Stimulates NE and 5 HT release; blocks 5HT2 and 5HT3 receptors

Question 21

Uses for bupropion.

Answer 21

approved for depression and smoking cessation

Question 22

What is the MOA of bupropion.

Answer 22

relatively weak inhibitor of the neuronal re-uptake of NE and DA; does not inhibit the re-uptake of serotonin

Question 23

Which anti epileptic drug is associated with SJS?

Answer 23

lamotrigine