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ICOM - Mental Health > Clinical- Psychotic Disorders II > Flashcards

Clinical- Psychotic Disorders II Flashcards

1
Q

What are the 4 dopamine pathways?

A
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2
Q

An increase of dopamine causes positive/negative symptoms in schizophrenia?

A

positive

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3
Q

Which of the 4 dopamine pathways goes from the VTA to the nucleus accumbens and concerning schizophrenia -an increase in dopamine causes positive symptoms?

A

mesolimbic pathway

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4
Q

Which 2 of the 4 dopamine pathways are mostly related to schizophrenia?

A

mesolimbic and mesocortical

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5
Q

Which schizophrenia related dopamine pathway involves dopamine hypoactivity which can cause negative, cognitive, and affectives symptoms?

A

mesocortical

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6
Q

Dopamine hyper/hypo activity can cause negative, cognitive, and affective symptoms?

A

hypoactivity

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7
Q

Which dopamine pathway travels from the substantia nigra to the striatum and can be affected by drugs in a way that produces extrapyramidial symptoms (EPS) and tardive dyskinesia as side effects?

A

nigrostriatal

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8
Q

What are the side effects to drugs (antipsychotics) affect the tuberohypophyseal domapine pathway?

A

hyperprolactinemia

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9
Q

hyperprolactinemia from drugs that inhibit D2 receptors in the tuberhypophyseal pathway can lead to what two symptoms ?

A

gynecomastia and lactation

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10
Q

What is the duration of time difference to separate brief psychotic disorder, schizophreniform, and schizophrenia?

A
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11
Q

Along with symptoms lasting less than a month, what is the other critera that must be met for brief psychotic disorder?

A

At least one Criterion A for Brief Psychotic Disorder

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12
Q

How many crietria for schizophreniform must be met along with a duration of 1 to 6 months?

A

2

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13
Q

Which disorder is being described of the primary psychiatric disorders?

A. An uninterrupted period of illness in which there is a major mood episode concurrent with Criterion A of schizophrenia

B. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode

C. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness

D. Not attributable to the effects of a substance or another medical condition

A

schizoaffective disorder

(combo of schizophrenia and mood disorder- depression or bipolar)

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14
Q

What are the 2 subtypes of schizoaffective disorder?

A
  • Bipolar type – applies if patient has had a history of manic episode(s)
  • Depressive type – no history of manic episodes (2 + weeks)
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15
Q

What primary psychiatric disorder is being described:

  • Presence of one (or more) delusions with a duration of 1 month or longer
  • Criterion A for schizophrenia has never been met
  • Functioning is not impaired outside of the direct impact of the delusions
  • Mood symptoms, if present, have been brief relative to the delusional periods
  • Not attributable to another medical or psychiatric illness
A

delusional disorder

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16
Q

What is the most common subtype of delusional disorder?

A

persecutroy

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17
Q

What are the 6 subtypes of delusional disorder?

A

Persecutory – Most common subtype

  • Erotomanic
  • Jealous – More common in males
  • Grandiose
  • Somatic
  • Mixed
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18
Q

What is the most common delusional disorder subtype in males?

A

jealous delusional disorder

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19
Q

Delusional disorder is/is not often resistant to antipsychotic medications alone

A

is

(therapy is useful)

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20
Q

• Delusional disorder late in life increases risk for

A

dementia

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21
Q

What is the single most important intervention outside of antipsychotic medication regarding schizophrenia?

A

family education

22
Q

Which of the antipsychotic medicatons can cause agranulocytosis (decrease neutrophil count) as a side effect and must be closely monitored?

A

clozapine (clozaril)

23
Q

Most antipsychotics target which receptor?

A

D2 dopamine receptor

24
Q

What are some of the most commonly used and affordable antipsychotics?

A

risperidone and olanzapine

25
Q

First gen antipsychotics are consicered typical/atypical and what is the mechanism of action?

A

typical

Dopamine Receptor Antagonists (DRA) - High Affinity for D2 receptors

26
Q

Which two first gen antipsychotics (FGA) are stilled used?

A

haloperidol and fluphenazine

27
Q

FGA cause sedation and are considered “major “.

A

tranquilizers

28
Q

What are 3 major extrapyramidal symptoms (EPS) caused by FGAs?

A
  • Akathisia= restlessness
  • Dystonic reactions= stiff muscles
  • Parkinsonism – tremors, bradykinesia, “Thorazine Shuffle”
29
Q

What is akathisia?

A

restlessness

causes pacing

30
Q

What is tardive dyskinesia and what type of drug causes its symptoms?

A

FGAs

involuntary movements, repetive, grimace, eye blinking, arems

31
Q

Second Generation Antipsychotics (SGA) are also called “ Antipsychotics”

A

Atypical

32
Q

Why are SGAs or second gen antipsychotics called atypicals?

A

Their MOA includes Serotonin-Dopamine Antagonist (SDA) & Partial Dopamine Antagonist (PDA) vs. full dopamine (D2 receptor) antagonist

33
Q

Which SGA when given in high doses can act as an antagonist and when given in low doses act as an agonist?

A

partial dopamine antagonists (PDA)

34
Q

Which 2 SGAs are considerd partial dopamine antagonists?

A
  • Aripiprazole (Abilify) - PDA
  • Brexpiprazole (Rexulti) - PDA
35
Q

Which SGA can also cause increased levels of prolactin which could lead to lactation and gynecomastia?

A

risperidone

36
Q

What are the 6 SGAs that are most commonly used?

A
37
Q

Which type of SGAs will most likely cause metabolic side effects such as • Hyperlipidemia • Hyperglycemia • Weight Gain?

A

those that end with -apine

clozapine

olanzapine

quetiapine

38
Q

Name 7 possible side effects of SGAs?

A
39
Q

neuroleptic maligant syndrom can be caused by which group of antipsychotics?

A

first generation antipsychotics

40
Q

What are some other medications, other than antipsychotics, that can treat psychosis?

A

benzodiazepines

pimavanserin= for Parkinson’s psychosis

41
Q

What is the best drug for treating psychosis along with catatonia?

A

benzos

42
Q

What can benzos treat as concerning psychotic patients:

A

agitation, catatonia with psychosis

43
Q

What is best to treat acute psychosis with agitation?

A

Short-acting IM FGA or SGA

44
Q

Which drug can be used to treat akathisia, a side effect of FGAs?

A

Beta blockers (propranolol)

45
Q

What drug class can be used to treat EPS from FGAs?

A

anticholinergic medications

46
Q

What drug can be used to treat Parkinson’s psychosis and is the only antipsychotic that doesn’t target D2 receptors?

A

Pimavanserin

47
Q

a progressive neurodevelopmental & neurodegenerative disease with a waxing and waning course and a poor overall prognosis

A

schizophrenia

48
Q

If psychotic symptoms start in an older person, strongly consider alternatives to schizophrenia, such as Huntington’s or dementia

A

abruptly

49
Q

Positive/negative symptoms respond the best to current medications

A

positive

50
Q

What is the best model for treatment of psychiatric disorders?

A

biopsychosocial

51
Q
A

ICOM - Mental Health (24 decks)

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