CNS: ANTIPSYCHOTICS

Question 1

CNS DRUGS
-long history, widely used
-a wide variety of agents
-prescribed and non-prescribed
\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_
-addiction/dependence
-incomplete understanding of how they act

Answer 1

benzodiazepenes
antidepressants
caffeine, alcohol

Question 2

Biogenic Amines

• ______
• ______
• ______
• ______

which ones are broken down by MAO?

Answer 2

dopamine
NE
serotonin
histamine

first 3

Question 3

Acidic Amino Acids

• in the CNS they are extremely _____ modifiers of neuronal _______
• -present in high concentrations, wideS
• acidic amino acid
• -_______, _______
• • ionotropic receptors: ____, ___
• -metabotropic ( transmembrane __________)
• -excitatory __ present in excitatory vesicles

Answer 3

potent
excitability
glutamate, aspartate
AMPA, NMDA
transmembrane G protein coupled
NT

Question 4

psychosis: schizophrenia
- Positive symptoms include _____, ______ and _____ disorder
- Negative symptoms involve a loss of normal ____
- ______ symptoms involve disorganized thoughts, attentional impairment, lost of executive functioning
- split and mind - 1% of population

Answer 4

delusions, hallucinations, thought
normal
cognitive

Question 5

schizophrenia
etiology and pathogenesis
-complex heterogenous disease
-multifactorial etiology with both \_\_\_\_\_ and \_\_\_\_\_\_ components
hypothesis
-\_\_\_\_\_\_ hypothesis
-\_\_\_\_\_ hypothesis
-\_\_\_\_\_\_\_\_ lobe abnormalities

Answer 5

genetic, environmental
dopamine
NMDA
prefrontal lobe

Question 6

schizophrenia symptoms

• disturbance of the _____ process of the patient
• hallucinations: _____ and ____
• ______: persecution and grandeur
• _______: minimal stimulation
• interpersonal withdrawal
• _______
• memory loss
• loss of interest and driave

Answer 6

thought process
auditory, visual
delusions
agitation
flat affect

Question 7

antipsychotics (neuroleptics)

• reduce symptoms and improve behavior
• suppress ______ activity and _____ expression
• MOA
• -______ inhibition of ______ and _____ receptors
• -precisely how they alleviate symptoms is unclear

Answer 7

neuronal
emotional
competitive
dopamine, 5HT2

Question 8

antipsychotic drugs
typical
-phenothiazines: \_\_\_\_\_\_\_\_\_
-thioxanthenes: \_\_\_\_\_\_\_\_\_\_
-butyrophenones: \_\_\_\_\_\_, \_\_\_\_\_

atypical

azepines: ________, _______, _______
others: ________, ______

Answer 8

chlorpromazine
chlorprothixene
haloperidol, droperidol
clozapine, loxapine, olanzapine
molindone, risperidone

Question 9

atypical antipsychotics
clozapine, loxapine, olanzapine
-risperidone
-quetiapne
-ziprasidone
-amisulpride

Answer 9

idk

Question 10

schizophrenia - typical antipsychotics
Phenothiazenes -
-_________ (________;_______)
-well absorbed _______
-large number of _____ and _____ metabolites
- _____ (20 to 30 hour) elimination half life
-blocks __ receptors (typical antipsychotic drugs)

Answer 10

chlorpromazine, ormazine, thorazine
orally
active, inactive
D2

Question 11

schizophrenia - antipsychotics
-phenothiazines: adverse effects
-\_\_\_\_\_\_\_\_\_ effects
-\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_\_\_
may be due to blockage of \_\_\_\_ receptors present in the \_\_\_\_\_\_\_
-sedation
-anticholinergic effects
-orthostatic hypotension
-adverse effects need to be managed

Answer 11

extrapyramidal 
akathisia
pseudoparkinsonism
dystonia
tardive dyskinesia
sigma
red. nucleus

Question 12

schizophrenia - antipsychotics
Thioxanthenes
-_______(Navane)
-closely related to _______
-less autonomic _____ effects than phenothiazenes
-more _______ side effects than phenothiazenes

Answer 12

thiothixine
phenothiazienes
adverse
extrapyramidal

Question 13

schizophrenia - antipsychotics
Butyrophenones - \_\_\_\_\_\_\_\_\_ (Haldol)
-first drug used for schizophrenia
-significant \_\_\_\_\_\_\_ effects
-extensively metabolized in the \_\_\_\_
-excreted in \_\_\_\_\_ and \_\_\_\_
-used to manage \_\_\_\_\_\_ syndrome
-facial and vocal tics,  coprolalia, echolalia

Answer 13

haloperidol
extrapyramidal
liver
urine, bile
Tourette's

Question 14

Schizophrenia - antipsychotics
Azepines (Atypical)
-\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_
-atypical antipsychotic
-\_\_\_\_\_ extrapyramidal effects
-therapeutic effects via blocking \_\_\_. and \_\_\_\_\_. receptors
-has ability to block \_\_\_\_\_\_\_\_\_ receptors. 
-may also cause \_\_\_\_\_\_

Answer 14

clozapine, loxapine, olanzapine
fewer
D2, 5HT2
histamine
toxicity

Question 15

schizophrenia - antipsychotics
Clozapine (Clozaril)
-\_\_\_\_ extrapyramidal effects
-significant \_\_\_\_\_\_ and \_\_\_\_\_\_\_ effects
--due to its ability to block \_\_\_\_\_\_, \_\_\_\_\_\_ and \_\_\_\_\_ adrenergic receptors
--\_\_\_\_\_ gain
-potentially fatal \_\_\_\_\_\_\_\_\_. (1-3%)
-require weekly monitoring during the first _ months followed by _ months of biweekly \_\_\_\_\_\_\_ counts

Answer 15

less
sedation, autonomic
histamine, muscarinic, alpha
weight
agranulocytosis
6
leukocyte

Question 16

schizophrenia - antipsychotics
Azepines
Olanzapine (Zyprexa)
-similar to _______ but not associated with _________
-has a higher affinity for _____ than __ receptor
–has __ and __ receptor blocking properties
–less ____ blocking than clozapine
–_____ gain is major side effect

Answer 16

Clozapine
agranulocytosis
5HT2, D2
D3, D4
histamine
weight

Question 17

Schizophrenia - antipsychotics 
Risperidone (Risperdal)
Atypical antipsychotics
-similar to \_\_\_\_\_\_\_
--less sedation
-\_\_\_ orthostatic hypotension
--\_\_\_\_\_\_\_ incidence of extrapyramidal effects
-may elevate \_\_\_\_\_\_\_ levels and prolong \_\_\_ intervals, predisposing patients to cardiac arrhythmias (including torsade de pointes)

Answer 17

Olanzapine
more
higher
prolactin
QT

Question 18

schizophrenia - antipsychotics
Molindone
-unique agent, may be classified as _____ antipsychotic
-relatively low ______ side effects and sedation
-similar incidence of ________ effects
-only antisychotic associated with ________
-parent drug has a ___ half life, metabolites have a ______ half life

Answer 18

atypical 
autonomic
extrapyramidal 
weight loss
short
longer