CNS III

Question 1

SE of typical antipsychotics?

Answer 1

NMS- neuroleptic malignant syndrome
EPS- Extrapyramidal Syndrome
Tardive Dyskinesias, Hyperprolactinemia

Question 2

MOA of typical antipsychotics?

Answer 2

block D2 receptors, increase cAMP

Question 3

Name three high potency Antipsychotics

Answer 3

Trifluoperazine
Fluphenazine
Haloperidol

Question 4

Name two low potency antipsychotics

Answer 4

Chlorpromazine, Thioridazine

Question 5

Symptoms of NMS?

Answer 5

Fever
Encephalopathy (cognitive changes)
Vital unstable
Elevated enzymes (serum CK, myoglobinemia)
Rigidity

Question 6

Treatment of NMS?

Answer 6

cool blankets
Dopamine agonist- Bromocriptine
hydration to avoid renal damage due to myoglobinemia
Benzos- agitation

Question 7

What are tardive dyskinesias?

Answer 7

asymmetric muscle movements

lip smacking, pursing, tongue protrusions

Question 8

How do you treat tardive dyskinesia?

Answer 8

Tetrabenazine- VMAT inhibitor, dopamine depleting drug, used to treat HD

Question 9

Why do you see hyperprolactinemia in typical antipsychotic use?

Answer 9

Dopamine is depleted by typical antipsychotics. Dopamine suppresses the release of prolactin from the pituitary.

Question 10

What is the use of dantrolene?

Answer 10

Treats malignant hyperthermia of NMS by inducing muscle relaxation.

Question 11

Use of typical anti-psychotics?

Answer 11

Schizophrenia, positive symptoms only

Question 12

Use of atypical anti-psychotics?

Answer 12

Schizophrenia- positive and modest effect on negative symptoms

Question 13

Use of clozapine?

Answer 13

treatment resistant psychoses, suicide risk

Question 14

SE of clozapine?

Answer 14

agranulocytosis, weight gain, type II DM, seizure risk, hyperlipidemia

Question 15

MOA of risperidone, olanzapine, quetiapine, clozapine, ziprazidone?

Answer 15

D2 receptor anatagonist, 5HT2 receptor antagonist

Question 16

SE of ziprazidone?

Answer 16

arrhythmia, prolonged QT

Question 17

What must be monitored weekly with clozapine use?

Answer 17

WBC monitoring

Question 18

What SE do olanzapine and clozapine cause?

Answer 18

Significant weight gain

Question 19

What is paliperidone’s relationship to risperidone?

Answer 19

It is the P450 metabolite of risperidone

Question 20

What dopaminergic tract mediates the positive symptoms of Schizophrenia?

Answer 20

Mesolimbin

Question 21

What dopaminergic tract mediates the negative symptoms of Schizophrenia?

Answer 21

Mesocortical