Dopamine Pathways

Question 1

Tuberoinfundibular Pathway (2)

Answer 1

Hypothalamus to the pituitary gland, dopaminergic cells go from Hypothalamus to the pituitary gland which releases prolactin

Question 2

Parkinsonism is caused by (2)

Answer 2

increase in dopamine in the mesolimbic pathway causing positive symptoms and a decrease dopamine in mesocortical pathway causing negative symptoms

Question 3

Treatment for Parkinsonism is

Answer 3

Antipsychotics which decrease dopamine affecting the nigrostriatal pathway

Question 4

What pathway is responsible for the coordination of movement?

Answer 4

Substantia Nigra to striatum (nigrostriatal pathway)

Question 5

Negative symptoms in schizophrenia occur from what in the brain?

Answer 5

decrease dopamine b/w the MCP and VTA to cortex

Question 6

Schizophrenia- what is happening to dopamine between VTA and Cortex?

Answer 6

Decrease in Dopamine

Question 7

The mesocortical pathway consists of?

Answer 7

VTA projecting to the Cortex

Question 8

How do most antipsychotics work?

Answer 8

decrease dopamine in the mesolimbic pathway

Question 9

What do positive symptoms from schizophrenia result from in the brain? (2)

Answer 9

overactive mesolimbic pathway and excess dopamine from VTA to NA

Question 10

Mesolimbic pathway consists of?

Answer 10

Ventral tegmental area (VTA) Where the trouble arises to nucleus accumbent (NA) and Dopamine cell pathways arising from VTA to NA

Question 11

when decreased dopamine with antipsychotics what happens to prolactin and FSH and Galactorrhea (2)

Answer 11

prolactin increases
and inhibits FSH
causing amenorrhea
increase prolactin causes galactorrhea

Question 12

Relationship between dopamine and prolactin (4)

Answer 12

inverse rx

increase dopamine from the hypothalamus will decrease prolactin

decrease in dopamine will increase prolactin

increase in prolactin causes amenorrhea (FSH) and GalactorrheaA

Question 13

Antipsychotic effects on mesolimbic pathway

Answer 13

improve positive symptoms due to a decrease in dopamine

Question 14

antipsychotic effects on mesocortical pathway

Answer 14

potential to worse negative symptoms because there’s already low dopamine to begin with

Question 15

Antipsychotic effects on nigrostriatal

Answer 15

risking EPS (can induce movement disorder)

Question 16

Antipsychotic effects on tuberoinfundibular pathway

Answer 16

risk galactorrhea and amenorrhea (increase in prolactin r/t decrease in dopamine)

Question 17

What causes TD in nigrostriatal pathway

Answer 17

long standing D2 blockade

Question 18

Blockade of D2 receptors in the nigrostriatal pathway can lead to (4)

Answer 18

EPS increase in ACH and decrease in dopamine
dystonia
parkinsonian
akathisia

Question 19

Hyperprolactinemia and amenorrhea occurs from a-typtical antipsychotics because (5)

Answer 19

blockage of D2 pathway in tuberoinfundibular pathway and galactorrhea, sexual dysfunction, gynecomastia

Question 20

long term _____ can be associated with osteoporosis

Answer 20

hyperprolactinemia

Question 21

Dopamine blockage in the nigrostriatal pathway can lead to (4)

Answer 21

Increase in ACH
Increase in salivation
increase in lacrimation
blurry vision

Question 22

what pathway mediates motor movements?

Answer 22

nigrostriatal pathway

Question 23

By enhancing dopamine release in _____ atypical antipsychotics can help alleviate negative symptoms such as (5)

Answer 23

mesocortical pathway

social withdrawal
lack of motivation
improve cognitive functions
memory and attention

Question 24

What pathway is responsible for negative depressive symptoms in schizophrenia

Answer 24

decreased dopamine in mesocortical projection

Question 25

What do positive symptoms from schizophrenia result from (in brain)? (2)

Answer 25

over active mesolimbic pathway excess dopamine from VTA to NA

Question 26

What treats positive psychotic symptoms

Answer 26

Antagonism of D2 receptors

Question 27

What causes positive symptoms?

Answer 27

Hyperactivity of dopamine in mesolimbic pathway

Question 28

Parkinsonism in schizophrenia occurs when

Answer 28

pt has positive symptoms (increase in dopamine) MLP given antipsychotics decrease in dopamine between

Question 29

Mesocortical pathway consists of?

Answer 29

VTA projecting to the cortex

Question 30

Schizophrenia what is happening to dopamine between VTA and Cortex?

Answer 30

decreased dopamine

Question 31

Negative symptoms in schizophrenia occur from what in the brain?

Answer 31

dopamine b/w MCP and VTA to cortex

Question 32

Mesolimbic pathway consist of (3)

Answer 32

ventral tegmental area (VTA) (where the trouble arises) to nucleus accumbent Dopamine cell pathways arising from VTA to NA

Question 33

Tuberoinfundibular pathway

Answer 33

hypothalamus to pituitary gland dopernergic go from hypothalamus to pituitary gland, which releases prolactin

Question 34

Parkinsonism is caused by and tx (2)

Answer 34

increase dopamine in mesolimbic pathway causing + symptoms and decrease in dopamine in the mesocortical pathway causing negative symptoms tx is antipsychotics which decreases dopamine affecting the NS pathway causing Parkinsonism

Question 35

the blockade of 5-HT2A receptors modulates dopamine release particularly increasing dopamine release in the prefrontal cortex, which is an area associated with ____ &_____

Answer 35

negative and cognitive symptoms of schizophrenia

Question 36

dopamine blockade in the Nigrostriatal pathway can lead to increase in ACH levels causing an increase in what symptoms 3

Answer 36

salivation, teary eyes, diarrhea

Question 37

Blockage of D2 receptors in this pathway can lead to increase prolactin levels leading to hyperprolactinemia which manifests as (4)

Answer 37

Amenorrhea Galactorrhea (risperidone) Sexual dysfunction gynecomastia

Question 38

Long-term hyperprolactinemia can be associated with

Answer 38

osteoporosis

Question 39

What two antipsychotics are less likely to cause hyperprolactinemia

Answer 39

Quetiapine (Seroquel) Aripriprazole (abilify)

Question 40

Prolactin levels for men and women

Answer 40

men less than 20ng/ml women less than 25 ng/ml

Question 41

Hyperactivity of dopamine in the _______ pathway mediates positive psychotic symptoms

Answer 41

mesolimbic pathway

Question 42

Antagonism of D2 receptors in the mesolimbic pathway treats __________

Answer 42

positive psychotic symptoms

Question 43

Decreased dopamine in the ________ projection to the ________________ prefrontal cortex is postulated to be responsible for ________ & ________ symptoms

Answer 43

mesocortical dorsolateral

Question 44

In the mesocortical pathway, the blockade of _________ receptors modulates _________ release particularly increasing ________ release in the _________ cortex which is associated with negative and cognitive symptoms

Answer 44

5-HT2A dopamine dopamine prefrontal cortex

Question 45

what pathway mediates motor movements

Answer 45

nigrostriatal pathway

Question 46

dopamine blockade in the nigrostriatal pathway can lead to increase in _______ levels causing increase in _______, _______, _______-

Answer 46

ACH increase in salvation, teary eyes diarrhea

Question 47

blockade of dopamine in the ________ pathway can lead to EPS effects

Answer 47

Nigrostriatal

Question 48

Reglan can cause (3)

Answer 48

EPS symptoms like tardive dyskinesia, Parkinsonism

Question 49

EPS has increase in ______ and decrease in _______

Answer 49

ACH and decrease in dopamine

Question 50

Pseudo Parkinson has decrease ______ levels

Answer 50

dopamine

Question 51

Benztropine is a ____ used for?

Answer 51

anticholinergic (Cogentin) EPS

Question 52

Cogentin cannot be used to treat?

Answer 52

TD

Question 53

FDA APPROVED for TD are what type of medications

Answer 53

VMAT2 inhibitors (Austedo and Valbenazine/Ingrezza)

Question 54

Blockade of D2 receptors in _______ pathway can lead to an increase in _______ levels, leading to ______

Answer 54

tuberoinfundibular prolactin levels hyperprolactinemia

Question 55

Hyperprolactinemia manifests as (4)

Answer 55

amenorrhea, galactorrhea, sexual dysfunction, gynecomastia

Question 56

long term hyperprolactinemia can be associated with

Answer 56

osteporosis

Question 57

long term risperidone can cause

Answer 57

galactorrhea

Question 58

what two medications antipsychotics can less likely cause hyperprolactinemia?

Answer 58

quetiapine and aripiprazole

Question 59

prolactin level for men

Answer 59

less than 20mg/ml

Question 60

prolactin level for women

Answer 60

less than 25mg/ml