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PMHNP > Dopamine Pathways > Flashcards

Dopamine Pathways Flashcards

1
Q

Tuberoinfundibular Pathway (2)

A

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

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2
Q

Parkinsonism is caused by (2)

A

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

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3
Q

Treatment for Parkinsonism is

A

Antipsychotics which decrease dopamine affecting the nigrostriatal pathway

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4
Q

What pathway is responsible for the coordination of movement?

A

Substantia Nigra to striatum (nigrostriatal pathway)

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5
Q

Negative symptoms in schizophrenia occur from what in the brain?

A

decrease dopamine b/w the MCP and VTA to cortex

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6
Q

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

A

Decrease in Dopamine

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7
Q

The mesocortical pathway consists of?

A

VTA projecting to the Cortex

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8
Q

How do most antipsychotics work?

A

decrease dopamine in the mesolimbic pathway

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9
Q

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

A

overactive mesolimbic pathway and excess dopamine from VTA to NA

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10
Q

Mesolimbic pathway consists of?

A

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

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11
Q

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

A

prolactin increases
and inhibits FSH
causing amenorrhea
increase prolactin causes galactorrhea

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12
Q

Relationship between dopamine and prolactin (4)

A

inverse rx

increase dopamine from the hypothalamus will decrease prolactin

decrease in dopamine will increase prolactin

increase in prolactin causes amenorrhea (FSH) and GalactorrheaA

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13
Q

Antipsychotic effects on mesolimbic pathway

A

improve positive symptoms due to a decrease in dopamine

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14
Q

antipsychotic effects on mesocortical pathway

A

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

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15
Q

Antipsychotic effects on nigrostriatal

A

risking EPS (can induce movement disorder)

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16
Q

Antipsychotic effects on tuberoinfundibular pathway

A

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

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17
Q

What causes TD in nigrostriatal pathway

A

long standing D2 blockade

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18
Q

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

A

EPS increase in ACH and decrease in dopamine
dystonia
parkinsonian
akathisia

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19
Q

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

A

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

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20
Q

long term _____ can be associated with osteoporosis

A

hyperprolactinemia

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21
Q

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

A

Increase in ACH
Increase in salivation
increase in lacrimation
blurry vision

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22
Q

what pathway mediates motor movements?

A

nigrostriatal pathway

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23
Q

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

A

mesocortical pathway

social withdrawal
lack of motivation
improve cognitive functions
memory and attention

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24
Q

What pathway is responsible for negative depressive symptoms in schizophrenia

A

decreased dopamine in mesocortical projection

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25
Q

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

A

over active mesolimbic pathway
excess dopamine from VTA to NA

26
Q

What treats positive psychotic symptoms

A

Antagonism of D2 receptors

27
Q

What causes positive symptoms?

A

Hyperactivity of dopamine in mesolimbic pathway

28
Q

Parkinsonism in schizophrenia occurs when

A

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

29
Q

Mesocortical pathway consists of?

A

VTA projecting to the cortex

30
Q

Schizophrenia what is happening to dopamine between VTA and Cortex?

A

decreased dopamine

31
Q

Negative symptoms in schizophrenia occur from what in the brain?

A

dopamine b/w MCP and VTA to cortex

32
Q

Mesolimbic pathway consist of (3)

A

ventral tegmental area (VTA) (where the trouble arises) to nucleus accumbent

Dopamine cell pathways arising from VTA to NA

33
Q

Tuberoinfundibular pathway

A

hypothalamus to pituitary gland

dopernergic go from hypothalamus to pituitary gland, which releases prolactin

34
Q

Parkinsonism is caused by and tx (2)

A

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

35
Q

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

A

negative and cognitive symptoms of schizophrenia

36
Q

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

A

salivation, teary eyes, diarrhea

37
Q

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

A

Amenorrhea
Galactorrhea (risperidone)
Sexual dysfunction
gynecomastia

38
Q

Long-term hyperprolactinemia can be associated with

A

osteoporosis

39
Q

What two antipsychotics are less likely to cause hyperprolactinemia

A

Quetiapine (Seroquel)
Aripriprazole (abilify)

40
Q

Prolactin levels for men and women

A

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

41
Q

Hyperactivity of dopamine in the _______ pathway mediates positive psychotic symptoms

A

mesolimbic pathway

42
Q

Antagonism of D2 receptors in the mesolimbic pathway treats __________

A

positive psychotic symptoms

43
Q

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

A

mesocortical
dorsolateral

44
Q

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

A

5-HT2A
dopamine
dopamine
prefrontal cortex

45
Q

what pathway mediates motor movements

A

nigrostriatal pathway

46
Q

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

A

ACH
increase in salvation, teary eyes
diarrhea

47
Q

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

A

Nigrostriatal

48
Q

Reglan can cause (3)

A

EPS symptoms like tardive dyskinesia, Parkinsonism

49
Q

EPS has increase in ______ and decrease in _______

A

ACH and decrease in dopamine

50
Q

Pseudo Parkinson has decrease ______ levels

A

dopamine

51
Q

Benztropine is a ____ used for?

A

anticholinergic (Cogentin) EPS

52
Q

Cogentin cannot be used to treat?

A

TD

53
Q

FDA APPROVED for TD are what type of medications

A

VMAT2 inhibitors (Austedo and Valbenazine/Ingrezza)

54
Q

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

A

tuberoinfundibular
prolactin levels
hyperprolactinemia

55
Q

Hyperprolactinemia manifests as (4)

A

amenorrhea, galactorrhea, sexual dysfunction, gynecomastia

56
Q

long term hyperprolactinemia can be associated with

A

osteporosis

57
Q

long term risperidone can cause

A

galactorrhea

58
Q

what two medications antipsychotics can less likely cause hyperprolactinemia?

A

quetiapine and aripiprazole

59
Q

prolactin level for men

A

less than 20mg/ml

60
Q

prolactin level for women

A

less than 25mg/ml

PMHNP (46 decks)

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