Dopamine Pathways Flashcards
Tuberoinfundibular Pathway (2)
Hypothalamus to the pituitary gland, dopaminergic cells go from Hypothalamus to the pituitary gland which releases prolactin
Parkinsonism is caused by (2)
increase in dopamine in the mesolimbic pathway causing positive symptoms and a decrease dopamine in mesocortical pathway causing negative symptoms
Treatment for Parkinsonism is
Antipsychotics which decrease dopamine affecting the nigrostriatal pathway
What pathway is responsible for the coordination of movement?
Substantia Nigra to striatum (nigrostriatal pathway)
Negative symptoms in schizophrenia occur from what in the brain?
decrease dopamine b/w the MCP and VTA to cortex
Schizophrenia- what is happening to dopamine between VTA and Cortex?
Decrease in Dopamine
The mesocortical pathway consists of?
VTA projecting to the Cortex
How do most antipsychotics work?
decrease dopamine in the mesolimbic pathway
What do positive symptoms from schizophrenia result from in the brain? (2)
overactive mesolimbic pathway and excess dopamine from VTA to NA
Mesolimbic pathway consists of?
Ventral tegmental area (VTA) Where the trouble arises to nucleus accumbent (NA) and Dopamine cell pathways arising from VTA to NA
when decreased dopamine with antipsychotics what happens to prolactin and FSH and Galactorrhea (2)
prolactin increases
and inhibits FSH
causing amenorrhea
increase prolactin causes galactorrhea
Relationship between dopamine and prolactin (4)
inverse rx
increase dopamine from the hypothalamus will decrease prolactin
decrease in dopamine will increase prolactin
increase in prolactin causes amenorrhea (FSH) and GalactorrheaA
Antipsychotic effects on mesolimbic pathway
improve positive symptoms due to a decrease in dopamine
antipsychotic effects on mesocortical pathway
potential to worse negative symptoms because there’s already low dopamine to begin with
Antipsychotic effects on nigrostriatal
risking EPS (can induce movement disorder)
Antipsychotic effects on tuberoinfundibular pathway
risk galactorrhea and amenorrhea (increase in prolactin r/t decrease in dopamine)
What causes TD in nigrostriatal pathway
long standing D2 blockade
Blockade of D2 receptors in the nigrostriatal pathway can lead to (4)
EPS increase in ACH and decrease in dopamine
dystonia
parkinsonian
akathisia
Hyperprolactinemia and amenorrhea occurs from a-typtical antipsychotics because (5)
blockage of D2 pathway in tuberoinfundibular pathway and galactorrhea, sexual dysfunction, gynecomastia
long term _____ can be associated with osteoporosis
hyperprolactinemia
Dopamine blockage in the nigrostriatal pathway can lead to (4)
Increase in ACH
Increase in salivation
increase in lacrimation
blurry vision
what pathway mediates motor movements?
nigrostriatal pathway
By enhancing dopamine release in _____ atypical antipsychotics can help alleviate negative symptoms such as (5)
mesocortical pathway
social withdrawal
lack of motivation
improve cognitive functions
memory and attention
What pathway is responsible for negative depressive symptoms in schizophrenia
decreased dopamine in mesocortical projection
What do positive symptoms from schizophrenia result from (in brain)? (2)
over active mesolimbic pathway
excess dopamine from VTA to NA
What treats positive psychotic symptoms
Antagonism of D2 receptors
What causes positive symptoms?
Hyperactivity of dopamine in mesolimbic pathway
Parkinsonism in schizophrenia occurs when
pt has positive symptoms (increase in dopamine) MLP given antipsychotics decrease in dopamine between
Mesocortical pathway consists of?
VTA projecting to the cortex
Schizophrenia what is happening to dopamine between VTA and Cortex?
decreased dopamine
Negative symptoms in schizophrenia occur from what in the brain?
dopamine b/w MCP and VTA to cortex
Mesolimbic pathway consist of (3)
ventral tegmental area (VTA) (where the trouble arises) to nucleus accumbent
Dopamine cell pathways arising from VTA to NA
Tuberoinfundibular pathway
hypothalamus to pituitary gland
dopernergic go from hypothalamus to pituitary gland, which releases prolactin
Parkinsonism is caused by and tx (2)
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
the blockade of 5-HT2A receptors modulates dopamine release particularly increasing dopamine release in the prefrontal cortex, which is an area associated with ____ &_____
negative and cognitive symptoms of schizophrenia
dopamine blockade in the Nigrostriatal pathway can lead to increase in ACH levels causing an increase in what symptoms 3
salivation, teary eyes, diarrhea
Blockage of D2 receptors in this pathway can lead to increase prolactin levels leading to hyperprolactinemia which manifests as (4)
Amenorrhea
Galactorrhea (risperidone)
Sexual dysfunction
gynecomastia
Long-term hyperprolactinemia can be associated with
osteoporosis
What two antipsychotics are less likely to cause hyperprolactinemia
Quetiapine (Seroquel)
Aripriprazole (abilify)
Prolactin levels for men and women
men less than 20ng/ml
women less than 25 ng/ml
Hyperactivity of dopamine in the _______ pathway mediates positive psychotic symptoms
mesolimbic pathway
Antagonism of D2 receptors in the mesolimbic pathway treats __________
positive psychotic symptoms
Decreased dopamine in the ________ projection to the ________________ prefrontal cortex is postulated to be responsible for ________ & ________ symptoms
mesocortical
dorsolateral
In the mesocortical pathway, the blockade of _________ receptors modulates _________ release particularly increasing ________ release in the _________ cortex which is associated with negative and cognitive symptoms
5-HT2A
dopamine
dopamine
prefrontal cortex
what pathway mediates motor movements
nigrostriatal pathway
dopamine blockade in the nigrostriatal pathway can lead to increase in _______ levels causing increase in _______, _______, _______-
ACH
increase in salvation, teary eyes
diarrhea
blockade of dopamine in the ________ pathway can lead to EPS effects
Nigrostriatal
Reglan can cause (3)
EPS symptoms like tardive dyskinesia, Parkinsonism
EPS has increase in ______ and decrease in _______
ACH and decrease in dopamine
Pseudo Parkinson has decrease ______ levels
dopamine
Benztropine is a ____ used for?
anticholinergic (Cogentin) EPS
Cogentin cannot be used to treat?
TD
FDA APPROVED for TD are what type of medications
VMAT2 inhibitors (Austedo and Valbenazine/Ingrezza)
Blockade of D2 receptors in _______ pathway can lead to an increase in _______ levels, leading to ______
tuberoinfundibular
prolactin levels
hyperprolactinemia
Hyperprolactinemia manifests as (4)
amenorrhea, galactorrhea, sexual dysfunction, gynecomastia
long term hyperprolactinemia can be associated with
osteporosis
long term risperidone can cause
galactorrhea
what two medications antipsychotics can less likely cause hyperprolactinemia?
quetiapine and aripiprazole
prolactin level for men
less than 20mg/ml
prolactin level for women
less than 25mg/ml
