Exam #02 - Antipsychotics Flashcards
Which of the following statements about schizophrenia are false:
A. Schizophrenics have significant cognitive impairment
B. Has an early onset (~23 y/o)
C. Suicide is the most frequent cause of death
D. A single gene has been implicated in the development of the disease
E. Worlwide incidence is 1.1%
(D)
No single gene has been implicated in the development of schizophrenia. There are (3) susceptibility genes involved in neurodevelopment: DISC-1, neuroregulin, and dysbindin. If a child has these susceptibility genes, they are primed to develop schizophrenia.
True or False - there is a higher likelihood of developing schizophrenia if your parents or relatives have schizophrenia?
True - schizophrenia is hereditary
What causes the early onset of schizophrenia?
DA surge in late adolescence + alterations in neuronal development (brain circuitry) correlates with first psychotic break associated with schizophrenia
[Neurodevelopmental Hypothesis]
All of the following represent anatomical differences seen in a schizophrenic brain compared to a normal brain, except a schizophrenic brain has…?
A. Enlarged ventricles B. Reduction in white matter C. Reduction in hippocampus D. Decrease in dendritic spines E. All of the above are true
(E) all the above are true
The decrease in hippocampus volume is a logical difference since this is the region associated with cognition/memory and schizophrenic patients have severe cognition/memory impairment
Which of the following symptoms of schizophrenia are associated with cognitive impairment:
A. memory B. thought disorganization C. plan and organize D. A & C E. All of the above
(D)
Problems with memory and ability to plan and organize are symptoms associated with schizophrenic cognitive impairment. Thought disorganization is a positive symptom, not a cognitive impairment
All of the following statements regarding schizophrenia are true, except:
A. Decreased ability to express emotion is a negative symptom
B. Most patients are impaired in all three symptom domains (positive, negative, cognitive)
C. Positive symptoms are a result of dopaminergic overactivity in mesolimbic pathway
D. Negative symptoms are a result of dopaminergic overactivity in mesocortical pathway
E. Cognitive impairment is a result of decreased activity in mesocortical pathway
(D)
Negative symptoms are a result of DECREASED dopaminergic activity in mesocortical pathway
Which of the following symptoms of schizophrenia are associated with positive symptoms:
A. Unusual thoughts and perceptions B. Delusions C. Thought disorganization D. Hallucinations E. All of the above
(E) all of the above are positive symptoms
True or False - currently, there are no effective treatment options for CIS (cognitive impairment symptoms)
True
True or False - a stabilized schizophrenic with positive/negative symptoms controlled, are able to function in society like a normal individual?
False - although their psychotic symptoms are controlled, they are still plagued by cognitive impairment and cannot do simple things like planning out their day, read a bus schedule, or hold a job
Which region of the brain is associated with hyperprolactinemia in patients given antipsychotics (D2 antagonists)?
Tuberoinfundibular pathway - DA released at this site regulates secretion of prolactin from anterior pituitary gland. Antipsychotics block DA in this pathway resulting in increase in blood prolactin levels which can lead to abnormal lactation (even in males)
Which of the following drugs would NOT produce hallucinations:
A. Amphetamine B. Cocaine C. L-DOPA D. Risperidone (Risperdal ®) E. All of these drugs would produce hallucinations
(D)
Risperidone (Risperdal ®) is an atypical antipsychotic used in the treatment of schizophrenia. It TREATS positive symptoms, which include hallucinations
Which of the following statements regarding NMDA receptor are false:
A. It is ionotropic
B. Activation requires glutamate and glycine
C. Agonist binding allows positive ion flow into cell
D. Ketamine would block NMDA receptor
E. None of the above
(E) all are true
True or False NMDA antagonists like Ketamine and PCP can precipitate psychotic symptoms?
True - NMDA antagonists increase DA in mesolimbic pathway and decrease DA in prefrontal cortex; the same pathology seen in schizophrenic patients.
[Glutamate Hypothesis of Schizophrenia]
Blocking glutamate and glycine agonist activity at the NMDA receptor with an NMDA antagonist results in psychotic symptoms
All of the following statements regarding schizophrenia are true, except:
A. glutamate (NMDA) hypofunction results in disinhibition of GABA
B. weight gain is a common AE seen in typical antipsychotic agents
C. core element of atypical antipsychotics is 5-HT2a antagonism
D. prolonged use of antipsychotic drugs increases the risk of tardive dyskinesia
E. decrease of DA in prefrontal cortex is associated with psychotic symptoms
(B)
weight gain is a common AE seen in ATYPICAL antipsychotic agents
Glutamate (NMDA) hypofunction results in disinhibition of GABA - body is not producing as much glutamate (excitatory) so it reacts by not producing as much GABA (inhibitory) to regulate the balance of excitatory and inhibitory control
Tardive dyskinesia is slow, jerky uncontrolled movements that come from prolonged use of antipsychotic use. EPS are more transient than tardive dyskinesia
Which of the following are NOT adverse effects associated with typical antipsychotics:
A. EPS
B. Hyperprolactinemia
C. Tardive dyskinesia
D. Dyslipidemia
(D)
Dyslipidemia is a common AE of ATYPICAL antipsychotics
All of the following are primarily D2 antagonists, except:
A. Chlorpromazine B. Haloperidol C. Clozapine D. Thioridazine E. Fluphenazine
(C) Clozapine is an ATYPICAL antipsychotic whose MOA is primarily 5-HT2A antagonism
Haloperidol is a typical antipsychotic and DA inverse agonist
