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Pharmacology > EXAM #3: ANTIPSYCHOTICS > Flashcards

EXAM #3: ANTIPSYCHOTICS Flashcards

1
Q

What is psychosis?

A

Variety of mental disorders that are characterized by:

1) Delusions– false beliefs
2) Hallucinations– auditory, visual, tactile, and olfactory

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2
Q

What is Schizophrenia?

A

A neurodevelopmental disorder characterized by severe psychosis

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3
Q

What are “positive” symptoms in Schizophrenia?

A

Manifestations of abnormal behavior including:

  • Delusions
  • Hallucinations
  • Agitation
  • Paranoia
  • Aberrant thinking
  • Intrusion of throughts
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4
Q

What are the “negative” symptoms of Schizophrenia?

A

Absence of normal behavior including:

  • Flat affect
  • Social withdrawal
  • Inattentiveness
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5
Q

What is the “Dopamine Hypothesis” of Schizophrenia?

A

HYPERACTIVITY of the mesolimibic/ mesocortical DA system causes psychosis

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6
Q

What NTs have been implicated in Schizophrenia aside from DA?

A

1) 5-HT hyperactivity

2) Hypofunction of Glutamate (NMDA) receptors

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7
Q

What is the main mechanism of action of antipsychoitc drugs?

A

D2 receptor blockers (antagonists)

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8
Q

What is the main side effect of antipsychotic medications?

A

Extraparyamidal Symptoms

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9
Q

What are the two categories of antipsychotics?

A

Typical vs. Atypical

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10
Q

What are the clinical indications for antipsychotic agents?

A

1) Schizophrenia
2) Psychotic behavior
3) Severe mania (Bipolar)
4) Antiemetic

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11
Q

List the typical antipsychotics.

A

Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol

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12
Q

List the atypical antipsychotics.

A 
Clozapine 
Olanzapine
Risperiodone 
Aripiprazole 
Quetiapine
Ziprasidone
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13
Q

What is the difference between the metabolism of the typical and atypical antipsychotics?

A

Typical= metabolism into INACTIVE metabolite

Atypical= metabolism into ACTIVE metabolite

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14
Q

What receptor do the antipsychotics block?

A

D2 (mainly)

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15
Q

How does the mechanism of action of atypical antipsychotics differn from typical?

A

Atypical agents antagonize D2 AND 5-HT2A receptors

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16
Q

What is the relationship between D2 affinity and potency antipsychotic drugs?

A

Higher affinity for D2= more potent

17
Q

What antipsychotic has high 5-HT affinity?

A

Clozapine

18
Q

What is the relationship between receptor binding and EPS?

A

D2 antagonism is associated with more EPS

19
Q

What receptor is associated with orthostatic hypotension?

A

Alpha-1

20
Q

What receptor is associated with sedation in antipsychotics?

A

Histmaine

21
Q

What can be expected from a drug with a high D2/5-HT2A ratio?

A

EPS symptoms

22
Q

Antipsychotic action in what part of the brain produces antiemetic effects?

A

Medullary periventricular area

23
Q

What are the different types of EPS?

A

1) Parkinson-like Syndrome
2) Akathesia (motor restlessness and anxiety)
3) Dystonia
4) Tardive Dyskinesia

24
Q

What are the endocrine effects of antipsychotics?

A

Hyperprolactinemia

Males:

  • Gynecomastia
  • Decreased libido
25
Q

What two antipsychotics are highly associated with weight gain?

A

Clozapine and Olanzapine

26
Q

What type of antipsychotics are associated with weight gain?

A

Atypical/ newer antipsyhotics

27
Q

What is Neuroleptic Malignant Syndrome?

A

Life-threatening HTN and Hyperthermia seen with antipsychotic administration

28
Q

What type of antipsychotic is associated with LESS orthostatic hypotension/ alpha-1 effects?

A

Atypical antipsychotics

29
Q

What atypical antipsychotic is most associated with EPS?

A

Risperidone

30
Q

What atypical agents are least associated with EPS?

A

Clozapine

Quetiapine

31
Q

What patients are more susceptible to tardive dyskinesia?

A

Elderly patients i.e. older than 65

32
Q

What type of antipsychotics are associated with the development of Parkinson-like symptoms?

A

Typical antipsychotics

33
Q

Which atypical antipsychotics are associated with an increased risk of DM?

A

Clozapine
Olanzapine

These are the drugs that are also most associated with weight gain

34
Q

What are the common reasons that patients will stop taking antipsychotic medications?

A

1) Lack of efficacy
2) Unwilling to tolerate side effects
3) Weight gain
4) Sexual side effects

Pharmacology (64 decks)

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