Intro To Substance Use

Question 1

opioid addiction postive and negative reinforcement

Answer 1

positive reinforcement: get eurphoria (high)

negative reinforcement: get withdrawal when wears off

Question 2

Methadone

Answer 2

mu partial agonist

Question 3

Buprenphine

Answer 3

Mu full agonist

Question 4

three early theories of neurobio of schizo

Answer 4

dysregulated 5HT
dysreguated NE
hyperactive DA transmission

Question 5

2 current models of schizo

Answer 5

neurodevelopmental

neurodegenerate

Question 6

neurodevelopmental model

Answer 6

early abnormaity in utero, then around puberty development of hypofrontality which usually inhibits mesolimbic, so subsequent mesolimbic hyperactivity (Kindling Model)

Question 7

neurodegenerate model

Answer 7

NMDA antagonists produce positive and negative symptoms and cognitive deficits

glutamatergic dysregulation leads to apoptosis

Question 8

all first generation antipsychotics cause

Answer 8

extrapyramidal symptoms

Question 9

4 typical antipsychotics (from low to high potency)

Answer 9

chlorpromazine
perphenazine
haloperidol (Haldol)
Fluphenazine (Prolixin)

Question 10

typicla antipsychotics are

Answer 10

anti-cholinergics

Question 11

diagnosis of neuroleptic malignant syndrome

Answer 11

major manifestations: fever, rigidity, elevated CPK

minor: abnormal bp, a;tered consciousness, tachypnea, altered conciousness, diaphoresis

3 major, or 2 major 4 minor

Question 12

Clozapine

Answer 12

daramtically effective for positive and some negative symptoms

minimal EPS effects

minimal prolactin elevation

Question 13

Clozapine mech of action

Answer 13

weak DA D2 receptor antagonism, but potent antagonist at 5HT and NE a2 R

Question 14

worst side effects of clozapine

Answer 14

agranulocytosis
seizures
myocarditis

Question 15

risperidone

Answer 15

first post-clozapine atypical antipsych

Question 16

olanzapine

Answer 16

5HT/D2 R blockade

also has low EPS and low prolactin elevation

Question 17

biggest side effect of olanzapine

Answer 17

weight gain, glucose/lipid dysregulation

Question 18

Aripiprazole

Answer 18

partial DA agonist
minimal EPS, no prolactin elevation, low weight gain

functional antagonist under conditions of DA hyperactivity (pos symptoms)

functional agonist in conditions of DA hypoactivity (neg symptoms, cognitive)

Question 19

What makes aripiprazole unique?

Answer 19

early activation

Question 20

result of catie phase 2

Answer 20

clozapine is most effective

Question 21

novel atypical antipsychotics

Answer 21

release of DA in PFC

Question 22

D-cycloserine

Answer 22

partial agonist at glycine modulatory site
–+ typical antipsych–>decrease in neg symptoms
when added to cloz, no effect or increased symptoms

Question 23

people are less likely to relapse on Cloz because

Answer 23

not dependent on D2 block