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PHRM 845 > L52-53 watts schizo > Flashcards

L52-53 watts schizo Flashcards

1
Q

T or F: Decreased ventricle size is included in the etiology of schizo

A

False, increased ventricle size

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2
Q

T or F: migration of neurons is included in the etiology of schizo

A

True

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3
Q

T or F: COMT-marijuana is included in the etiology of schizo

A

True

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4
Q

T or F: Negative sxs respond well to drug therapy in comparison with positive sxs

A

false

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5
Q

T or F: Decrease in cognitive function involves d2 receptors and glutamate receptors

A

False, d1 and glutamate receptors

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6
Q

what neurotransmitters are involved in the neurotransmitter hypotheses of schizo

A

dopamine
serotonin
glutamate

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7
Q

dopamine neurotransmitter hypothesis

A

first to be developed, but incomplete

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8
Q

serotonin neurotransmitter hypothesis

A

based on mechanism of LSD and mescaline

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9
Q

glutamate neurotransmitter hypothesis

A

based on phencyclidine and ketamine

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10
Q

which 2 drugs are noncompetitive inhibitors of ndma receptors that exacerbate psychosis and cognition deficits

A

phencyclidine and ketamine

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11
Q

T or F: LY2140023-mGluR2/3 antagonists are effective in schizo

A

False, agonists

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12
Q

T or F: Ampakine (AMPA receptors) are effective in animal models

A

True

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12
Q

T or F: Dopaminergic agents exacerbate sxs of schizo

A

yes, too much dopamine is the problem

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13
Q

T or F: Increased D1 receptor density in treated and untreated pts of schizo

A

false, d2

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14
Q

Saturation binding experiments
A. Vary concentration of radio-labeled ligands
B. Constant radioligand (hot) concentration competing with unlabeled ligand (cold)

A

A. Vary concentration of radio-labeled ligands

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15
Q

Competition binding experiments
A. Vary concentration of radio-labeled ligands
B. Constant radioligand (hot) concentration competing with unlabeled ligand (cold)

A

B. Constant radioligand (hot) concentration competing with unlabeled ligand (cold)

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16
Q

Which of the following receptors are antagonized by antipsychotic drugs
A. Dopamine
B. Serotonin
C. Norepinephrine
D. ACh
E. Histamine
F. A and B
G. A, B, and E
H. All of the above

A

H. All of the above

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17
Q

antagonism of which receptor is responsible for weight gain?
A. alpha 1
B. histamine
C. ACh
D. D2

A

B. histamine

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18
Q

antagonism of which receptor is responsible for hypotension?
A. alpha 1
B. histamine
C. ACh
D. D2

A

A. alpha 1

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19
Q

T or F: most antipsychotic drugs are receptor antagonists

A

True

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20
Q

antagonism of which receptor modulates synthesis and release of dopamine

A

D2

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21
Q

Which of the following is the primary region of the CNS for therapeutic effects of D2 antagonists?
A. Basal ganglia
B. Mesolimbic
C. Mesocortical
D. Medulla

A

B. Mesolimbic

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22
Q

Which of the following is the primary region for motor effects and extrapyramidal sxs (EPS)
A. Basal ganglia
B. Mesolimbic
C. Mesocortical
D. Medulla

A

A. Basal ganglia

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23
Q

what 2 systems are responsible for the d2 receptor blockade in the endocrine system

A

hypothalamus and endocrine system lol

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24
Q

Which of the following regions is the chemoreceptor trigger zone
A. Basal ganglia
B. Mesolimbic
C. Mesocortical
D. Medulla

A

D. Medulla

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25
Q

know the kd shit on slides 20 and 21

A

i will go look at that (you too whoever is on this card rn)

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26
Q

D2 Antagonism:
Extrapyramidal Sxs (EPS)
occurs ______

A

early, days/weeks

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27
Q

Symptoms of EPS: (4)

A

dystonia - increased muscle tone
pseudoparkinsonism
tremor
akathisia - restlessness

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28
Q

What is an antihistamine that can treat EPS?

A

Benadryl

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29
Q

what anticholinergic agents can be used to treat EPS? (3)

A

Benztropine, trihexyphenidyl, akineton

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30
Q

what dopamine releasing agent can be used to treat EPS?

A

Amantadine

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31
Q

What medication can be used to treat akathisia in pts w/ EPS

A

propranolol 1st line -> +lorazepam (Ott)

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32
Q

Excitatory neurotransmitter involved in EPS
A. ACh
B. Dopamine

A

A.ACh

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33
Q

inhibitory neurotransmitter involved in EPS
A. ACh
B. Dopamine

A

B. Dopamine

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34
Q

what drug induced movement disorder occurs late (months/year)

A

Tardive Dyskinesia

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35
Q

T or F: Both EPS and Tardive Dyskinesia are irreversible disorders

A

False, EPS is reversible

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36
Q

4 sxs of tardive dyskinesia

A
  • Mouth-rhythmic involuntary movements
  • Choreiform- irregular purposelessness
  • Athetoid - worm-like movements
  • Axial hyperkinesia- “to-and-fro” movements
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37
Q

what is the MOA of tardive dyskinesia?

A

its unknown, pussy

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38
Q

what monitoring scale should be used in pts experiencing tardive dyskinesia

A

AIMS (Abnormal Involuntary Movement Scale)

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39
Q

what is the best treatment option for tardive dyskinesia?

A

prevention, then to use the least risky agent at lowest dose possible

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40
Q

what drug class is a “newer drug therapy” option for tardive dyskinesia?

A

VMAT2 inhibitors

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41
Q

what are the 3 VMAT2 inhibitors

A

Tetrabenazine
Valbenazine
Deutetrabenazine

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42
Q

what do VMAT2 inhibitors do to dopamine?

A

Deplete it so it cant activate receptors that affect movement

43
Q

Used for Huntington’s Chorea
A. Tetrabenazine
B. Valbenazine
C. Deutetrabenazine

A

A. Tetrabenazine
B. Deutetrabenazine

44
Q

used for tardive dyskinesia
A. Tetrabenazine
B. Valbenazine
C. Deutetrabenazine

A

B. Valbenazine
C. Deutetrabenazine

45
Q

used for tardive dyskinesia and huntington’s chorea
A. Tetrabenazine
B. Valbenazine
C. Deutetrabenazine

A

C. Deutetrabenazine

46
Q

Serious and rapid with 10% fatality
A. EPS
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome

A

C. Neuroleptic malignant syndrome

47
Q

Occurs early, days/weeks, reversible
A. EPS
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome

A

A. EPS

48
Q

Occurs late (months/year), irreversible, 20-40% incidence
A. EPS
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome

A

B. Tardive dyskinesia

49
Q

how long do antipsychotic drugs take to show effectiveness in the tx of psychosis?
A. 4-8 weeks
B. 4-7 days
C. 6 weeks-6 months
D. 2-3 weeks

A

D. 2-3 weeks

50
Q

How long does it take an antipsychotic drug to reach its maximal efficacy?

A

6 weeks to 6 months (damn)

51
Q

Used in Huntington’s chorea
A. Tetrabenazine
B. Chlorpromazine
C. Haloperidol
D. Metoclopramide
E. Droperidol

A

A. Tetrabenazine

52
Q

Used for intractable hiccups
A. Tetrabenazine
B. Chlorpromazine
C. Haloperidol
D. Metoclopramide
E. Droperidol

A

B. Chlorpromazine

53
Q

Used for alcohol withdrawal
A. Tetrabenazine
B. Chlorpromazine
C. Haloperidol
D. Metoclopramide
E. Droperidol

A

C. Haloperidol

54
Q

Used for N/V
A. Tetrabenazine
B. Chlorpromazine
C. Haloperidol
D. Metoclopramide
E. Droperidol

A

D. Metoclopramide

55
Q

Used for potentiation of opiates and sedatives
A. Tetrabenazine
B. Chlorpromazine
C. Haloperidol
D. Metoclopramide
E. Droperidol

A

E. Droperidol

56
Q

Orthostatic hypotension, impotence, failure to cum
A. Muscarinic cholinoceptor blockade
B. Alpha adrenoceptor blockade
C. Dopamine receptor blockade
D. Histamine receptor blockade

A

B

57
Q

Loss of accommodation, dry mouth, cant piss, cant shit
A. Muscarinic cholinoceptor blockade
B. Alpha adrenoceptor blockade
C. Dopamine receptor blockade
D. Histamine receptor blockade

A

A

58
Q

Parkinson’s syndrome, akathisia, dystonias
A. Muscarinic cholinoceptor blockade
B. Alpha adrenoceptor blockade
C. Dopamine receptor blockade
D. Histamine receptor blockade

A

C

59
Q

Sedation
A. Muscarinic cholinoceptor blockade
B. Alpha adrenoceptor blockade
C. Dopamine receptor blockade
D. Histamine receptor blockade

A

D

60
Q

Tardive dyskinesia
A. Supersensitivity of dopamine receptors
B. Muscarinic blockade
C. Dopamine receptor blockade resulting in hyperprolactinemia
D. Possibly combined H1 and 5HT2 blockade

A

A

61
Q

Toxic-confusional state
A. Supersensitivity of dopamine receptors
B. Muscarinic blockade
C. Dopamine receptor blockade resulting in hyperprolactinemia
D. Possibly combined H1 and 5HT2 blockade

A

B

62
Q

Amenorrhea-galactorrhea, infertility, impotence
A. Supersensitivity of dopamine receptors
B. Muscarinic blockade
C. Dopamine receptor blockade resulting in hyperprolactinemia
D. Possibly combined H1 and 5HT2 blockade

A

C

63
Q

Weight Gain
A. Supersensitivity of dopamine receptors
B. Muscarinic blockade
C. Dopamine receptor blockade resulting in hyperprolactinemia
D. Possibly combined H1 and 5HT2 blockade

A

D

64
Q

Contraindications for antipsychotics (4)

A

Cardiovascular
Parkinsons (no shit)
epilepsy (no shit)
Diabetes (in atypicals)

65
Q

First antipsychotic
A. Chlorpromazine
B. Promezine
C. Triflupromazine
D. Promethazine

A

A. Chlorpromazine

66
Q

what does the 3 atom chain allow for in chlorpromazine?

A

nitrogen to bind the receptor (why the fuck do i care about this)

67
Q

2 aliphatic phenothiazines that had a * next to them

A

Chlorpromazine
Promethazine

68
Q

what are promethazine and chlorpromazine used for, mostly

A

H1 antagonist properties

69
Q

what is the one drug under piperidine phenothiazine with a * next to it

A

Thioridazine

70
Q

whats next to thioridazine in the slide that tells us about it

A

sedation, hypotension, anticholinergic, many SE

so just dont ever put this as an option

71
Q

What are the 3 piperazine phenothiazines with a *

A

Fluphenazine
Prochlorperazine
Perphenazine

72
Q

Fluphenazine
A. EPS
B. Antiemetic
C. just as effective w/ anticholinergic vs. new agents

A

A

73
Q

Prochlorperazine
A. EPS
B. Antiemetic
C. just as effective w/ anticholinergic vs. new agents

A

B

74
Q

Perphanzine
A. EPS
B. Antiemetic
C. just as effective w/ anticholinergic vs. new agents

A

C

75
Q

Thioxanthine drug

A

Thiothixene

76
Q

Butyrophenone drug

A

haloperidol

77
Q

Which drug is most appropriate for a pt with tourette’s?
A. Molindone
B. Haloperidol
C. Pimozide
D. Chlorpromazine

A

C. Pimozide

78
Q

T or F: Atypical agents were the first generation of antipsychotics

A

False, second

79
Q

First atypical antipsychotic

A

Clozapine

80
Q

what is the significant side effect that clozapine has

A

agranulocytosis

81
Q

T or F: Weight gain is a side effect of olanzapine

A

true

82
Q

what does the metabolite of the atypical antipsychotic loxapine do? do you remember what its called?

A

amoxipine, inhibits NET which leads to antidepressive properties

83
Q

T or F: Quetiapine’s metabolite has antidepressant properties

A

True

84
Q

what receptors does quetiapine antagonize

A

5HT2A
D2
Alpha 1
histamine (H1)

85
Q

9-hydroxyrisperidone
A. Risperidone
B. Paliperidone
C. Iloperidone

A

B. Paliperidone

86
Q

vert potent at alpha 1 receptors
A. Risperidone
B. Paliperidone
C. Iloperidone

A

C. Iloperidone

87
Q

specifically and structurally designed to be both a 5HT and D2 receptor antagonist
A. Risperidone
B. Paliperidone
C. Iloperidone

A

A. Risperidone

88
Q

Relatively low EPS at <8mg/day
A. Risperidone
B. Paliperidone
C. Iloperidone

A

A. Risperidone

89
Q

5HT, D2, alpha 1 affinity
A. Ziprasidone
B. Asenapine

A

A. Ziprasidone

90
Q

prolongs qt interval
A. Ziprasidone
B. Asenapine

A

A. Ziprasidone

91
Q

5HT and D2. (nM affinity at most 5HT, alpha, DA, and histamine receptors)
A. Ziprasidone
B. Asenapine

A

B. Asenapine

92
Q

Inverse agonist of 5HT *
A. Lurasidone
B. Pimavanserin

A

B. Pimavanserin

93
Q

Less weight gain and metabolic effects (vs olanzapine)
A. Lurasidone
B. Pimavanserin

A

A. Lurasidone

94
Q

Low doses similar effectiveness to high doses
A. Lurasidone
B. Pimavanserin

A

A. Lurasidone

95
Q

Used for parkinson disease psychosis
A. Lurasidone
B. Pimavanserin

A

B. Pimavanserin

96
Q

make sure you understand the table on slide 57 because it will definitely be on the exam

A

okay fuckface

97
Q

what receptors does aripiprazole have high affinity for

A

5HT2 and D2

98
Q

aripiprazole is a partial agonist of what receptor (being used in depression)

A

5HT1a

99
Q

T or F: Aripiprazole has moderate affinity for D4, alpha, and histamine receptor s

A

True

100
Q

what drug class are these guys?
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

D2/D3 receptor partial agonists.

101
Q

a D2/D3 partial agonist with greater affinity D3.
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

B. Cariprazine

102
Q

Partial D2 agonist presynaptic receptors/antagonist at postsynaptic receptors
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

C. Lumateperone

103
Q

A D2/D3 partial agonist with supposedly less akathisia vs aripiprazole
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

A. Brexpiprazole

104
Q

Schizophrenia and as an adjunct to antidepressants for major depression
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

A. Brexpiprazole

105
Q

Schizophrenia, mania, and bipolar disorder
A. Brexpiprazole
B. Cariprazine
C. Lumateperone

A

B. Cariprazine

106
Q

what is the one drug class that has a * on it in the drugs in development/under investigation slid e

A

dual M1/M4 muscarinic agonist combined with peripheral muscarinic antagonist (KarXT*)

PHRM 845 (34 decks)

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