Lecture 2 - Antipsychotics

Question 1

psychosis:

distorted perception of ____ characterized by ____, ____, and/or disorganized though/speceh

Answer 1

reality, delusions, hallucinations

Question 2

schizophrenia:
presents earlier in ____ (late teens, early 20s) than _____ (20s to 30s);
frequent ____ use is associated with it in teens.
decline in functioning must be greater than ___ months

Answer 2

males, females;
cannabis;
6

Question 3

positive symptoms of schizo include ____, _____ hallucinations, ____ speech or behavior

Answer 3

delusions, auditory, disorganized

Question 4

negative symptoms of schizo include ____ affect, avolition, reduced speech, interest, drive;

which symptoms are more treatable with meds, positive or negative?

Answer 4

flat;

positive

Question 5

schizophrenia is associated with ____ dopaminergic activity and decreased ____ branching

Answer 5

increased;

dendritic

Question 6

First gen antipsychotics (FGA):

_____, pimozide, and the _______‘es which all end in “-___”

Answer 6

haloperidol, phenothiazines, azine;

Question 7

chlorpromazine and thioridazine are ____ potency.

haloperidol, trifluoperazine, and fluphenazine are ___ potency.

Answer 7

low, high

Question 8

high vs low potency drugs FGA's:
which has more...
extrapyramidal symptoms?
anti-histamine effects?
alpha 1 antagonism?
anticholinergic?

Answer 8

high;

low, low, low

Question 9

all FGA’s block what receptor?
2 major dopamine pathway that this blocks?
blocking this receptor causes a ____ in prolactin release;

Answer 9

D2 (dopamine);
mesolimbic, nigrostriatal
increase

Question 10

FGA’s are ___ soluble. they have a ___ Vd and a ____ half life

Answer 10

lipid;

large, long

Question 11

all antipsychotics can cause these effects:
heart = \_\_\_\_\_;
antimuscarinic = \_\_\_\_\_, \_\_\_\_\_
antihistamine = \_\_\_\_\_
alpha blocking =

Answer 11

prolonged QT;
dry mouth, constipation;
sedation;
orthostatic hypotension

Question 12

antipsychotic EPS effects: what is the pneumonic to remember?

due to blockage of what pathway?

Answer 12

ADAPT

nigrostriatal

Question 13

ADAPT:
A____ D___ within what time period?
A____, P ____ within what time period?
T_____ within what time period?

which can be irreversible

Answer 13

acute dystonia within hours to days;
akathisia, parkinsonism within days to months;
tardive dyskinesia within months to years

tardive = can be irreversible

Question 14

____ is the protypical second gen antipsychotic (SGA)

other’s typically end in “____” or “____”

Answer 14

clozapine;

“apine” ie asen, olanz, qeutiapine

“idone” ie iloper, paliper, risper, luras, ziparsidone

Question 15

in addition of D2 selectivity, SGAs also target the ___ receptor.

SGAs have lower risk of ____ and ____ side effects than typical antipsychotics

Answer 15

5HT2a;

Extrapyrimdal, anticholinergic

Question 16

mechanism of action of apriprazole

Answer 16

D2 partial agonist

Question 17

FGA vs SGA:
which have better control of negative symptoms?
which typically has more metabolic effects?
which is more associated with Neuroleptic malignant syndrome?

Answer 17

SGA, SGA, FGA

Question 18

metabolic effects are seen in the “-____’s” especially. these effects include ____, ____, and _____

Answer 18

pines (ie SGA);

weight gain, diabetes, hyperlipidemia

Question 19

clozapine is associated with:
_____ (hematologic effect);
_____ (CNS effect);
___ and _____ (heart effect);

Answer 19

agranulocytosis;
seizures;
myocarditis, cardiomyopathy

also orthostatic hypotension, somnolescence

Question 20

of the SGAs, ____ is especially associated with hyperprolactinemia.
____ and ____ are associated with metabolic effects such as weight gain

Answer 20

risperidone;

clozapine, olanzapine

Question 21

FGA effects:

_____ is associated with corneal deposits. _____ is associated with retinal deposits

Answer 21

chlorpromazine, thioridazine