Module 6: 1st generation antipsychotics

Question 1

1st generation antipsychotic examples

Answer 1

Chlorpromazine
Haldol

Question 2

Onset of schizophrenia males vs females

Answer 2

Males: early 20’s
Females: late 20’s-early 30’s

Question 3

Causes of schizophrenia

Answer 3

neurodevelopment in 2nd trimester in utero
-stress/illness/nutrient deficit?
-genetic component (50% in identical twins)
-genetic vulnerabilities + environmental stressors

*abnormal dopaminergic transmission
*abnormal glutaminergic transmission
(glutamate deficiency)

Question 4

Diagnosing schizophrenia

Answer 4

2+ symptoms persisting for a month for 6+ months
Symptoms:
-Delusions
-Hallucinations
-Disorganized speech
-catatonic behavior
-negative symptoms
-social/occupational dysfunction

(symptoms may be on/off during the month as long as majority of time active)

Question 5

Three types of schizophrenia symptoms

Answer 5

Positive symptoms: Refer ot symptoms that should NOT be present: Hallucinations, Delusions, Disorganized speech

Negative symptoms: Lack of characteristics that SHOULD be present: Reduced speech, lack of emotion, decrease activeness, socially withdrawn

Cognitive deficits: memory, attention, planning, decision making

Question 6

Treatment for schizophrenia

Answer 6

MEDS ARE ESSENTIAL
ECT can be very effective

Dopamine antagonists: Typical or atypical antipsychotics

Question 7

_____________ has increased risk of EPS

Answer 7

1st generation antipsychotics

Question 8

_______________ has increased risk of metabolic syndrome

Answer 8

2nd generation antipsychotics

Question 9

Dopamine 2

Answer 9

Responsible for EPS, prolactin deficit (sexual dysfunction, gynecomastia)

Question 10

Alpha-1 adrenergic

Answer 10

Responsible for ortho-hypo, sedation, dizziness

Question 11

Cholinergic

Answer 11

Dry mouth, urine retention, constipation

Question 12

Histamine-1

Answer 12

Responsible for sedation, weight gain SE

Question 13

_______________ can TREAT tardive dyskinesia

Answer 13

Clozapine

Question 14

Neuroleptic Malignant Syndrome (NMS)

Answer 14

Life threatening neurologic emergency
Caused by antipsychotics
Usually develop in first 2 weeks

S/S: Mental status changes, agitated delirium, lead-pipe rigidity, fever, tremor, autonomic instability (tachycardia, HTN, tachypnea)

10%-20% mortality rate

Question 15

LAI Zyprexa should be monitored for

Answer 15

3 hours after injection!