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Justin Lyle Cards > Neuro 6 > Flashcards

Neuro 6 Flashcards

1
Q

_________________ drugs do not cause Extra-pyramidal effects at clinically effective doses

A

“atypical” anti-psychotic

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2
Q

what is the prototype “atypical” antipsychotic drug

A

clozapine

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3
Q

what is the prototype neuroleptic antipsychotic drug

A

thorazine

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4
Q

what is psychosis

A
  1. denotes a variety of mental disorders 2. presence of delusions 3. various types of hallucinations 4. grossly disorganized thinking
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5
Q

excessive ___________________ plays a role in psychosis

A

limbic dopaminergic activity

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6
Q

what is the most common type of psychosis

A

schizophrenia

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7
Q

what are the 2 clusters of behavior seen with schizophrenia

A

positive symptoms negative symptoms

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8
Q

positive symptoms of schizophrenia are defined as

A

something that is added to the situation, i.e. something that should not be there

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9
Q

delusions, hallucinations, reality distortions, bizzarre and agitated behavior are all ______________ symptoms seen with schizophrenia

A

positive

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10
Q

positive symptoms of schizophrenia are mediated by ___________ receptors

A

D2

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11
Q

what would define schizophrenic negative symptoms

A

lack of something that should be there

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12
Q

flat affect, emotional/social withdrawal are examples of _____________ symptoms with schizophrenia

A

negative

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13
Q

what receptor mediates the negative symptoms seen with schizophrenia

A

5-HT receptor (esp the 5-HT2A)

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14
Q

diminished ____________ or _____________ activity underlies the cognitive impairment and negative symptoms seen with schizophrenia

A

cortical; hippocampal

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15
Q

_________-_________% of schizophrenics are drug resistant

A

20-25

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16
Q

in general, anti-psychotic drugs tend to be _________________ antagonists

A

serotonin

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17
Q

what is the MOA of clozapine

A

inverse agonist of the 5HT2A receptor and anatagonizes the D2 receptor

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18
Q

which drug will treat the positive and negative symptoms of schizophrenia

A

clozapine

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19
Q

clozapine has greater affinity for the ____________ receptor over the _________ receptor

A

5HT2A; D2

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20
Q

what is the normal fx of the 5HT2A receptor

A
  1. depolarizes glutamate neurons 2. stabilizes NMDA receptors on the post-synaptic neuron
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21
Q

clozapine main MOA is with the antagonism of serotonin and D2 receptors; however, if also has some blockade effects on __________, _________, and _________ receptors

A

alpha; muscarinic; H1

22
Q

clozapine is used in the tx of what d/o’s

A
  1. schizophrenia (positive and negative sx) 2. some benefits in tx agitation with alzheimers and parkinsons
23
Q

general absorption of anti-psychotics

A
  1. readily but not complete absorbed 2. significant first pass metabolism
24
Q

general distribution of anti-psychotics

A
  1. highly lipid soluble and protein bound 2. large Vd 3. longer clinical duration of action than indicated by their 1/2 life
25
general metabolism of anti-psychotics
1. almost completely metabolized to by oxidation or demethylation by CYP450 nz in the liver
26
____________________ is an antipsychotic that may be excreted in the urine weeks after the last dose of chronically administered drug
chlorpromazine
27
what is the only antipsychotic that has rapid and severe return of symptoms after discontinuation
clozapine
28
what is the average time for schizophrenic sx return in pts who d/c their meds?
6 months (exception with clozapine)
29
efficacy of anti-psychotics is driven by ___________ receptor blockade
D2
30
adverse reactions of anti-psychotics are d/t antagonism at what receptors?
1. alpha 2. Muscarinic 3. H1 4. 5-HT2
31
MOA of typical (neuroleptic) anti-psychotics
act as D2 antagonists w/ primary action at the mesolimbic and mesocortical regions of the brain
32
D2 receptor blockade in the __________________ and ______________ pathways mediate some of the side-effects of typical (neuroleptic) anti-psychotics
basal ganglia ; tuberoinfundibular
33
MOA of atypical antipsychotics
mild D2 receptor antagonists combined with serotonin 5-HT2 receptor blockade (5HT2 > D2)
34
atypical antipsychotics main MOA is on D2 and 5HT2, but they also have high affinity for _____________ & ______________ receptors
5-HT2c & D4
35
Therapeutic uses of anti-psychotics
1. tx of psychoses 2. tx of schizophrenia 3. mood stabilizers (atypical) 4. tourettes 5. ADD 6. antiemetics 7. intracatable hiccups
36
in schizophrenia tx, _______________ anti-psychotics are only useful with positive sx; however, ___________________ fx in tx of both positive and negative sx
typical; atypical
37
what are the general s/e of antipsychotics
1. severe sedation 2. anti-cholinergic effects 3. parkinsonian like tremors 4. hyperlactinemia 5. Hypotension
38
why do you get hyperlactinemia with antipsychotic meds
dopamine is the inhibitor of prolactin. The MOA of most antipsychotics fx as dopamine antagonists thus removing the inhibitory effect of dopamine on PRL
39
MOA of chlorpromazine
blockade of D2 receptors >> 5HT2A receptors
40
clinical applications of chlorpromazine
1. schizophrenia (alleviates positive sx) 2. bipolar disorder (manic phase) 3. anti-emesis 4. pruritus
41
T/F: many anti-depressants are now FDA approved for things outside of depression
TRUE
42
anti-depressants treat what?
1. Psychologic depression: major depressive disorder & dysthymia 2. anxiety disorders (PTSD, OCD, Generalized anxiety d/o, panic d/o, phobias) 3. bipolar disorder (manic depressive dz) 4. chronic pain 5. premenstrual dysphoric disorder 6. smoking cessation 7. eating disorders
43
________________ is unipolar, often totally disabling, interferes with work, sleep, and eating
major depressive disorder
44
_____________ less severe the major depressive disorder, involves long term chronic sx that do not disable, but keep a person from functioning at their highest level
dysthymia
45
__________________ is characterized by cycles of severe highs and gut wrenching lows, often develops into psychotic states
bipolar
46
_____________________ increase the risk of suicide in pts under the age of 25
anti-depressants
47
what meds can have discontinuation syndromes
SSRI SNRI TCA MAOI
48
discontinuation syndrome sx with SSRI, SNRI, and TCAs?
1. dizziness and paresthesias beginning 1-2 days after sudden d/c of drug 2. may persist for 1 wk or longer
49
discontinuation syndrome with MAOIs
delirium like state with psychosis, excitement, and confusion
50
(general) peak absorption of anti-depressants is at ____________ hours
3-Feb

Justin Lyle Cards (27 decks)

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