Parkinson and psychosis Flashcards

1
Q

What goes wrong in the nigrostriatal tract in Parkinson’s pt?

A

Decrease DA—>movement disorder

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2
Q

What goes wrong in the mesolimbic mesocortical tract in schizo pt?

A

Increase DA—>reinforce behaviors

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3
Q

Treating what diseases can cause Parkinson and schizo like symptoms?

A

Treat Parkinson with dopamine—>schizo like symptoms

Treat schizo with anti dopamine—>Parkinson like symptoms

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4
Q

What does tuberoinfundibular tract do?

A

DA inhibit prolactin

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5
Q

What is DA’s role in chemorecetpor trigger zone?

A

Stimulate DA—>emesis

DA antagonist—>antiemetic

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6
Q

Where are D1 and D2 receptors located and what protein are they coupled with?

A

D1—>renal—>Gs
D2—>CNS—>Gi
D2A—>nigrostriatal
D2C—>mesolimbic

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7
Q

What is the treatment approach for Parkinson?

A

Increase DA and decrease ACh

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8
Q

What are the 2 ways to treat pseudoparkinson caused by schizo treatment?

A

Switch drugs or use an antimuscarinic

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9
Q

What are the side effects of levodopa?

A
Dyskinesia (most common)
Psychosis (most common)
HoTN (dopamine vasodilate)
Vomiting
On-off effects
On--->improve mobility with dyskinesia (abnormal movement)
Off--->marked akinesia
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10
Q

Why do we use carbidopa with levodopa?

A

Carbidopa blocks peripheral AAAD (convert levodopa to dopamine)—>promote levodopa to go into CNS

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11
Q

What is tolcapone and entacapone’s role in Parkinson? and what do they give with?

A

COMT inhibitor—>prevent degradation of dopamine—>decrease On-off effect
They are usually given with levodopa to minimize on-off effect

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12
Q

What’s the affect of selegiline?

A

Inhibit MAO-B—>prevent degradation of dopamine—>increase dopamine half life—->treat parkinson

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13
Q

What is tolcapone’s side effect?

A

Hepatotoxic

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14
Q

Why does selegiline cause insomnia?

A

Selegiline is metabolized to amphetamine

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15
Q

What are some dopamine receptor agonists?

A

Bromocriptine/pramipexole/ropinirole/apomorphine/aripiprazole

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16
Q

What is bromocriptine used for?

A

NMS from antipsychotic drugs
Hyperprolactinemia
Acromegaly

17
Q

What else can pramipexole and ropinirole used for?

A

Restless leg syndrome

18
Q

What are the muscarinic blockers used for Parkinson’s?

A

Benztropine and trihexyphenidyl

19
Q

What is the mechanism of amantadine for Parkinson’s? and what is its side effect?

A

Block muscarinic receptor and increase dopamine release

Livedo reticularis

20
Q

What drugs are used to treat Tourette syndrome?

A

Halopridol and pimozide

21
Q

What is Tourette syndrome?

A

Involuntary tics of multiple muscles/at least one 1 vocal tic
Hyperkinetic

22
Q

What are the typical and atypical antipsychotic?

A

Typical—>(zines) haloperidol/chlorpromazine/thioridazine/fluphenazine
Atypical—>(idone and apines) clozapine/olanzapine/risperidone/aripiprazole

23
Q

What is acute EPS (extrapyramidal symptoms) and chronic EPS? and what do we use to treat them?

A

Movement disorder from antipsychotic drugs
Acute—>pseudoparkinson/dystonia/akathisia (agitation/distress)
Treat with anti M like benzatropine

Chronic—>tardive dyskinesia (irreversible)

24
Q

What is the mechanism of atypical antipsychotic?

A

D2 and 5HT2 blockers

25
What are the high and low potency of typical antipsychotic and what are their side effects?
High potency (Try to Fly High)--->Trifluoperazine, Fluphenazine, Haloperidol--->cause EPS (aka pseudoparkinson) Low potency (Cheating Thieves are low)--->Chlorpromazine, Thioridazine--->anti M/histamine/alpha 1 blockade
26
Which typical antipsychotic has the side effect of torsades and retinal deposits?
Thioridazine
27
What is clozapine's side effect?
Agranulocytosis
28
What are the general side effects for atypical antipsychotic?
Metabolic syndrome--->weight gain/hyperglycemia/hyper lipid | Especially quetiapine
29
What is NMS (neuroleptic malignant syndrome? How do we treat it?
Temp regulation problems--->muscle rigidity and increase temp Dantrolene (block Ca2+ in muscle) and bromocriptine
30
Anti M increase or decrease seizure threshold?
Decrease
31
What is premenstrual dysphoric disorder and what is used to treat it?
PMDD--->depression during periods | Treat with SSRIs