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Unit 4 > Parkinson and psychosis > Flashcards

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
Q

What are the high and low potency of typical antipsychotic and what are their side effects?

A

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
Q

Which typical antipsychotic has the side effect of torsades and retinal deposits?

A

Thioridazine

27
Q

What is clozapine’s side effect?

A

Agranulocytosis

28
Q

What are the general side effects for atypical antipsychotic?

A

Metabolic syndrome—>weight gain/hyperglycemia/hyper lipid

Especially quetiapine

29
Q

What is NMS (neuroleptic malignant syndrome? How do we treat it?

A

Temp regulation problems—>muscle rigidity and increase temp
Dantrolene (block Ca2+ in muscle) and bromocriptine

30
Q

Anti M increase or decrease seizure threshold?

A

Decrease

31
Q

What is premenstrual dysphoric disorder and what is used to treat it?

A

PMDD—>depression during periods

Treat with SSRIs

Unit 4 (28 decks)

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