Part II: Psychotic Flashcards
Major Tranquilizers are in contrast to the
Benzos and barbs
Neuroleptic refers to the tendency of a drug to produce neuro side effects for example
Parkinsonism
Type of symptoms that are common in schizophrenia
Negative symptoms more often than positive
Heritability of Schizophrenia
50% (identical twin w/ schizophrenia means 50% other twin has it)
Important dopamine pathways important in the brain
Mesolimbic
Mesocortical
Neurotransmitter that mediates hallucinogenic effects of schizophrenia
5-HT2A and 5-HT2C
NMDA neurotransmitter important in exacerbating schizophrenic symptoms
Glutamate (phencyclidine and ketamine)
All antipsychotics are ___________ antagonists
D2 dopamine receptor antagonists
What types of symptoms are improved with antipsychotics?
Positive symptoms
Extrapyramidal effects of anti-psychotics
Dystonia
Akathisia
Parkinsonian symptoms (tremor, rigidity, bradykinesia)
Cardiovascular alterations that can occur with anti-psychotics
Prolonged Q-T which can lead to Torsade de Pointes
Endocrine alterations w/ anti-psychotics
Increased prolactin release from D2 antagonism
Blurred vision and retinitis pigmentosa can be a side effect of
thioridazine
Metabolic syndrome, diabetes can be a side effect of
Olanzepine
Dantrolene can treat what syndrome that is a side effect of anti-psychotics
Neuroleptic Malignant Syndrome
Long term side effects of anti-psychotics
Tardive Dyskinesia (writhing)
Perioral Tremor (rabbit syndrome)
Blood dyscrasias: agranulocytosis w/ clonazapine and some phenothiazines
Long Term side effect of clonazapine
Blood dyscrasias (agranulocytosis)
Antipsychotics potentiate which drugs
CNS depressants (classically barbs)
What Typical (older) antipsychotics are tricyclic
Phenothiazines (Chlorpromazine, fluphenazine, thioridazine)
what typical antipsychotic is more selective for dopamine receptors than the typical antipsychotics with the highest incidence of EPS that isn’t a phenothiazine
Haloperidol
Atypical antipsychotic that does not cause extrapyramidal side effects and antagonist at 5HT2>D2
Clozapine (agranulocytosis)
used for tx resistant psychosis (NEVER FIRST LINE), need blood testing
Other Newer 5HT2 antagonists w/ EPS at high dose
Risperidone 5HT2=D2
Lurasidone 5HT2, D2, 5HT7
5HT2 antagonists with less EPS
Olanzapine
Quetiapine
Ziprasidone
Aripiprazole
