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Neuroscience 2.0 > Pharm - Drug Treatment of Schizophrenia & Depression > Flashcards

Pharm - Drug Treatment of Schizophrenia & Depression Flashcards

1
Q

What are the Positive symptoms of Schizophrenia?

A

Positive symptoms - development of abnormal functions; delusions, hallucinations, disorganized speech, catatonic behaviour

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2
Q

What are the Negative symptoms of Schizophrenia?

A

Reduction or loss of normal functions – affective flattening (decrease in range or intensity of emotional expression), alogia (decrease in fluency of speech), avolition (decrease in initiation of goal- directed behaviour)

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3
Q

What are the Cognitive symptoms of Schizophrenia ?

A

Problems with attention, memory & executive functions that allow one to plan & organize

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4
Q

Fill in the blanks. “ The Mesolimbic hyperactivity is responsible for the ____________ symptoms of Schizophrenia .”

A

Mesolimbic - POSTIVE Symptoms

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5
Q

Fill in the blanks.” The Mesocortical system plays a role in the _____________ symptoms of schizophrenia .”

A

Mesocortical - NEGATIVE Symptoms

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6
Q

What are the types of Typical antipsychotics?

A

Phenothiazines
Thioxanthines
Butyrophenones

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7
Q

What are examples of Phenothiazines?

A
  • Chlorpromazine - prototype
  • Fluphenazine
  • Trifluoperazine
  • Thioridazine

” azines’

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8
Q

What are examples of Thioxanthenes?

A
  • Flupenthixol ,Flupenthixol decanoate
  • Zuclopenthixol ,Zuclopenthixol decanoate
  • Chlorprothixene
  • Thiothixene
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9
Q

What are examples of Butyrophenones?

A

Haloperidol
Droperidol

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10
Q

What are examples of the Atypical antipsychotics?

A

Sulpiride
Aripiprazole
Clozapine (prototype)
Olanzapine
Quetiapine
Asenapine
Risperidone
Ziprasidone
Lurasidone
Paliperidone
Sertindole

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11
Q

What is the MOA of Antipsychoics?

A

Antagonists or partial agonists at D2 dopamine receptors, but most block a variety of other receptors.

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12
Q

What are the 4 tracts that are in the Central Dopamine system ?

A
  • Mesolimbic
  • Mesocortical
  • Nigrostriatal
  • Tuberoinfundibular
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13
Q

A blockade of the Tuberinfundibular tract would cause?

A

Hyperprolactinemia

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14
Q

A antispsychotic blockade of the Nigrostriatal tract would cause ?

A

Extrapyramidal side effects

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15
Q

True or False? Atypical antipsychotics affect all 4 dopamine tracts with varying degrees of potency.

A

FALSE!!! TYPICAL Antipsychotics affect all 4 Dopamine tracts with varying degrees of Potency.

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16
Q

True or False? Atypical antipsychotics primarily affect dopamine tracts in limbic system & are limbic specific.

A

TRUE!!

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17
Q

Which Antipsychotic can also be used in the treatment of Tourette’s syndrome?

A

Chloropromazine & Haloperidol

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18
Q

What are the adverse effects of Chlorpromazine?

A
  • Cholinergic blockade → dry mouth, constipation, urinary retention, blurred vision.
  • α adrenergic blockade → postural hypotension.
  • Histamine blockade → sedation
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19
Q

True or False? Cannabis use impacts the potency of antipsychotics .

A

TRUE!!

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20
Q

True or False? Atypical antipsychotics are NOT usually associated with Extrapyramidal side effects ( EPSE)?

A

TRUE!!

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21
Q

Which Atypical antipsychotic is NOT a D4 receptor antagonist?

A

Quetiapine

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22
Q

Which antipsychotic Prior to initiating, obtain CBC w differential; regularly monitor ANC & WBC?

A

Clozapine

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23
Q

Fill in the blanks. “ Clozapine is effective in treating the __________ symptoms of Schizophrenia .”

A

NEGATIVE

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24
Q

Fill in the blanks . “ Risperidone is effective in treating the _________ symptoms.”

A

Both Positive and Negative symptoms

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25
Q

Which Anticholinergic drugs are used to treat Parkinsonism & akathisia?

A

Trihexyphenidyl
Benztropine
Diphenhydramine

” TBD- to be determined)”

26
Q

What is the Dopaminergic drug used to treat Parkinsonism & Akathisia?

A

Amantadine

27
Q

What are the GABAminergic drugs used to treat Parkinsonism & Akathisia?

A

Diazepam
Clonazepam
Lorazepam

28
Q

Fill in the blanks.” _____________ is a noradrenergic blocker used to treat Parkinsonism and Akathisia.”

A

Propanolol

29
Q

What are the symptoms of Mania?

A

Pressure of speech, motor hyperactivity, reduced need for sleep, flight of ideas, grandiosity, elation, poor judgment, aggressiveness & possibly hostility .

30
Q

What drugs can be used to treat Bipolar affective disorder?

A

Lithium
Valproic acid
Carbamazepine
Lamotrigine
Gabapentin
Topiramate

31
Q

What is the half life of Lithium?

A

20-24 hours

32
Q

Which drug is indicated for treatment of manic episodes of bipolar affective disorder?

A

Lithium Carbonate

33
Q

What are the Adverse effects of Lithium?

A
  • Tremor
  • Hyperactivity
  • Seizures
  • @ toxic levels- confusion
  • Mild ↓ thyroid function (monitor for lithium induced hypothyroidism)
  • Teratogen
  • Weight gain
  • Vomiting
  • Abdominal cramps
  • Diarrhoea
  • Reversible * nephrogenic diabetes insipidus ( blocks effect of ADH on kidney )
  • Leukocytosis
34
Q

Which Antipsychotic drug should be used with caution in patients w abnormal QT intervals?

A

Risperidone

35
Q

What is Depression?

A

Affective syndrome characterized by intense sadness, general loss of interest in everyday activities, insomnia, changes in appetite & low self esteem

  • often accompanies many ailments seen in the primary care setting.
36
Q

What are the signs of Significant depression?

A
  • guilt
  • low self-esteem
  • lack of pleasure
  • low energy
  • insomnia / hypersomnia
  • poor hygiene
  • increase or decrease appetite
  • suicidal ideation
37
Q

A decrease in what neurotransmitters are associated with causing depression?

A

Serotonin & Nor- Epinephrine

38
Q

What are examples of Selective Serotonin Reuptake Inhibitors ( SSRI’s) ?

A

Patrick - Paroxetine
Fly - Fluoxetine
Free - Fluvoxamine
Easy - Escitalopram
to
South - Sertraline
Carolina - Citalopram

39
Q

What is the MOA of SSRI’s ?

A

Inhibition of serotonin reuptake without significant effects on norepinephrine, muscarinic, histaminic or ɑ-adrenergic receptors.

40
Q

Which SSRI’s potent inhibitors of CYP2D6 isoenzyme –administration of 2D6 substrates ex. TCAs ?

A

Fluoxetine & paroxetine

41
Q

Which SSRI’s are relatively free of pharmokinetics?

A

Citalopram & Escitalopram

42
Q

What are the adverse effects of SSRI’s ?

A
  • Anorexia, nausea, diarrhoea
  • Nervousness
  • Insomnia
  • Dizziness
  • Sexual dysfunction (erectile dysfunction, ↓libido)
  • ↑ risk of suicide when used in children & adolescents
  • Serotonin syndrome
43
Q

What is the duration in order for Antidepressants to take effect?

A

2-3 weeks to be noticeable.

44
Q

What are examples of Selective Serotonin - Noradrenergic reuptake inhibitors (SNRI’s) ?

A

D- Desvenlafaxine
D - Duloxetine
V - Venlafaxine
M - Milnacipran

” Doc of Veterinary medicine’

45
Q

True or False? Venlafaxine - at higher doses ↑ risk of elevated blood pressure.

A

TRUE!!

46
Q

Which SNRI can be used to treat Fibromyalgia?

A

Duloxetine & Milnacipran

47
Q

What are other treatments the drug Duloxetine can be used for?

A
  • Fibromyalgia
  • Chronic musculoskeletal pain - osteoarthritis .
  • Generalised Anxiety disorder
  • Chemotherapy-induced painful peripheral neuropathy
  • Diabetic neuropathy
  • Depression duh
48
Q

Which SNRI can be used to read Hot flashes flashes due to hormonal chemotherapy ?

A

Venlafaxine

49
Q

Which SNRI can be used to treat Social anxiety and Generalised anxiety disorder?

A

Venlafaxine

50
Q

Which enzyme metabolises the drug Duloxetine?

A

CYP2D6 and CYP1A2

51
Q

What are the adverse effects of Duloxetine?

A

Nausea
Dry mouth
Headache
Somnolence
Fatigue
Constipation
Dizziness
Insomnia
Diarrhea
Anorexia
Abdominal pain
Increased sweating
Agitation
Nasopharyngitis
Vomiting

52
Q

Which Tricyclics are Nor-Adrenergic selective?

A

Desipramine
Nortriptyline
Protriptyline

53
Q

What are examples of Tricyclics antidepressants?

A

Imipramine
Amitriptyline
DoxepinClomipramine
Trimipramine
Desipramine *
Nortriptyline*
Protriptyline*

54
Q

What are examples of Atypical antidepressants ?

A
  • Bupropion
  • Mirtazapine
  • Trazodone
  • Amoxapine
  • Maprotiline
  • Tianepine
55
Q

What is the MOA of Bupropion?

A
  • Inhibits reuptake of serotonin, NE & dopamine (possibly inhibits reuptake of DA more than NE).
  • Non-competitive nicotine receptor antagonist ; at high concentrations inhibits firing of noradrenergic neurons in the locus coeruleus.
56
Q

What are examples of Irreversible Monoamine Oxidase Inhibitors MAOI’s ( irreversible non-competitors) ?

A

Phenelzine
Tranylcypromine

57
Q

What are examples of Reversible MAO - A selective inhibitors?

A
  • Moclobemide
  • MAO- B inhibitor
  • Selegiline
58
Q

What are the adverse effects of MAOI’s ?

A

Orthostatic hypotension
Impotence
Agitation
Hallucinations
Seizures
Hyperthermia
Hepatotoxicity

59
Q

What is the active ingredient in St.Johns wort?

A

Hyperforin

60
Q
A

Neuroscience 2.0 (29 decks)

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