pharmacology: antipsychotics

Question 1

what is involved in the etiology of schizophrenia?

Answer 1

too much dopamine and serotonin

Question 2

positive symptoms of schizophrenia? negative symptoms?

Answer 2

positive symptoms: though disorders, delusions, hallucination, paranoia
negative symptoms: amotivation, social withdrawal, flat affect, poverty of speech

Question 3

mechanism of antipsychotics

Answer 3

blockade of dopamine and/or 5HT2 receptors

Question 4

uses of antipsychotics

Answer 4

schizophrenia, schizoaffective states, bipolar disorder, tourettes, huntingtons, drug or radiation emesis

Question 5

side effects from dopamine bloackade

Answer 5

dyskinesias (EPS), dysphoria, endocrine dysfunction (temp regulation problems on central level; increased prolactin, increased eating disorders)

Question 6

management of acute EPS vs management of chronic EPS

Answer 6

acute: antimuscarinic drugs (benztropine or diphenhydramien)
chronic: discontinuation/switch to atypical

Question 7

what are the typical antipsychotics?

Answer 7

chlorpromazine, thioridazine, fluphenazine, haloperidol

Question 8

characteristics of the antipsychotic typicals (chlorpromazine, thioridazine, fluphenazine, haloperidol)

Answer 8

muscarinic block, alpha block, sedation, EPS

Question 9

side effects of thioridazine

Answer 9

cardiotoxicity and convulsions, retinal deposits

Question 10

haloperidol side effects

Answer 10

most likely cause of neuroleptic malignant syndrome and tardive dyskinesias (because more potent)

Question 11

what are the antipsychotic atypicals

Answer 11

clozapine, olanzapine, risperidone, aripiprazole

Question 12

side effects of clozapine

Answer 12

agranulocytosis (destruction of WBC), increased salivation, seizures

Question 13

why is there less EPS with the atypicals

Answer 13

blocks serotonin receptors, improving negative symptoms

Question 14

aripiprazole mechanism

Answer 14

partial agonist of D2 receptor and also blocks serotonin receptor