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Human disease and therapeutics 2020 > Psychopath lecture 2 > Flashcards

Psychopath lecture 2 Flashcards

1
Q

What are the physical findings in a person with Schizophrenia?

A
  • Enlarged ventricles

- Changes in prefrontal cortex perfusion

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2
Q

What is the neurochemistry of Schizophrenia?

A
  • Dopamine related phenomenon with too much stimulation of the D2 receptors
  • 5HT (serotonin)/glutamate
  • Nicotine
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3
Q

What is the genetic predisposition of Schizophrenia?

A

1% of population have schizophrenia

  • If one identical twin has schizo, then the other twin has a 40-50% chance
  • Environment plays a role, there seems to be a link between influenza during pregnancy leading to schizophrenia
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4
Q

What are the pharmacological treatments for schizophrenia?

A
  • Block D2 receptors (typical antipsychotics)(D2 antagonist)

- Block 5HT2 receptors (atypical antipsychotics)

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5
Q

What are the clinical benefits of schizophrenia treatment?

A
  • Reduce psychotic symptoms
  • Enhance cognition and executive functioning
  • Alleviate depression
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6
Q

What are the social benefits of schizophrenia treatment?

A

-Made outpatient management of these patients possible

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7
Q

What are the side effects of schizophrenia treatment from a D2 receptor blocker?

A
  • Orthostatic hypotension
  • Sedation
  • Xerostomia
  • Extrapyramidal side effects (Parkinson-like)
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8
Q

What are the side effects of schizophrenia treatment from the atypical antipsychotics (5HT2 receptor blockers)?

A
  • Severe agranulocytosis

- Fewer side effects

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9
Q

What are the extrapyramidal side effects the antipsychotics can cause?

A
  • Tardive dyskinesias

- Parkinson’s like tremors

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10
Q

What are the psychologica/physical effects of antipsychotics?

A
  • Sleepiness
  • Restlessness
  • Disrupt endocrine
  • Can cause pseudo-depression
  • weight gain
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11
Q

What are phenothiazines?

A
  • Typical Antipsychotic drug
  • Chlorpromazine
  • Thioridizine
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12
Q

What causes the weight gain from phenothiazines?

A

-Anticholinergic effect

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13
Q

Which class of antipsychotics have less extrapyramidal side effects?

A

-Phenothiazines

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14
Q

What are Butyrophenones?

A
  • Typical Antipsychotic drug

- Haloperidol (Can cause tardive dyskinesias)

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15
Q

What antipsychotic drug class has high extrapyramidal side effects?

A

-Butyrophenones

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16
Q

What do atypical antipsychotic drugs block?

A
  • D2 receptors

- 5HT2A receptors

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17
Q

What class of antipsychotic drugs are more effective against negative symptoms of schizophrenia?

A

-Atypical antipsychotics

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18
Q

What is Clozapine?

A

-Atypical antipsychotic drug

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19
Q

What can Clozapine cause?

A

-Serious agranulocytosis

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20
Q

What is Quetiapine (Seroquel)?

A

-atypical antipsychotic

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21
Q

What is Olanzepine (Zyprexa)?

A

-atypical antipsychotic

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22
Q

What are atypical antipsychotic drugs??

A
  • Clozapine
  • Quetiapine
  • Olanzepine
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23
Q

What is acute psychotic disorder?

A
  • It is Temporary schizophrenia type and situation dependent
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24
Q

What is Schizoaffective?

A
  • Schizophrenia and depression

- Schizophrenia and mania

25
Q

What is the background of mood disorders?

A
  • 5%

- Depression and mania are the two sides of mood disorders

26
Q

In mood disorders can mania present by itself?

A

-Not typically, depression can but mania is typically coupled with depression

27
Q

What is the usual affective process of Mood disorders?

A
  • Sadness
  • Simple unhappiness
  • Grief
  • Bereavement
28
Q

What are the minor affective disorders of mood disorders?

A
  • Depression-dysthymia

- Cyclothymia

29
Q

What is depression-dysthymia?

A
  • Last longer than 2 years
  • Can function though
  • Do not respond well to drugs
  • Female dominant
30
Q

What is cyclothymia?

A
  • Minor bipolar that lasts longer than 2 years
  • don’t medicate
  • Need behavior management
31
Q

What two things do you see in mood disorders?

A
  • Manic

- Depression

32
Q

What are the subtypes of Major depression?

A

-Postpartum

33
Q

Major depression has variable expressions, what are they?

A
  • Profound to Vegetative

- May have several episodes throughout life

34
Q

When does postpartum show up?

A

1-4 weeks after delivery

35
Q

What is SADS?

A

-Season Affective Disorder Syndrome

36
Q

When are some common features of the treatment for major depression?

A
  • Delayed onset (it takes a little while to work)

- 70% effectiveness

37
Q

What are the drug categories to treat Major depression?

A
  • Monoamine Oxidase Inhibitors

- Tricyclic antidepressants

38
Q

What was the 1st modern antidepressants?

A

-Monoamine Oxidase Inhibitors

39
Q

What are the side effects of Monoamine Oxidase Inhibitors?

A
  • Alter autonomic system activity
  • Orthostatic hypotension
  • Weight gain
40
Q

What do MAOIs do?

A

-increase 5HT, DA, NE

41
Q

What might monoamine oxidase inhibitors interact with?

A
  • foods that contain tyramine such as cheeses and beer

- OTC cold decongestants

42
Q

What are two examples of MAOI’s?

A
  • Phenelzine

- Selegiline

43
Q

What are the characteristics of tricyclic antidepressants?

A
  • Long half life/single daily dose

- Block the uptake of NE and varying affinity for 5HT transporter

44
Q

What are the side effects of Tricyclic antidepressants?

A
  • Dry mouth (anticholinergic effect)
  • Histamine blockade
  • Orthostatic hypotension
  • Withdrawal with abrupt discontinuation
45
Q

What are examples of tricyclic antidepressants?

A
  • Amytriptyline
  • Desipramine
  • Doxepin
46
Q

What do monoamine uptake blocker work on?

A
  • 5HT
  • NE
  • DA
47
Q

What are the properties of monoamine uptake blockers?

A
  • Better tolerated
  • Mixture of selectivity
  • Minimal withdrawal
48
Q

What do 5HT (SSRIs) cause for side effects?

A
  • GI upset
  • Sexual dysfunction
  • Depression in adolescents
  • Headaches
  • Can cause weight loss)
49
Q

Is there anticholinergic activity in SSRIs?

A

-No

50
Q

What are the SSRI drugs?

A
  • Fluoxetine (prozac)

- Sertraline (Zoloft)

51
Q

What are the NE or mixed transport blocker drugs?

A
  • Venlafaxine (effecxor)

- Duloxetine (Cymbalta)

52
Q

What is bipolar referred to as?

A

-Manic/Depressive

53
Q

What are the types of bipolar?

A
  • Cyclothymia (mild type)

- Major manic depressive

54
Q

What is major manic depressive?

A
  • The mania can cause major compromised function
  • Poor decision making abilities
  • Impulsivity
  • Unrealistic
55
Q

What are the medications used to treat Bipolar disorder?

A
  • Lithium carbonate

- Antiepileptic drugs

56
Q

What antiepileptic drugs are used to treat bipolar?

A
  • Valproic acid
  • Carbamazepine
  • Lamotrigine
57
Q

What are the general properties of lithium carbonate?

A
  • Slow onset
  • Alters 2nd messenger systems
  • Often Combined with an antidepressant
  • Potent mood stabalizers
58
Q

What are the side effects of lithium carbonate?

A
  • Narrow therapeutic window
  • Tremors common
  • Potential kidney damage
  • Weight gain
  • Edema
  • High rate of compliance problems
59
Q

What are the biological theories of mood disorders?

A
  • Catecholamine theory

- imbalance of DA, NE, or 5HT activity

Human disease and therapeutics 2020 (60 decks)

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