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Psychiatry > Psychopharmacology 2 > Flashcards

Psychopharmacology 2 Flashcards

1
Q

Indications for antipsychotics

A

Schizophrenia,
Schizoaffective disorder,
Bipolar disorder

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2
Q

Describe mesocortical pathway

A

Projects from ventral tegmentum to the cerebral cortex

Where negative sympt0ms and cognitive disorder arise

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3
Q

Issue of mesocortical pathway in psychotic patients

A

Too little dopamine

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4
Q

Describe mesolimbic pathways

A

Projects from the dopaminergic cell bodies in the ventral tegmentum to the lambic system

This pathway is where the positive symptoms come from

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5
Q

Problem with mesolimbic pathways in psychotic patients

A

Too much dopamine

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6
Q

Types of antipsychotics

A

Typical

Atypical

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7
Q

What is the action of typicals antipsychotics

A

D2 dopamine receptor antagonistis

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8
Q

Examples of typical antipsychotics with high potency

A

Fluphenazine,
Haloperidol,
Pimozide

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9
Q

What side effects do high potency typical antibiotics have

A

Extrapyramidal

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10
Q

Examples of low potency typical antipsychotics

A

Chlopromazine

Thioridazine

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11
Q

Side effects of low potency typical antipsychotics

A

Cardiotoxic and anticholinergic adverse effects- sedation, hypotension

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12
Q

What are atypical antipsychotics

A

Serotonin-dopamine 2 antagonists

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13
Q

Examples of atypical antipsychotics

A 
Risperidone,
Olanzapine,
Quetiapine,
Aripiprazole,
Clozapine
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14
Q

Risperidone side effects

A

Increased extrapyramidal,
Hyperprolactinemia,
Weight gain,
Sedation

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15
Q

Olanzapine side effects

A 
Weight gain, 
Hypertriglyceridemia,
Hypercholesterolemia,
Hyperglycaemia,
Abnormal LFTs,
Hyperprolactinemia
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16
Q

Quetiapine side effects

A 
orthostatic hypotension,
Abnormal LFTs
Weight gain, 
Hypertriglyceridemia,
Hypercholesterolemia,
Hyperglycaemia,
17
Q

Aripiprazole positive

A

Not associated with weight fain

18
Q

When is clozapine used?

A

Reserved for treatment of resistant patients

19
Q

Side effects of clozapine

A

Agranuloocytosis,
Increased risk of seizures,
Most sedation, weight gain and abnormal LFTs,
Increased risk of hypertriglyceridemia, hypercholesterolemia, hyperglycaemia,
Nonketotic hyperosmolar coma and death

20
Q

Antipsychotics adverse effects

A

Tardive dyskinesia,
Neuroleptic malignant syndrome,
Extrapyramidal side effects

21
Q

What is tardive dyskinesia

A

Involuntary muscle movements that may not resolve with drug discontinuation due to antipsychotics

22
Q

What is neuroleptic malignant syndrome

A

Severe muscle rigidity, fever, altered mental status, autonomic instability,
Elevated wbc, CPK,
Fits

23
Q

Extrapyramidal side effects of antipsychotics

A

Acute dystonia,
Parkinson syndrome,
Akathisia

24
Q

Treatment for extrapyramidal se

A 
Anticholinergics (eg benztropine, tihexyphenidyl, diphenhydramine)
Dopamine facilitators (Amantadine),
Beta blockers (propranolol)
25
Q

Baseline blood work to do on someone before starting antipsychotics

A

Fading lipid profile,
Fasting blood sugar,
LFTs,
FBC

26
Q

What are anxiolytics used to treat

A 
Panic disorder, 
Generalised anxiety disorder,
Substance related disorder and withdrawal 
Insomnias 
Parasomnias
27
Q

Anxiolytics drugs

A

Buspirone,

Benziodiazapams

28
Q

Buspirone cons

A

Takes around 2 weeks to work,

Won’t reduce anxiety

29
Q

Side effects of benzodiazepines

A 
Somnolence,
Congnitive deficits, 
Amnesia, 
Disinhibition, 
Tolerance, 
Dependence
30
Q

Describe the nigrostriatal dopamine pathway with regards to psychotic symptoms

A

D2 blockade by antipsychotics associated with parkinsonian side-effects

31
Q

Describe the tuberoinfunibular dopamine pathway with regards to psychosis

A

D2 blockade by antipsychotics leads to increased prolactin levels and hyperprolactinaemia

32
Q

What diseases are people on atiosychotics at a higher risk of getting

A

Diabetes,
Metabolic syndrome,
Hyperprolactinaemia,
QT prolongation leading to Torsade De Pointes,

33
Q

What is metabolic syndrome

A

Syndrome of obesity, hypertension, dislipidaemia and abnormal glucose metabolism

Diagnosed if 3 or more are present:
BP >130/85
Serum HDL cholesterol >1.04 (male) or >1.29 (female)
Serum triglyceride (>1.69)
Waist circumference >102 cm (male) or >88 (female)

34
Q

What antipsychotics can cause hyperprolactinaemia

A

Amisulpride,
Risperidone,
Typical antipsychotics

35
Q

Hyperprolactinaemia symptoms

A 
Galactorrhea, 
Menstrual irregularities, 
Sexual dysfunction, 
Osteoporosis, 
Increased risk of breast cancer
36
Q

What antipsychotic doesn’t cause tardive dyskinesis

Psychiatry (23 decks)

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