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psychiatry > psychopharmacology 2 > Flashcards

psychopharmacology 2 Flashcards

1
Q

what is the mesocortical pathway ?

A

from ventral tegmentum to cerebral cortex
negative symptoms and cognitive disorders
TOO LITTLE dopamine

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2
Q

what is the mesolimbic pathway ?

A

dopaminergic cell bodies to the limbic system
positive symptoms
TOO MUCH dopamine

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3
Q

what is the nigrostriatal pathway ?

A

from dopaminergic cell bodies in substantia nigra to basal ganglia
movement regulation
dopamine suppresses acetylcholine
DOPAMINE HYPOACTIVITY can cause parkinsonian syndrome

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4
Q

what is the tuberofundibular pathway ?

A

from hypothalamus to anterior pituitary
DOPAMINE INHIBITS prolactin
blocking dopamine predisposes to hyperprolactinaemia

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5
Q

what are typical antipsychotics ?

A

D2 receptor antagonists
high extrapyramidal side effects
fluphenazine, haloperidol
chlorpromazine low potency

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6
Q

what are atypical antipsychotics ?

A

serotonin-dopamine antagonists

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7
Q

what are extrapyramidal symptoms ?

A 
dystonia
akathisia
parkinsonisms
bradykinesia
tremor
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8
Q

what are side effects of risperidone ?

A

extrapyramidal side effects
hyperprolactinaemia
weight gain
sedation

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9
Q

what are side effects of olanzapine ?

A

weight gain
high TAG, cholesterol, glucose
hyperprolactinaemia
abnormal LFTs

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10
Q

what are side effects of quetiapine ?

A

abnormal LFTs
weight gain
high TAG, cholesterol, glucose
ORTHOSTATIC HYPOTENSION

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11
Q

what are pros of aripriprazole ?

A

no QT prolongation
low sedation
no weight gain

ADR makes akathisia

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12
Q

what are side effects of clozapine ?

A 
agranulocytosis - weekly bloods
sedation
weight gain
abnormal LFTs
high TAG, cholesterol, glucose
coma/death
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13
Q

what are adverse effects of antipsychotics ?

A

tardive dyskinesia - involuntary muscle movements may not resolve

neuroleptic malignant syndrome - rigidity, fever, mental status change, elevated WBC, LFTs

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14
Q

how do you treat extrapyramidal symptoms ?

A

anticholinergics - benztropine
dopamine facilitators - amantadine
B-blockers

watch anticholinergics with TCAs

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15
Q

what are anxiolytics ?

A

anxiety meds

use in combo with SSRI

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16
Q

what are pros and cons of buspirone ?

A

pros - augmentation, no sedation

cons- 2 weeks til results, no reduction in anxiety if BZDs

17
Q

what are side effects of BZDs ?

A 
somnolence
cognitive deficits
amnesia
disinhibition
tolerance
dependence

psychiatry (16 decks)

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