Psychopharmacology Treatments of Psychotic Disorders Flashcards
What are key pathways affected by dopamine in the brain?
- Mesocortical
- Projects from ventral tegmentum (brain stem) to the cerebral cortex
- Is where negative symptoms and cognitive disorders (lack of executive function) arise
- Problem for psychotic patient is too little dopamine
- Mesolimbic
- Projects from dopaminergic cell bodies in ventral tegmentum to the limbic system
- Is where positive symptoms come from (hallucinations, delusions, thought disorders)
- Problem for psychotic patient is too much dopamine
- Nigrostriatal
- Projects from dopaminergic cell bodies in substantia nigra to the basal ganglia
- Involved in movement regulation
- Dopamine suppresses acetylcholine activity
- Dopamine hypoactivity can cause Parkinsonian movements (such as rigidity, bradykinesia, tremors) and akathisia and dystonia
- Tuberoinfundibular
- Projects from hypothalamus to anterior pituitary
- Remember dopamine release inhibits/regulates prolactin release
- Blocking dopamine in this pathway will predispose patient to hyperprolactinemia (gynecomastia, galactorrhea, decreased libido, menstrual dysfunction)
Where do the following pathways project from and to:
- mesocortical
- mesolimbic
- nigrostriatal
- tuberoinfundibular
- Mesocortical
- Projects from ventral tegmentum (brain stem) to the cerebral cortex
- Mesolimbic
- Projects from dopaminergic cell bodies in ventral tegmentum to the limbic system
- Nigrostriatal
- Projects from dopaminergic cell bodies in substantia nigra to the basal ganglia
- Tuberoinfundibular
- Projects from hypothalamus to anterior pituitary
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- Projects from hypothalamus to anterior pituitary
Where do the negative and positive symptoms of psychosis come from (what pathways)?
- Negative symptoms
- Mesocortical
- Positive symptoms
- Mesolimbic
In the following pathways is the problem for the psychotic patient too much or too little dopamine:
- mesocortical
- mesolimbic
- Mesocortical
- Problem for psychotic patient is too little dopamine
- Mesolimbic
- Problem for psychotic patient is too much dopamine
What is the nigrostriatal pathway involved in?
- Involved in movement regulation
What does dopamine do in the nigrostriatal pathway?
- Projects from dopaminergic cell bodies in substantia nigra to the basal ganglia
- Involved in movement regulation
- Dopamine suppresses acetylcholine activity
- Dopamine hypoactivity can cause Parkinsonian movements (such as rigidity, bradykinesia, tremors) and akathisia and dystonia
What effect does dopamine hypoactivity have on the nigrostriatal pathway?
- Nigrostriatal
- Projects from dopaminergic cell bodies in substantia nigra to the basal ganglia
- Involved in movement regulation
- Dopamine suppresses acetylcholine activity
- Dopamine hypoactivity can cause Parkinsonian movements (such as rigidity, bradykinesia, tremors) and akathisia and dystonia
What are examples of Parkinsonian movements?
- Dopamine hypoactivity can cause Parkinsonian movements (such as rigidity, bradykinesia, tremors) and akathisia and dystonia
How does dopamine release affect prolactin release?
- Tuberoinfundibular
- Projects from hypothalamus to anterior pituitary
- Remember dopamine release inhibits/regulates prolactin release
- Blocking dopamine in this pathway will predispose patient to hyperprolactinemia (gynecomastia, galactorrhea, decreased libido, menstrual dysfunction)
What does blocking dopamine in the tuberoinfundibular pathway cause?
- Tuberoinfundibular
- Projects from hypothalamus to anterior pituitary
- Remember dopamine release inhibits/regulates prolactin release
- Blocking dopamine in this pathway will predispose patient to hyperprolactinemia (gynecomastia, galactorrhea, decreased libido, menstrual dysfunction)
What are the 2 classes of antipsychotics?
- Typicals
- High potency D2 dopamine receptor antagonist
- As result higher risk of extrapyramidal side effects
- Drugs – Fluphenazine, Haloperidol and Pimozide
- Low potency D2 dopamine receptor antagonist
- Tender to interact with nondopaminergic receptors resulting in more cardiotoxic and anticholinergic adverse effects such as sedation, hypotension
- Drugs – Chlorpromazine
- High potency D2 dopamine receptor antagonist
- Atypicals
- Serotonin-dopamine 2 antagonists (SDAs)
- Atypical as affect both
What are the different kinds of typical antipsychotics?
- High potency D2 dopamine receptor antagonist
- As result higher risk of extrapyramidal side effects
- Drugs – Fluphenazine, Haloperidol and Pimozide
- Low potency D2 dopamine receptor antagonist
- Tender to interact with nondopaminergic receptors resulting in more cardiotoxic and anticholinergic adverse effects such as sedation, hypotension
- Drugs – Chlorpromazine
What kind of side effects are associated with high potency typical antipsychotics?
- High potency D2 dopamine receptor antagonist
- As result higher risk of extrapyramidal side effects
- Drugs – Fluphenazine, Haloperidol and Pimozide
- Low potency D2 dopamine receptor antagonist
- Tender to interact with nondopaminergic receptors resulting in more cardiotoxic and anticholinergic adverse effects such as sedation, hypotension
- Drugs – Chlorpromazine
What are examples of high potency typical antipsychotics?
- Drugs – Fluphenazine, Haloperidol and Pimozide
What side effects are associated with low potency typical antipsychotics?
- Tender to interact with nondopaminergic receptors resulting in more cardiotoxic and anticholinergic adverse effects such as sedation, hypotension