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Pharmacology Y2 > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What are positive type 1 symptoms of psychosis?

A

Auditory hallucinations
Delusions
Thought disorders
Thought broadcasting

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2
Q

What are negative type 2 symptoms of psychosis?

A

Lack of drive
Social withdrawal
Motor disturbances (catatonia)

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2
Q

What are negative type 2 symptoms of psychosis?

A

Lack of drive
Social withdrawal
Motor disturbances (catatonia)

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3
Q

What drugs act as agonists to dopamine receptors?

A

Amphetamines

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4
Q

What drugs act as agonists to serotonin receptors?

A

LSD

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5
Q

What drugs act as an antagonist to glutamate receptors?

A

Phencyclidine

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6
Q

Name a drug that antagonises the effect of dopamine

A

Reserpine

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7
Q

How does reserpine decrease the effect of dopamine?

A

It removes dopamine from the synaptic vesicles

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8
Q

How will amphetamines affect schizophrenia and Parkinson’s?

A

Exacerbates schizo
Decreases Parkinson’s

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9
Q

How will reserpine affect schizophrenia and Parkinson’s?

A

Exacerbates Parkinson’s
Decreases schizo

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10
Q

Which dopamine receptors do amphetamine and reserpine act on?

A

D2 receptors

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11
Q

List the 5 dopaminergic pathways on the brain

A

Ventral Tegmental area
Mesocortical
Mesolimbic
Nigro-striatal
Tubero-infundibular

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12
Q

What symptoms of schizo are caused by hyperactivity of the mesolimbic pathway?

A

Positive symptoms (hallucinations etc)

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13
Q

What symptoms of schizo are caused by hypoactivity of the mesocortical pathway?

A

Negative symptoms (social withdrawal)

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14
Q

What receptor antagonist will reduce the positive symptoms of schizophrenia?

A

D2 receptor antagonist

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15
Q

Name 3 types of drug that are typical D2 receptor antagonists

A

Phenothiazines
Thioxanthines
Butyrophenones

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16
Q

Name 3 drugs that are phenothiazines

A

Chlorpromazine
Thioridazine
Trifluoperazine

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17
Q

Name a drug that is a thioxanthine

A

Flupenthixol

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18
Q

Name a drug that is a butyrophenone

A

Haloperidol

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19
Q

Why is it not beneficial to have a very high D2 affinity receptor antagonist?

A

It can be so effective that it causes hypokinestic disorder effects!

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20
Q

Name a typical drug that has a very high D2 receptor affinity

A

Haloperidol

21
Q

What is the effect of typical D2 antagonists on the mesolimbic pathway?

A

Neuroleptics prevent hallucinations

22
Q

What is the effect of typical D2 antagonists affect the nitro-striatal system?

A

Neuroleptic induce movement disorders

23
Q

What is the effect of typical D2 antagonists on the tuberoinfundibular system?

A

Neuroleptics cause hyperprolactinaemia

23
What is the effect of typical D2 antagonists on the tuberoinfundibular system?
Neuroleptics cause hyperprolactinaemia
24
What are the extra pyramidal symptoms of typical neuroleptics?
Parkinsonian-like Dystonia Tardive dyskinesia Akathesia
25
How do typical neuroleptics affect H1 histamine receptors?
They block H1 receptors, act as anti-histamines
26
What is orthostatic hypertension?
Blockage of alpha 1 receptors: Dry mouth, glaucoma, constipation, urinary hesitancy
27
What is neuroleptic malgnant syndrome?
Emergency from use of antipsychotic drugs, muscle rigidity, fever, autonomic dysfunction
28
What are the autonomic side effects of typical neuroleptics?
Orthostatic hypertension Aplastic anaemia Neuroleptic malignant syndrome
29
What are the autonomic side effects of typical neuroleptics?
Orthostatic hypertension Aplastic anaemia Neuroleptic malignant syndrome
30
Is the nucleus accumbens part of the mesolimbic or mesocortical pathway?
Mesolimbic (positive symptoms)
31
Does lack of dopamine in the prefrontal cortex cause positive or negative symptoms?
Negative symptoms
31
Does lack of dopamine in the prefrontal cortex cause positive or negative symptoms?
Negative symptoms
32
What is the effect of typical neuroleptics on positive schizo symptoms?
Decreases positive symptoms
33
What is the effect of typical neuroleptics on negative schizo symptoms?
Does not decrease negative symptoms
34
What is the difference between typical and atypical neuroleptic drugs?
Atypical neuroleptics cause fewer extra pyramidal symptoms They only occupy 30% of D2 receptors (reduced affinity)
35
What are the 3 main groups of atypical neuroleptics drugs?
Dibenzazepine Bensisoxazole Third generation
36
Name 3 atypical dibenzazepine neuroleptics
Clozapine Olanzapine Quetiapine
37
Name 2 atypical bensisoxazole neuroleptics
Risperidone Paliperidone
38
Name 2 3rd generation neuroleptics
Ziprasidone Aripiprazole
39
How does Clozapine, an atypical neuroleptic, affect positive and negative symptoms of schizo?
It decreases the positive and negative symptoms
40
How do atypical neuroleptics decrease positive and negative symptoms of schizo?
They block serotonin receptors as well as D2 receptors - serotonin blocks the release of dopamine, so less serotonin means that more dopamine is present in parts of the brain that require it
41
What is an extrapyramidal symptoms of atypical neuroleptics?
Hyperprolactinaemia
42
How do leuroleptics cause hyperprolactinaemia?
Dopamine in the tuberoinfundibular pathway prevents the production of lactate - D2 antagonists will increase it
43
What are the autonomic side effects of atypical neuroleptics?
Orthostatic hypertension Weight gain Increased glucose and lipid levels (leads to type 2 diabetes) QT interval prolongation
44
What specific symptoms does clozapine cause?
Agranulocytosis - no production of granulocytes
45
Do high affinity neuroleptics have autonomic side effects?
No, low affinity neuroleptics tend to have more autonomic side effects
46
Is aripiprazole, an atypical neuroleptic, a D2 antagonist or agonist?
Apripiprazole is a partial D2 agonist
47
How does aripiprazole work?
It is a partial agonist for pre synaptic D2 receptors, It is a weak antagonist of serotonin receptors - means that at low concentrations of dopamine it agonises, however at high concentrations (such as in schizo), it antagonises by preventing the agonist from working at its full extent. Means there is always a low activity of dopamine at the receptors, only when it is excessively high it actually stops it.
48
Which are preferred as first line treatment, typicals or atypicals?
Atypicals
49
Why would aripiprazole be preferred even if it doesn't completely block dopamine receptors?
Has very little extrapyramidal side effects

Pharmacology Y2 (9 decks)

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