psychosis

Question 1

what are the drug classes for treating psychosis?

Answer 1

conventional antipsychotics (phenothiazines and phenothiazine-like drugs) (+)

atypical antipsychotics (nonphenothiazines)(+/-)

Question 2

Phenothiazines (conventional antipsychotics)

Answer 2

chlorpromazine HCl
fluphenazine HCl
prephenazine HCl
promazine HCl
thioridazine HCl
trifluoperazine HCl

Question 3

Non-Phenothiazines (conventional antipsychotics)

Answer 3

haloperidol
loxapine succinate
pimozide
thiothixene

Question 4

Therapeutic action of conventional antipsychotics

Answer 4

block excitement associated with positive symptoms of schizophrenia

act by preventing dopamine and serotonin from occupying their receptor sites in certain regions of the brain

Question 5

Chlorpromazine

Answer 5

Prototype phenothiazine, conventional antipsychotic

blocks positive symptoms of schizophrenia

used primarily for severe mental illness

adverse effects include: dizziness, drowsiness, orthostatic hypotension, extra-pyramidal signs, and neuroleptic malignant syndrome

Question 6

Haloperidol

Answer 6

prototyp non-phenothiazine, conventional antipsychotic

blocks postsynaptic D2-receptors

primarily used in management of acute and chronic psychotic disorders

adverse effects include: dizziness, drowsiness, orthostatic hypotension, extra-pyramidal signs, and neuroleptic malignant syndrome

Question 7

Atypical Antipsychotic Drugs

Answer 7

clozapine
olanzapine
quetiapine fumarate
risperidone

Question 8

therapeutic action of atypical antipsychotics

Answer 8

treat both positive and negative symptoms of schizophrenia

act by blocking several different receptor types in the brain including dopamine D2-receptors, serotonin 5-HT receptors, alpha-adrenergic receptors

Question 9

clozapine

Answer 9

prototype atypical antipsychotic

blocks dopamine receptors in limbic system and binds to serotonergic, alpha-adrenergic and cholinergic receptors throughout the brain

primarily used for severe mental illness. Treats both positive and negative symptoms

adverse effects include dizziness, drowsiness, headache, constipation, transient fever, salivation, flu-like symptoms, and trachycardia

Question 10

What conditions have symptoms that may mimic schizophrenia?

Answer 10

chronic use of amphetamines or cocaine
seizures
brain neoplasm
infections
hemorrhage

Question 11

Extrapyramidial symptoms must be monitored for when patients are given antipsychotics. What are these symptoms?

Answer 11

acute dystonia (muscle spasms)
akathisia (inability to relax)
tardive dyskinesia (tongue and face movements)
psuedo-parkinsonism (tremor, stooped posture, shuffling gait)

Question 12

What is neuroleptic malignant syndrome?

Answer 12

it is a toxic reaction to therapeutic doses of antipsychotic drugs

it is life threatening

signs include: elevated temperature, unstable BP, profuse sweating, dyspnea, muscle rigidity, incontinence