Schizophrenia

Question 0

Schizophrenia

Answer 0

Cause: too much dopamine being released
Typical onset 20-30 years old
Hereditary involvement
Thought to be a neuro developmental disorder that isn’t expressed till later in life
Positive symptoms: can be see (hallucinations)
Negative symptoms (loss of initiative, emotional responsiveness)

Question 1

Psychoses

Answer 1

Mental disorders characterized by disturbances in thought, mood, sense of self and relations to external world and bx

Distorted or non existant sense of reality

Question 2

Schizophrenia symptoms from…

Answer 2

Excessive DA function in mesolimbic system

Question 3

Schizophrenia negative symptoms from…

Answer 3

Deficits in DA function in mesocortical system

Question 4

Antipsychotics best treat ____ symptoms

Answer 4

Positive

Question 5

Mesolimbic-mesocortical system

Answer 5

Emotional and cognitive circuitry

Drugs reduce abnormal responses

Question 6

Nigrostriatal pathway

Answer 6

Voluntary motor control

Drugs can produce Parkinson’s like effects

Question 7

Tubero-infundibular (hypothalamus)

Answer 7

Regulation of hormone release,nemesis

Drugs can produce hyperprolatctemia, reduce vomiting

Question 8

Chlorpromazine

Answer 8

Typical antipsychotic 
Lower affinity for D2 receptors
Lower potency 
Increased sedative effects
Orthostatic hypotension 
Low risk of EPSE

Question 9

Haloperidol

Answer 9

Typical antidepressants
Higher affinity for D2 receptors
Higher potency
Low incidence of hyperlipemia, hyperglycemia, weight gain
EPSE more likely
Neuroleptic malignant syndrome greater risk

Question 10

Mechanism of action for typical antidepressants

Answer 10

Antagonists at D2 receptors
Highly lipid soluable
Highly bound to plasma proteins
First pass metabolism in the liver if given orally

Question 11

Adverse effects of typical antipsychotics

Answer 11

Muscarinic effects
Alpha antagonist effects - orthostatic hypotension
Seizures

Question 12

Extrapyramidal side effects

Answer 12

Result from taking dopamine antagonists:
Reversible
     Akinesia (lack of movement)
     Dystonia (muscle spasms of face, neck, back)
     Dyskinesia (blinking, twitching)
     Akathisia (can't sit still)
Irreversible
     Tardive dyskinesias - uncontrolled movements of the face, neck,         extremities

Question 13

Neuroleptic Malignant Syndrome

Answer 13

Happens with haloperidol
Hyperthermia, diffuse muscular rigidity, diaphoresis

Resembles severe form of Parkinsonism

Question 14

Neuro endocrine effects of atypical antipsychotics

Answer 14

Hyperprolatctemia
Sexual dysfunction
Weight gain

Question 15

Atypical antipsychotic agents

Answer 15

More effective negative symptoms and cognitive symptoms
About equally as effective against positive symptoms

Increased risk of weight gain, developing type II diabetes

Clozapine
Quetiapine
Risperidone
Apriprazole

Question 16

Clozapine

Answer 16

Atypical antipsychotic
Extremely low incidence of EPSE
Effective in pts resistant to typical antipsychotics

Question 17

Adverse effects of clozapine

Answer 17

Hyperlipdemia, hyperglycemia, weight gain

Agranulocytosis!

Question 18

Risperidone

Answer 18

Atypical antipsychotic
Broadly effective against positive and negative symptoms
Hypotension w/ high doses

sedation
GI problems
Tremors

Question 19

Quetiapine

Answer 19

Atypical antipsychotic
Hyperlipemia, hyperglycemia, weight gain
Hypertension

Question 20

Ariprazole

Answer 20

Atypical antipsychotic
Newer agent
Not associated w/ hyperlipemia, hyperglycemia, weight gain