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(UNI) Neuropharmacology (3rd Year) > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What other names does schizophrenia go by?

A

paranoid illness, delusional disorder, psychotic state, psychosis.

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2
Q

What conditions are related to schizophrenia?

A

Drug-induced psychosis, schizoaffective disorder, psychotic depression.

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3
Q

What is a schizoaffective disorder?

A

A combination of bipolar and schizophrenia.

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4
Q

What is psychotic depression?

A

When one becomes so depressed that they lose touch with reality.

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5
Q

What is the lifetime prevalence of schizophrenia?

A

0.5 - 1%.

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6
Q

When does schizophrenia usually develop?

A

In late adolescence or early adult life.

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7
Q

Why are schizophrenia rates higher in ethnic minorities/immigrants?

A

Because the condition is exacerbated by the prejudice that these groups experience in their host country.

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8
Q

What is Knight’s Move Thinking?

A

Discourse consisting of a sequence of unrelated or only remotely linked thoughts/ideas.

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9
Q

What thought interferences are associated with schizophrenia?

A

Insertion, withdrawal, broadcasting, block.

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10
Q

What is thought broadcasting?

A

The belief that everyone can hear one’s thoughts.

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11
Q

What’s Knight’s Move Thinking?

A

Discourse consisting of a sequence of unrelated or only remotely linked thoughts/ideas.

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12
Q

What two categories are Schizophrenia symptoms separated into?

A

Positive and negative symptoms.

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13
Q

What are the positive symptoms of Schizophrenia?

A

Delusions, thought disorders, hallucinations, movement disorders. These are often the first symptoms to present.

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14
Q

What are the negative symptoms of Schizophrenia?

A

Social withdrawal, apathy.

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15
Q

Do Schizophrenic patients know they are acting bizarre?

A

No, they do not show insight of their condition.

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16
Q

What is insulin coma therapy?

A

This therapy uses large doses of insulin to induce hypoglycaemia and put the patient into a coma and cause them to seize. The patient would then be given glucose recovery.

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17
Q

What theory was insulin coma therapy based upon?

A

This was based on the now disproved theory that a person with epilepsy wouldn’t develop schizophrenia, hence inducing epilepsy/seizures to cure schizophrenia.

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18
Q

What is psycho-surgery (lobotomy)?

A

A drill or rod is used to permanently destroy brain cells.

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19
Q

What are the potential negative consequences of a lobotomy?

A

This treatment has many adverse events associated with it, such as cognitive and emotional effects.

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20
Q

What is electroconvulsive therapy?

A

It is uses to produce fits by electricity, based upon the same ideas about epilepsy and schizophrenia.

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21
Q

Does electroconvulsive therapy help in Schizophrenia? Does it help in any other conditions?

A

It hasn’t been found to help those suffering from schizophrenia however it has been proven to be of some help in depression.

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22
Q

What two categories are anti-psychotic medicines split into?

A

Typicals and atypicals.

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23
Q

What are some typical anti-psychotics?

A

Chlorpromazine, trifluoperazine.

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24
Q

What are some atypical anti-psychotics?

A

Risperidone, olanzapine, clozapine.

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25
Q

Which symptoms are anti-psychotic medication most useful against?

A

Anti-psychotic medication is generally more effective against the positive symptoms (with the exception of clozapine) and they work in three ways.

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26
Q

In what three ways do anti-psychotics affect the patient?

A

Calming affect, symptom control, relapse prevention.

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27
Q

How long can it take for anti-psychotics to have an effect on symptoms?

A

6-8 weeks.

28
Q

Who usually provides support to Schizophrenic patients?

A

Community psychiatric nurses, support workers.

29
Q

To whom do Schizophrenic patients pose the biggest risk?

A

Themselves.

30
Q

When medication is stopped, how long does it take for relapse to occur?

A

2-6 months.

31
Q

Why should some anti-psychotic drugs be used with caution in epileptic patients?

A

They can lower a person’s seizure threshold.

32
Q

What side effects can one experience from anti-psychotic drugs?

A

Dry mouth, blurred vision, constipation, acute dystonia, Parkinsonian symptoms, akathisia, tardive dyskinesia.

33
Q

What are Depot medications?

A

These are long acting injections which are given every 1-4 weeks and are effective for under 4 months.

34
Q

What are the major advantages of atypical neuroleptics?

A

The major advantage of the atypical neuroleptics is that they give little or no movement disorder.

35
Q

How much weight gain can one expect as a side effect of atypical neuroleptics?

A

5-10 kg.

36
Q

What drug is indicated in the treatment of treatment resistant Schizophrenia?

A

Clozapine.

37
Q

What neuroleptic is regarded as a dirty drug due to its activity at a lot of different receptors?

A

Clozapine has activity at many receptors hence it is considered a dirty drug.

38
Q

What are the side effects of Clozapine?

A

Neutropenia/agranulocytosis, weight gain (10-20kg), diabetes, seizures, tachycardia, hypersalivation, constipation.

39
Q

How can the hypersalivation associated with Clozapine use be treated OTC?

A

Hyoscine 300mcg.

40
Q

Why should Clozapine patients be given regular blood tests?

A

Because neutropenia/agranulocytosis is a possible side effect and blood cell levels should be monitored to prevent this happening.

41
Q

What advice should be given to Clozapine patients regarding weight gain?

A

Patients should be advised on reducing fatty foods, increasing fruit and veg intake, and undertake regular exercise. In extreme cases, a dietitian support may be needed.

42
Q

On what receptors does Olanzapine have an effect?

A
  • D (including D2).
  • 5HT (including 5HTA).
  • H1.
  • Anti-cholinergic.
43
Q

What are the side effects of Olanzapine?

A

Weight gain (10kg), diabetes, increased cholesterol.

44
Q

What monitoring should be given to those patients on Olanzapine?

A

Regular blood tests and weight monitoring.

45
Q

To what receptors does Risperidone have activity?

A

Risperidone has a high affinity for serotonergic 5-HT2 and dopaminergic D2 receptors.

46
Q

What are the side effects of Risperidone?

A

Weight gain (3-5kg), hypotension, increased serum prolactin.

47
Q

What are the consequences of increased serum prolactin?

A
  • Galactorrhoea,
  • Gynecomastia.
  • Amenorrhea.
  • Sexual side effects – impotence etc.
  • Potential risk of osteoporosis.
  • Possible link with breast cancer.
48
Q

Describe the unique release mechanism of release in Risperidone consta.

A

This mechanism features microsphere biodegradable polymer beads which degrade releasing over a sustained period.

49
Q

To what receptors does Quetiapine have action?

A

Quetiapine has affinities for serotonin receptors (5-HT2), dopamine receptors (D1 and D2), adrenergic receptors, and H1 receptors.

50
Q

What are the side effects of Quetiapine?

A

As with other drugs, it can lead to weight gain and there have been case studies showing a diabetes risk.

51
Q

To what receptors does Aripiprazole have action?

A

Aripiprazole shows partial agonism at D2 and 5-HT1a receptors and antagonism against 5-HT2a receptors.

52
Q

What are the side effects of Aripiprazole?

A

Some weight gain, anxiety, insomnia, akathisia, nausea, and vomiting.

53
Q

When in Schizophrenia is Aripiprazole used?

A

First episode use.

54
Q

Why are schizophrenic thought abnormalities hard to detect?

A

They can be subtle.

55
Q

When may male patients begin to show schizophrenic symptoms? What about this may cause problems diagnosing the symptoms as being caused by schizophrenia?

A

In their late teens or early 20s. These symptoms may be overlooked as normal adolescent behaviours.

56
Q

What environmental factors are associated with the development of Schizophrenia?

A

Various factors, including prenatal and perinatal events, such as rubella, maternal influenza, smoking, and obstetric complications associated with hypoxia are associated with an increased risk of schizophrenia.

57
Q

If one parent has schizophrenia, how likely is the child to develop schizophrenia?

A

14% chance.

58
Q

If both parents have schizophrenia, how likely is the child to develop schizophrenia?

A

24% chance.

59
Q

If a patient just commenced on clozapine, when are agranulocytosis and neutropenia most likely to occur?

A

Within the first 18 weeks.

60
Q

The serum levels of which antipsychotic, in particular, are affected by smoking?

A

Clozapine. Smoking reduces clozapine levels by up to 50%. Patient on clozapine, who give up smoking, can experience dramatically increased drug levels with disastrous consequences.

61
Q

How should tolerability be confirmed prior to the initiation of Risperidal Consta (risperidone)?

A

A trial of oral risperidone is used to confirm tolerability.

62
Q

Which antipsychotics are associated with the highest risk of diabetes?

A

Clozapine and olanzapine.

63
Q

What is the most significant biochemical change during Neuroleptic Malignant Syndrome (NMS)?

A

Dopamine blockade in the hypothalamus.

64
Q

What is tardive dyskinesia?

A

A late onset involuntary movement disorder that is irreversible and difficult to treat; it is a form of brain damage.

65
Q

What is aripiprazole’s key receptor activity?

A

D2 receptor activation and 5HT2A antagonism.

66
Q

What is treatment-resistant schizophrenia?

A

It is defined as a lack of response to two antipsychotic drugs, one of which is an atypical, prescribed at the therapeutic dose for at least 6-8 weeks.

(UNI) Neuropharmacology (3rd Year) (20 decks)

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