Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm + Patient Year 3 Sem 2 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is the normal age for onset of schizophrenia?

A

Men 20-28 years

Women 26-32 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What evidence is there for physiological changes in schizophrenia?

A

Evidence seen in identical twins, only one of whom presented with symptoms
Dilated ventricles in disease potentially due to loss of brain tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give examples of positive symptoms of schizophrenia.

A

Delusions
Hallucinations
Disorganised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give examples of negative symptoms of schizophrenia.

A

Reduced motion
Lack of motivation/interest
Reduced pleasure
Thought and speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give examples of cognitive deficits of schizophrenia.

A

Attention

Working and verbal memory executive function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give examples of mood symptoms of schizophrenia.

A

Depression
Anxiety
Hostility/aggression
Suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Positive schizophrenic symptoms are associated with malfunctioning of which brain circuits?

A

Mesolimbic and striatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Negative schizophrenic symptoms are associated with malfunctioning of which brain circuits?

A

Mesocortical/prefrontal cortex

Nucleus accumbens reward circuits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cognitive schizophrenic symptoms are associated with malfunctioning of which brain circuits?

A

Dorsolateral prefrontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aggressive schizophrenic symptoms are associated with malfunctioning of which brain circuits?

A

Orbitofrontal cortex

Amygdala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Affective (mood) schizophrenic symptoms are associated with malfunctioning of which brain circuits?

A

Ventromedial prefrontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What criteria of the DSM-V must be met for schizophrenia diagnosis?

A

At least two of delusions, hallucinations, disorganised speech, grossly disorganised behaviour, negative symptoms
Social/occupational dysfunction
Duration of at least 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the action of antipsychotics.

A

Inhibit D2 receptors
Competes with dopamine to occupy the receptors thus preventing dopamine from acting on all receptors, thus controlling positive symptoms
Does not manage high concentration of dopamine, thus stopping medication will mean reoccurrence of psychotic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the glutamate theory of schizophrenia.

A

GABA inhibits NMDA receptors, which also respond to glutamate, leading to further receptor activation and GABA function
Glutamate activation of dopamine cell bodies where GABA is not active, leading to too much dopamine thus psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the action of phencyclidine.

A

NMDA antagonist
Renders NMDA receptors hypo functional leading to disinhibition of pyramidal cell
Patients as a result experience positive symptoms as well as affective symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the dopamine theory of schizophrenia.

A

Increased dopamine in subcortical pathways leading to psychotic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give examples of atypical antipsychotics.

A

Clozapine
Olanzapine
Risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give examples of typical antipsychotics.

A

Haloperidol

Chlorpromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the action of typical antipsychotics.

A

High affinity for D2 receptors
Effective against positive symptoms
Cause motor control impairments due to increased blockade of D2
Less side effects potentially due to less rich pharmacology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the action of atypical antipsychotics.

A

Higher affinity for serotonin than D2 receptors
Potentially improved efficacy against negative symptoms
Rich pharmacology means significant side effects
Less motor impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the significant side effects of atypical antipsychotics?

A

Weight gain
Metabolic syndrome
Agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is clozapine shown to do best efficacy?

A

Treatment resistant schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the efficacy threshold for D2 receptor occupancy?

A

65% occupancy

The more D2 receptors blocked, the increased likelihood of EPSEs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the D2 receptor occupancy of haloperidol.

A

Very small effective window
Above 70% occupancy results in hyperprolactinaemia
EPS resent at >78% occupancy

25
Describe the theories of antipsychotics inducing weight gain.
Antagonism of histamine, serotonin 5HT2c and D2 receptors | Affecting hormonally controlled symptoms i.e. leptin
26
What psychotropic drugs show greatest risk of weight gain?
``` TCAs Mirtazapine Lithium Valproate Carbamazepine ```
27
What is the prodromal phase?
The first episode of schizophrenia, prior to psychotic symptoms Antipsychotics not offered
28
Which antipsychotics are most likely to give EPSE?
Typicals
29
What are the 4 types of EPSEs?
Dystonia Pseudo-parkinsonism Akathisia Tardive dyskinesia
30
What is dystonia?
Muscle spasms in any part of the body
31
How is dystonia treated?
Anticholinergic agents
32
What is pseudo-parkinsonism?
Tremor, rigidity, bradykinesia
33
How is pseudo-parkinsonism treated?
Reducing dose of antipsychotic | Anticholinergics may be used short term
34
What is akathisia?
Inner restlessness and compulsion to move
35
How is akathisia treated?
Reducing antipsychotic dose
36
What is tardive dyskinesia?
Lip smacking, tongue protrusion
37
How is tardive dyskinesia treated?
Approximately 50% of cases are irreversible Stop anticholinergics Reduce antipsychotic dose
38
What is metabolic syndrome?
Collection of side effects causing increased weigh gain, blood glucose and lipid profiles
39
Which antipsychotics most commonly cause metabolic syndrome?
Clozapine Olanzapine Risperidone Quetiapine
40
What can hyperprolactinaemia cause?
``` Impaired sexual function Breast growth Amenorrhoea Cancer BMD ```
41
How can hyperprolactinaemia be managed when on antipsychotics?
Switch to alternative drug or add aripiprazole
42
How can QT prolongation risk be monitored?
ECG | Limited to 440ms in men and 470ms in women
43
Which antipsychotics most commonly cause QT prolongation?
Quetiapine Haloperidol Amisulpride
44
Which antipsychotics is safest in QT prolongation risk?
Aripiprazole
45
What is the dangerous side effect caused by chlorpromazine?
Photosensitivity
46
Which antipsychotics commonly have anticholinergic effects?
Clozapine | Some typicals
47
What is neuroleptic malignant syndrome?
Dopamine depletion causing autonomic effects such as tachycardia, sweating, hyperthermia, rigidity, raised CK
48
Give examples of side effects of antipsychotics.
``` Sedation Lowered seizure threshold Hyponatraemia Neutropenia Postural hypotension ```
49
What common monitoring is required for antipsychotic therapy?
``` Weight Pulse and BP Fasting BMs Lipids Prolactin Nutrition/exercise adherence ECG at baseline ```
50
Describe the use of depot antipsychotics.
Injection into gluteal/deltoid muscle to ensure adherence, given at the longest possible dose interval
51
When is a test dose required for antipsychotics?
For depots given in oily bases i.e. typicals
52
What are the nice guidelines for combination antipsychotic treatment?
Do not initiate combination medication except for short periods i.e. such as when changing medication
53
What are the nice guidelines for treatment with clozapine?
Should be offered to those who do not respond adequately despite sequential use of at least 2 different antipsychotics, one of which being 2nd gen
54
What are the 6 main side effects associated with clozapine?
``` Sedation Hypersalivation Constipation Venous thromboembolism Myocarditis/cardiomyopathy Agranulocytosis/neutropenia ```
55
How can hypersalivation be managed?
Hyoscine hydrobromide | Chewing SF gum
56
What are the symptoms of myocarditis/cardiomyopathy?
``` Fatigue Chest pain Fever Palpitations Low BP, high pulse Shortness of breath ```
57
Describe the interaction between clozapine and aromatic hydrocarbons in cigarettes.
Induce CYP1A2 causing clozapine levels to fall by up to 50% | Upon stopping smoking, serum levels can rise by 50-72%
58
Describe the interaction between clozapine and caffeine.
Compete at CYP1A2 | Clozapine levels rise by 14-47%

Pharm + Patient Year 3 Sem 2 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions