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Neurology > Schizophrenia and Psychotic Disorders > Flashcards

Schizophrenia and Psychotic Disorders Flashcards

1
Q

Schizophrenia

A

Essentially, schizophrenia can be described as a debilitating disease of neuronal connectivity and function in which patients experience and interpret reality abnormally

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2
Q

What are some positive symptoms?

A
  • Hallucinations
  • Delusions
  • Disorganized
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3
Q

What are some negative symptoms?

A
  • Affective flattening: lack of emotional expression
  • Anhedonia: lack of pleasure
  • Avolition: inability to start or follow through with activities
  • Alogia: poverty of speech and lack of speech content
  • Attentional impairment
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4
Q

Cognitive symptoms

A
  • Impaired memory
  • Learning
  • Verbal fluency
  • Motor speed
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5
Q

What are the therapeutic goals of the acute phase?

A

Reduce acute sx and reduce threat to self or others

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6
Q

What are the therapeutic goals of the stabilization phase?

A
  • Minimize/prevent sx relapse
  • Optimize therapeutic dose; minimize side effects
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7
Q

What are the therapeutic goals of the maintenance phase?

A
  • Improve functioning and quality of life
  • Monitor for prodrome and adverse effects
  • Promote medication compliance
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8
Q

Schizoaffective Disorder

A

Sx of schizophrenia and a mood disorder (e.g., mania, depression, mixed)

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9
Q

Schizophreniform Disorder

A

Schizophrenic symptoms for greater than one month but less than 6 months

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10
Q

Brief Psychotic Disorder

A

Significant stress may have led to psychotic episode

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11
Q

When was the first antipsychotic discovered?

A

1952

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12
Q

What are the classical (typical or first generation) antipsychotic?

A
  • Phenothiazines
  • Thioxanthenes
  • Butyrophenones
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13
Q

Chlorpromazepine (Thorazine)

A
  • FGA
  • Significant central and peripheral alpha 1 adrenergic blockade –> sedation and hypotension
  • Significant extrapyramidal side effects due to dopamine D2 receptor blockade in basal ganglia
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14
Q

What is the dose of Chlorpromazine?

A

200-900 mg/day

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15
Q

Haldol

A
  • Butyrophenones
  • Significant extrapyramidal side effects
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16
Q

What is the dose of the haloperidol?

A

5-40 mg/day (high potency)

17
Q

Hallucinogens

A
  • LSD and mescaline
  • Serotonin receptor (i.e., 5-HT 2A receptor) agonists
18
Q

T/F: Some atypical antipsychotics like clozapine are inverse agonists at the 5-HT2A receptor

A

T

19
Q

SGA

A
  • Block more than one type of receptor
  • Greater affinity for serotonin receptors than dopamine receptors
  • Alleviates more negative symptoms
  • Less movement disorders with these agents
20
Q

Abilify

A
  • Third generation
  • Acts as a partial agonist at D2 receptors rather than an antagonist
  • Partial agonist at 5HT1A receptors and antagonist at 5HT-2A receptors
21
Q

What are the side effects of antipsychotics?

A
  • EPS (Parkinsonism, distonias, TD)
  • Metabolic (weight gain, hyperglycemia, DM)
  • Cardiac (QT prolongation)
  • Endocrine (Hyperprolactinemia)
  • Adrenergic (Orthostatic hypotension)
  • Anticholinergic
  • Antihistaminergic (sedation, weight gain)
  • Akathisia (Feeling of internal restlessness)
  • Neuroleptic Malignant Syndrome (muscular rigidity, fever, severe EPS)
22
Q

What are the side effects of chlorpromazine?

A
  • Dyslipidemia
  • Weight gain/T2DM
  • Anticholinergic effects
  • Orthostatic hypotension
  • QTC prolongation
23
Q

What are the side effects of haloperidol?

A
  • EPS/TD
  • Elevated prolactin
24
Q

What are the side effects of fluphenazine?

A
  • EPS/TD
  • Elevated prolactin
25
Q

What are the side effects of Olanzpine?

A
  • Dyslipidemia
  • Weight gain/T2DM
26
Q

What are the side effects of paliperidone?

A
  • EPS/TD
  • Weight gain/T2DM
  • Elevated prolactin
27
Q

What are the side effects of Quetiapine?

A
  • Dyslipidemia
  • Weight gain/T2DM
28
Q

What are the side effects of Risperidone?

A
  • EPS/TD
  • Weight gain/T2DM
  • Elevated prolactin
29
Q

What are the side effects of the ziprasidone?

A
  • QTC prolongation
30
Q

What are the side effects of clozapine?

A
  • Dyslipidemia
  • Weight gain/T2DM
  • Anticholinergic effects
  • Orthostatic hypotension

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