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integrated studies in mental health > SCHIZOPHRENIA mastered version > Flashcards

SCHIZOPHRENIA mastered version Flashcards

1
Q

all dopamine receptors are ___________

A

All are metabotropic (G-protein coupled)

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2
Q

Therapeutic potency of Antipychotic drugs does not correlate with their ____________________

A

Therapeutic potency of Antipychotic drugs does not correlate with their affinity for binding the D1 receptor

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3
Q

Binding affinity for D2 receptors is strongly correlated with ________________

A

Binding affinity strongly correlated with antipsychotic potency and extrapyramidal effects

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4
Q

Activation of D2 receptors in rats leads to?

A

Activation of D2 receptors 🡺 increased motor activity and stereotypes behaviour in rats.

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5
Q

Antipsychotic agents block ___________

A

Antipsychotic agents block D2 receptors

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6
Q

what brain regions for D1?

A

Putamen
Nucleus Accumbens
Olfactory tubercle

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7
Q

what brain regions for D5?

A

hippocampus and hypothamus

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8
Q

what brain regions for D2?

A

nearly the same as D1 but pre and post synapse
pre- and post-synaptically on neurons caudate-putamen; nucleus accumbens; olfactory tubercle

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9
Q

what brain regions for D3?

A

frontal cortex; medulla; midbrain

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10
Q

Q: What are the main categories of drug therapy for schizophrenia?

A

A: First-generation (‘typical’) and second-generation (‘atypical’) antipsychotics.

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11
Q

Q: What are some first-generation antipsychotics?

A

A: Chlorpromazine, haloperidol, fluphenazine, flupenthixol, clopenthixol.

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12
Q

Q: What are some second-generation antipsychotics?

A

A: Clozapine, risperidone, sertindole, quetiapine, amisulpride, aripiprazole, zotepine.

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13
Q

Q: What is the difference between typical and atypical antipsychotics?

A

A: Differences are based on receptor profile, incidence of extrapyramidal side effects (less in atypical), efficacy in treatment-resistant patients, and efficacy against negative symptoms.

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14
Q

Q: What are some characteristics of chlorpromazine?

A

A: It has pronounced sedative effects which wear off with repeated administration, moderate anti-muscarinic and extrapyramidal side effects, endocrine, hypotensive side effects, and is relatively inexpensive.

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15
Q

what are extrapyramidal effects

A

Akathisia: Feeling restless like you can’t sit still. …

Dystonia: When your muscles contract involuntarily. …

Parkinsonism: Symptoms are similar to Parkinson’s disease. …

Tardive dyskinesia: Facial movements happen involuntarily.

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16
Q

Q: How is clozapine distinguished among second-generation antipsychotics?

A

A: It has greater affinity for 5HT2 receptors than D2, is effective against negative and positive symptoms, has no extrapyramidal side effects but comes with the risk of agranulocytosis, and is licensed for use in treatment-resistant schizophrenia.

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17
Q

Q: What are some characteristics of risperidone?

A

A: It has greater affinity for 5HT2 receptors than D2, broad efficacy, is more potent than clozapine, and has little to no extrapyramidal, autonomic nervous system, and cardiac side effects at low doses.

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18
Q

Q: What are some advantages of second-generation agents over first-generation agents?

A

A: They cause little to no extrapyramidal side effects, are effective against positive and negative symptoms, and can be used in treatment-resistant patients.

19
Q

Q: What are some non-psychiatric indications for antipsychotics?

A

A: They can be used as anti-emetics and sedatives.

20
Q

Q: What are some neurological adverse events of antipsychotics?

A

A: They can cause extrapyramidal reactions like acute dystonia and tardive dyskinesia, and seizures.

21
Q

Q: What are some autonomic nervous system effects of antipsychotics?

A

A: They can cause anti-muscarinic effects like loss of accommodation, dry mouth, difficulty urinating, constipation, and adreno-receptor blocking effects like orthostatic hypotension, and impotence.

22
Q

Q: What are some metabolic and endocrine effects of antipsychotics?

A

A: They can cause weight gain, hyperglycaemia secondary to insulin resistance, and hyperprolactinaemia.

23
Q

Q: What are some cardiac effects of antipsychotics?

___________can cause ventricular arrhythmias, cardiac conduction block, and sudden death, while _____________ carries the greatest risk of ECG effects like QT prolongation.

A

A: Thioridazine can cause ventricular arrhythmias, cardiac conduction block, and sudden death, while ziprasidone carries the greatest risk of ECG effects like QT prolongation.

24
Q

Q: What are some toxic or allergic reactions to antipsychotics?

A

A: Agranulocytosis (especially with clozapine), jaundice, and skin eruptions.

25
Q

which first generation drugs are in group 1 of the phenothiazine class

A

chlorpromazine; levomepromazine; promazine

26
Q

which first generation drugs are in group 2 of the phenothiazine class

A

pericyazine; pipotiazine

27
Q

which first generation drugs are in group 3 of the phenothiazine class

A

fluphenazine; prochlorperazine

28
Q

Q: What are some behavioral effects of antipsychotics?

A

A: Older agents can cause pseudodepression and a toxic confusional state.

29
Q

Q: What is the Butyrophenone class of first-generation antipsychotics and what are its characteristics?

A

A: Haloperidol falls into this class. It has high D2 receptor affinity, is a potent antipsychotic, but can cause severe extrapyramidal side effects, though less anticholinergic and hypotensive side effects.

30
Q

Q: What are some characteristics of Aripiprazole?

A

A: It is fairly new, a partial agonist at D2 receptor, has limited side effect profile, and has a long half-life.

31
Q

Q: What are NICE guidelines on the use of atypical antipsychotics?

A

A: They are considered when choosing therapy for “newly diagnosed” psychotic patients, for management of an acute schizophrenic episode, for patients experiencing unacceptable side effects of conventional antipsychotics, and for patients in relapse whose symptoms were previously inadequately controlled.

32
Q

Q: What are some characteristics of group 3 phenothiazines?

A

they have fewer sedative and anti-muscarinic effects, and pronounced extrapyramidal side effects.

33
Q

Q: What are some characteristics of pericyazine and pipotiazine?

A

A: they have moderate sedative effects, severe anti-muscarinic but fewer extrapyramidal side effects.

34
Q

Q: What are the side effects of clozapine?

A

A: It can cause agranulocytosis, lower seizure threshold, and weight gain.

35
Q

Q: How does Olanzapine compare to Clozapine?

A

A: Olanzapine is similar to Clozapine in its effects but doesn’t carry a risk of agranulocytosis.

36
Q

Q: What is the use of Prochlorperazine?

A

A: Prochlorperazine is used mainly as an anti-emetic by blocking dopamine receptors centrally and peripherally in the stomach.

37
Q

Q: What are some behavioral side effects of older antipsychotic agents?

A

A: Older agents can be unpleasant to take and can cause pseudodepression and toxic confusional states.

38
Q
  1. Q: What are the properties of drugs from Group 1 of the Phenothiazine class, like chlorpromazine?
A

A: They have binding affinities for different receptors (D2, adrenergic > H1, mACh, 5-HT2), have pronounced sedative effects, moderate anti-muscarinic and extrapyramidal side effects, and endocrine/hypotensive side effects.

39
Q

Q: What is a distinctive characteristic of clozapine in terms of its receptor affinity?

A

A: Clozapine has a greater affinity for 5HT2 receptors than D2, and it is a potent antagonist at D4-receptors.

40
Q

Q: When is clozapine introduced according to NICE guidelines?

A

A: Clozapine is introduced if schizophrenia is inadequately controlled despite the sequential use of 2 or more antipsychotics (one of which should be 2nd generation) each for 6-8 weeks.

41
Q

Q: What is a potential life-threatening side effect of clozapine and how is it monitored?

A

A: Agranulocytosis is a potential life-threatening side effect of clozapine, hence regular blood tests are required.

42
Q

. Q: What is the significant risk associated with Thioridazine and Ziprasidone in terms of cardiac effects?

A

A: Thioridazine can cause ventricular arrhythmias, cardiac conduction block, and sudden death, while Ziprasidone carries the greatest risk of ECG effects like QT prolongation.

43
Q

schizophrenia positive symptoms?

A

Delusions
Hallucinations
Disorganised speech
Grossly disorganized or catatonic behaviour

44
Q

schizophrenia negative symptoms

A

Reduced expression of emotion
Poverty of speech
Difficulty in initiating goal-directed movements
Cognitive/Memory impairment

integrated studies in mental health (20 decks)

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