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D&T2 Exam 2 > Treatment of Psychosis - Egleton > Flashcards

Treatment of Psychosis - Egleton Flashcards

1
Q

when patients exhibit gross disturbances in their comprehension of reality, as evidence by false perceptions ( hallucinations) and False beliefs (delusions

A

psychoses

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2
Q

abnormalities in dopamine neurotransmission occur in what pathways

A

mesocrotical

mesolimbic

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3
Q

how does ampthetamine impact dopamine

A

increases dopamine release

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4
Q

what happens to the nigrostriatal pathway during psyhcosis

A

no change

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5
Q

what happens to the mesolimbic pathway during psyhcosis

A

hyperactive- positive symptoms

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6
Q

what happens to the mesocortical pathway during psyhcosis

A

hypoactive
DLPFC- negative and cognitive symptoms
VMPFC - negative and effective symptoms

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7
Q

what happens to the tuberoinfundibular pathway during psyhcosis

A

no change

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8
Q

what types of withdrawel can cause acute psychosis

A

amphetamines/cocaine
alcohol
sedative-hypnotic

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9
Q

what heavy metal can cause acute pyshosis

A

Mercury

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10
Q

what vitamin deficiencies can cause acute psychosis

A

thiamin- B1
niacin - B3
vitamin B 12

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11
Q

what are two types of psychosis disorders

A

affective disorders

manic depressive disorders

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12
Q

what are 2 category of drugs that treat psychosis

A

antidepressants

mood stabilizers

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13
Q

what might cause positive symptoms

A

excessive neural activity

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14
Q

positive symptoms of Schizophrenia respond well to what class of drugs

A

neuroleptics

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15
Q

negative symptoms do not respond well to what class of drugs? which ones do

A

neuroleptics

atypical antipsychotics more effective

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16
Q

what type of symptoms is associated with poor prognosis for Schizophrenia

A

negative symptoms

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17
Q 
what type of symptoms are theses
agitation
delusions
disorganized speech
disorganized thinking
hallucinations
insomnia
A

positive

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18
Q 
what type of symptoms are these
apathy
affective flattening
lack of motivation
lack of pleasure
poverty of speech
social isolation
A

negative

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19
Q

For Schizophrenia, in clinical settings the primary objective thing to treat is

A

active psychosis

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20
Q

For Schizophrenia, outside the hospital what needs to be treated

A

preventing relapses

maintaining social adjustment

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21
Q

MOA for antipsychotic drug

A

competitive blockade of DA and 5-HT receptors

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22
Q

what is the receptor affinity for typical antipsyhotics

A

D2 greater than 5-HT2

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23
Q

what is the receptor affinity for atypical antipsyhotics

A

5-HT2 greater than D2

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24
Q

why do atypical antipsychotics give you less Parkinson symptoms

A

selectivity for mesolimbic over nigro-striatal region for DA

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25
which antipsychotic drug is likely to improve both positive and negative symptoms
atypical antipsychotics
26
what are antipsychotics used for
``` psychosis Tourette's Huntington's Hicup nausea motion sickness ```
27
Adverse effects of antipsychotics are attributed to blockade of what receptors
alpha1- adrenergic histamine H1 muscarinic
28
what is seen in the urine if one takes antipyschotics
glucouronide conjugates
29
when do positive symptoms subside when take antipsychotics
1-3 weeks
30
what happens to impulse behavior when taking antipsychotics
decreases
31
what happens to motor when taking atypicals
- no motor incoordination at usual doses - spontaneous activity diminished - akathisia - catatonic signs relieved or rigidity induced
32
akathisia
state of agitation, distress, restlessness
33
D2 receptors are coupled with what kind of G protein
Gi or G0
34
blocking D2 receptors results in what
- increase DA synthesis and release - increase cAMP - decrease K+ currents
35
what is the dopaminergic neurotransmission presynaptic effect of short term treatment
activated neurons
36
what is the dopaminergic neurotransmission presynaptic effect of long term treatment
inactivated neurons
37
what is the dopaminergic neurotransmission postsynaptic effect of short term treatment
receptor blockade
38
what is the dopaminergic neurotransmission postsynaptic effect of long term treatment
receptor supersenitivity
39
what happens to the patient 1-3 days of therapy
decrease agitation/hostility, aggression/combativeness, anxiety normalization of eat/sleep patterns
40
what happens to the patient 1-2 weeks of therapy
increase socialization, self care habits, mood
41
what happens to the patient 3-6 weeks of therapy
increase thought disorder, decrease delusions/hallucinations appropriate conversations
42
what antipsychotic is used to treat Gilles de la Tourette's syndrome and Huntington's disease
Haloperidol
43
What drug is used for intractable hiccup
Chlorpromazine
44
what are contraindications of Chlorpromazine
don't give to patients with seizures | deposits in lens and cornea
45
what drug deposits in retina at higher doses
Thioridazine
46
what drugs can treat anti-emetics? how do they work
all except aripiprazole and thioridazine - block D2 receptor in CTZ
47
anti-emetics
drug that is effective against vomiting and nausea.
48
what drug is useful in treatment of "drug induced" nausea (chemotherapy)
Prochlorperazine
49
what is the drug of choice for motion sickness
Scopolamine
50
what drug is a component of neuroleptanesthesia
Droperidol
51
pseudoparkinsonism
rigidity/tremor at rest; akinesia pill-rolling movements masked face
52
dystonias
facial grimacing | torticollis
53
which antipsychotic has lower incidence of extrapyramidal side effects
atypicals
54
name the different kinds of side effects blocking the D2 receptor can create
extrapyramidal tardive dyskinesia neuroleptic malignant syndrome prolactin
55
what drugs block D2 and cause extrapyramidal side effects
Haloperidol Fluphenazine Thiothixene
56
what drugs are used to treat the extrapyramidal side effects of D2
Trihexyphenidyl Benztropine mesylate Procyclidine HCl Biperidin
57
what drugs can cause tardive dyskinesia? what drug has a low incidence
all, more common in typical | Clozapine
58
when do tardive dyskinesia symptoms appear and what is the MOA that causes this
- develops after months/years of treatment | - results from "supersensitivity" to DA
59
what type of drug causes neuroleptic malignant syndrome
typicals
60
what is the outcome if a patient gets neuroleptic malignant syndrome
potentially fatal
61
how does one treat neuroleptic malignant syndrome
stop antipsychotic immediately administer Bromocriptine and Dantrolene if high temp maintained, cool down patient
62
what drug causes an increase in prolactin production
Phenothiazines | chlorpromazine, Fluphenazine, Thioridazine, trifluoperazine, mesoridazine, perphenazine
63
what are cholinergic side effects of antipsychotics
dry mouth blurred vision urinary retention
64
what drugs cause M1 cholinergic side effects? special case?
Thioridazine Chlorpromazine Olanzapine Clozapine - also increases salvation
65
what are side effects of adrenergic
orthostatic hypotension
66
what drugs cause adrenergic side effects
chlorpromazine | Mesoridazine
67
what is a side effect of blocking histamine
sedation
68
what drugs give histamine side effects
Chlorpromazine Olanzapine Quetiapine Clozapine
69
which class of drug has more metabolic side effects
atypicals
70
what does Clozapine and Olanzapine do to weight gain, lipids and gluose
increase all
71
what does Chlorpromazine do to weight gain, lipids and gluose
increase all but not as much as Clozapine and Olanzapine
72
what does Risperidone do to weight gain, lipids and gluose
increae weight gain | no changes in lipids and glucose
73
what drug causes Leukpenia and agranulocytosis
Clozapine
74
what is "rabbit syndrome"
perioral tremor rare prolong drug use treat with anticholinergic antiparkinson rugs
75
what drugs what cardiac effects? what do they do?
Thioridazine: minor T wave abnormality Ziprasidone: QT prolongation
76
who should never use antipsychotics in what patients
pregnant and nursing mothers
77
drug interactions: amphetamines
antagonize antipsyhcotics
78
drug interactions: anticholinergics
worsen tardive dyskinesia
79
drug interactions: SSRI
worsen extrapyramidal symptoms
80
drug interactions: antihypertensives
more hypotensive

D&T2 Exam 2 (14 decks)

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