Tx psychotics

Question 1

Neuroleptic

Answer 1

Anti psychotic. Drug that produces a high incidence of movement disorders- extrapyramidal side effects. Ex: typical antipsychotics. Gen 1.

Question 2

dopamine receptor subtypes

Answer 2

D1-4

Question 3

Dopamine has cell bodies in which 3 locations

Answer 3

Midbrain. Project to neocortex and limbic system. Thought processing and emotion.

Substantia nigra. Project to striatum. Movement.

Hypothalamus. Release prolactin.

Question 4

Most common form of psychosis

Answer 4

Schizo
Most dx late teens/early 20s
Dx made by age 45

Question 5

Gen 1 other names and MOA

Answer 5

Gen 1/neuroleptics/typical
D2 antagonist. Decrease effectiveness of DA to produce action potential. Also blocks alpha, cholinergic, and histamine receptors.

Produces effect on movement.
Effective on positive signs

Question 6

Gen 2 other names and MOA

Answer 6

Gen 2/atypical
D2 antagonist but also D3, D4 and 5HT antagonists.

Do not produce movement disorders.
Effective on pos and neg signs
Higher risk of metabolic side effects- diabetes, hypercholesterolemia, weight gain.

Question 7

Gen 1 and Gen 2 other side effects

Answer 7

Antiemetic effects- inhibits nausea and vomiting.
Effects noradrenergic NT by blocking alpha 1- causes hypotension and reflex tachycardia/arrhythmia.
Effects cholinergic transmission- Blurry vision, dry mouth
Effects movement with gen 1 mostly

Question 8

Extrapyramidal side effects with gen 1

Answer 8

acute dystonia- spasms
Akathisia- pacing, squirming
Tardive dyskinesia- involuntary, tic like movements
Parkinsosns like signs-rigid, tremor, shuffle gate, stooped posture

Question 9

Lithium MOA

Answer 9

inhibits synthesis and action of NE, 5ht and Da.

Sometimes used along with typical antipsychotics.

Question 10

Therapeutic range of lithium

Answer 10

V small. Concentration must be monitored.

Question 11

Side effects of lithium

Answer 11

Polydipsia 
polyuria 
acne 
hand tremor 
Gi 
weight gain 
Drug interactions