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Pharmacology Y2 > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What are positive type 1 symptoms of psychosis?

A

Auditory hallucinations
Delusions
Thought disorders
Thought broadcasting

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2
Q

What are negative type 2 symptoms of psychosis?

A

Lack of drive
Social withdrawal
Motor disturbances (catatonia)

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2
Q

What are negative type 2 symptoms of psychosis?

A

Lack of drive
Social withdrawal
Motor disturbances (catatonia)

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3
Q

What drugs act as agonists to dopamine receptors?

A

Amphetamines

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4
Q

What drugs act as agonists to serotonin receptors?

A

LSD

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5
Q

What drugs act as an antagonist to glutamate receptors?

A

Phencyclidine

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6
Q

Name a drug that antagonises the effect of dopamine

A

Reserpine

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7
Q

How does reserpine decrease the effect of dopamine?

A

It removes dopamine from the synaptic vesicles

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8
Q

How will amphetamines affect schizophrenia and Parkinson’s?

A

Exacerbates schizo
Decreases Parkinson’s

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9
Q

How will reserpine affect schizophrenia and Parkinson’s?

A

Exacerbates Parkinson’s
Decreases schizo

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10
Q

Which dopamine receptors do amphetamine and reserpine act on?

A

D2 receptors

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11
Q

List the 5 dopaminergic pathways on the brain

A

Ventral Tegmental area
Mesocortical
Mesolimbic
Nigro-striatal
Tubero-infundibular

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12
Q

What symptoms of schizo are caused by hyperactivity of the mesolimbic pathway?

A

Positive symptoms (hallucinations etc)

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13
Q

What symptoms of schizo are caused by hypoactivity of the mesocortical pathway?

A

Negative symptoms (social withdrawal)

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14
Q

What receptor antagonist will reduce the positive symptoms of schizophrenia?

A

D2 receptor antagonist

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15
Q

Name 3 types of drug that are typical D2 receptor antagonists

A

Phenothiazines
Thioxanthines
Butyrophenones

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16
Q

Name 3 drugs that are phenothiazines

A

Chlorpromazine
Thioridazine
Trifluoperazine

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17
Q

Name a drug that is a thioxanthine

A

Flupenthixol

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18
Q

Name a drug that is a butyrophenone

A

Haloperidol

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19
Q

Why is it not beneficial to have a very high D2 affinity receptor antagonist?

A

It can be so effective that it causes hypokinestic disorder effects!

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20
Q

Name a typical drug that has a very high D2 receptor affinity

A

Haloperidol

21
Q

What is the effect of typical D2 antagonists on the mesolimbic pathway?

A

Neuroleptics prevent hallucinations

22
Q

What is the effect of typical D2 antagonists affect the nitro-striatal system?

A

Neuroleptic induce movement disorders

23
Q

What is the effect of typical D2 antagonists on the tuberoinfundibular system?

A

Neuroleptics cause hyperprolactinaemia

23
Q

What is the effect of typical D2 antagonists on the tuberoinfundibular system?

A

Neuroleptics cause hyperprolactinaemia

24
Q

What are the extra pyramidal symptoms of typical neuroleptics?

A

Parkinsonian-like
Dystonia
Tardive dyskinesia
Akathesia

25
Q

How do typical neuroleptics affect H1 histamine receptors?

A

They block H1 receptors, act as anti-histamines

26
Q

What is orthostatic hypertension?

A

Blockage of alpha 1 receptors:
Dry mouth, glaucoma, constipation, urinary hesitancy

27
Q

What is neuroleptic malgnant syndrome?

A

Emergency from use of antipsychotic drugs, muscle rigidity, fever, autonomic dysfunction

28
Q

What are the autonomic side effects of typical neuroleptics?

A

Orthostatic hypertension
Aplastic anaemia
Neuroleptic malignant syndrome

29
Q

What are the autonomic side effects of typical neuroleptics?

A

Orthostatic hypertension
Aplastic anaemia
Neuroleptic malignant syndrome

30
Q

Is the nucleus accumbens part of the mesolimbic or mesocortical pathway?

A

Mesolimbic (positive symptoms)

31
Q

Does lack of dopamine in the prefrontal cortex cause positive or negative symptoms?

A

Negative symptoms

31
Q

Does lack of dopamine in the prefrontal cortex cause positive or negative symptoms?

A

Negative symptoms

32
Q

What is the effect of typical neuroleptics on positive schizo symptoms?

A

Decreases positive symptoms

33
Q

What is the effect of typical neuroleptics on negative schizo symptoms?

A

Does not decrease negative symptoms

34
Q

What is the difference between typical and atypical neuroleptic drugs?

A

Atypical neuroleptics cause fewer extra pyramidal symptoms
They only occupy 30% of D2 receptors (reduced affinity)

35
Q

What are the 3 main groups of atypical neuroleptics drugs?

A

Dibenzazepine
Bensisoxazole
Third generation

36
Q

Name 3 atypical dibenzazepine neuroleptics

A

Clozapine
Olanzapine
Quetiapine

37
Q

Name 2 atypical bensisoxazole neuroleptics

A

Risperidone
Paliperidone

38
Q

Name 2 3rd generation neuroleptics

A

Ziprasidone
Aripiprazole

39
Q

How does Clozapine, an atypical neuroleptic, affect positive and negative symptoms of schizo?

A

It decreases the positive and negative symptoms

40
Q

How do atypical neuroleptics decrease positive and negative symptoms of schizo?

A

They block serotonin receptors as well as D2 receptors - serotonin blocks the release of dopamine, so less serotonin means that more dopamine is present in parts of the brain that require it

41
Q

What is an extrapyramidal symptoms of atypical neuroleptics?

A

Hyperprolactinaemia

42
Q

How do leuroleptics cause hyperprolactinaemia?

A

Dopamine in the tuberoinfundibular pathway prevents the production of lactate - D2 antagonists will increase it

43
Q

What are the autonomic side effects of atypical neuroleptics?

A

Orthostatic hypertension
Weight gain
Increased glucose and lipid levels (leads to type 2 diabetes)
QT interval prolongation

44
Q

What specific symptoms does clozapine cause?

A

Agranulocytosis - no production of granulocytes

45
Q

Do high affinity neuroleptics have autonomic side effects?

A

No, low affinity neuroleptics tend to have more autonomic side effects

46
Q

Is aripiprazole, an atypical neuroleptic, a D2 antagonist or agonist?

A

Apripiprazole is a partial D2 agonist

47
Q

How does aripiprazole work?

A

It is a partial agonist for pre synaptic D2 receptors,
It is a weak antagonist of serotonin receptors - means that at low concentrations of dopamine it agonises, however at high concentrations (such as in schizo), it antagonises by preventing the agonist from working at its full extent. Means there is always a low activity of dopamine at the receptors, only when it is excessively high it actually stops it.

48
Q

Which are preferred as first line treatment, typicals or atypicals?

A

Atypicals

49
Q

Why would aripiprazole be preferred even if it doesn’t completely block dopamine receptors?

A

Has very little extrapyramidal side effects

Pharmacology Y2 (9 decks)

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