Anti-Psychotics

Question 1

Chlorpromazine

Answer 1

First antipsych, was tested as antihistamine

Question 2

Affinity to D2 Binding

Answer 2

NOT correlated w/ efficacy

Question 3

Conventional/First Generation (3)

Answer 3

Phenothiazines
Thioxanthenes
Butyrophenones: haloperidol

Question 4

Atypica/2nd Gen (3)

Answer 4

Clozapine
5HT-DA Blockers (SDAs): Risperidone, olanzipine, etc
Partial Agonists: aripiprazole

Question 5

Convential Antipsych Mech/3 additional properties

Answer 5

Full D2 antags

Also M1, alpha1, and H1 antagos so you get drowsiness, decreased BP, etc

Question 6

4 DA Pathways/levels untreated Schiz/effects

Answer 6

Mesolimbic Pathway - high DA/positive symptoms
Mesocortical - low DA/cognitive and affective/negative symptoms
Nigrostriatal and Tuberoinfundibular Pathways have normal DA

Question 7

Good Results After D2 Antagonist

Answer 7

Normal in mesolimbic so reduced positive symptoms

Question 8

Bad Results After D2 Antag (4)

Answer 8

Decreased pleasure/reward from mesolimbic
Neg symptoms still bad bc low in mesocortical
Now low in nigrostriatal and tuberoinfundibular, so maybe parkinsonism and elevated prolactin

Question 9

Atypica Antipsych Mech

Answer 9

Indirectly augment DA via 5HT antagonism (high 5HT2/D2 ratio) and prevents total long/binding and actually has some partial D2 agonism. So may reduce DA activity in some ways while preserving a lot of functioning

Question 10

3 Mech Qualities of Atypical Antipsychs (similar to last card)

Answer 10

5HT DA R antagonist
D2 R antagonism w/ rapid dissociation
D2R partial agonist

Question 11

Results After 5HT DA Antagonist

Answer 11

Get lower in mesolimbic pathway (maybe still decrease pleasure/reward), but everything else normal. Remove negatives and positives, no prolactin or parkinson problems

Question 12

3 Antipsych Side Effects

Answer 12

Prolactin Elevation
Metabolic Side Effects (more common w/ newer)
Extrapyramidal Syndrome (more common w/ older psychs) like Tardive Syndrome

Question 13

Consequences of PRL elevation

Answer 13

Just everything sexual fucked up

Question 14

Acute Dystonia

Answer 14

Sustained abnormal postures/muscle spasms that develop w/ neuroleptic medication

Question 15

Akathasia

Answer 15

Inner driven restlessness from meds

Question 16

Tardive Dyskinesia

Answer 16

Abnormal, involuntary movements of tongue, jaw, trunk, or extremeties. Facial-lingual-orals most common. Often appear unconcerned w/ syptoms

Question 17

Blood Dyscrasias

Answer 17

Most dangerous w/ clozapine - can get leukopenia or agranulocytosis (much more dangerous)