Antipsychotics Flashcards

(53 cards)

1
Q

how do pre synaptic serotonin receptors impact dopamine?

A

decrease synaptic dopamine

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2
Q

what happens when we block post synaptic dopamine receptors?

A

movement disorders
(seen in typical antipsychotics)

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3
Q

what happens when we block dopamine and serotonin receptors

A

increase synaptic dopamine
competition between drug and dopamine
reduced motor side effects

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4
Q

possible etiologies of schizophrenia

A

neurodevelopmental
genetics
environmental
gene - environment interactions
neurodevelopment-environment interactions

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5
Q

which receptor mediator of hallucinations

A

5HT2a

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6
Q

which agents were originally identified as 5HT agonists

A

LSD and mescaline

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7
Q

5HT2a receptors modulate what

A

glutamate release and NMDA receptors
dopamine release

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8
Q

5HT2a ____ are beneficial in schizophrenia

A

antagonists

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9
Q

what is glutamate

A

major excitatory neurotransmitter

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10
Q

whats part of the glutamate theory that exacerbates psychosis and cognition

A

ketamine and phencyclidine which are noncompetitive inhibitors of NMDA receptors

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11
Q

patients with schizophrenia have increased _____ receptor density

A

D2

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12
Q

which region responsible for motor side effects (EPS)

A

basal ganglia

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13
Q

which region is primary therapeutic effects

A

mesolimbic

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14
Q

which region has hypofunction in schizoprenia

A

mesocortical

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15
Q

which region helps anti-emetic

A

medulla

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16
Q

when do we see EPS symptoms?

A

early, days/weeks

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17
Q

drug therapy for EPS

A

anticholinergics (benztropine, trihexphenidyl, akineton)
benadryl
amantadine
propranolol

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18
Q

how do EPS side effects happen?

A

since we blocking inhibitory and D2, we get excess excitatory so we need anticholinergic

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19
Q

when may tardive dyskinesia occur?

A

late, months to years

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20
Q

is tardive dyskinesia reversible

A

no
irreversible

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21
Q

treatment of tardive dyskinesia

A

prevention

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22
Q

how does tardive dyskinesia happen

A

unknown MOA
new therapies target VMAT2

23
Q

new drugs for tardive dyskinesia treatment

A

tetrabenazine
valbenazine
deutetrabenazine
VMAT2 inhibitors

24
Q

when does neuromalignant syndrome happen

A

serious and rapid
treatment is to stop drugs and restore dopamine through diazepam

25
what drug treats Tourettes
pimozide
26
alpha receptor blockade adverse effects?
hypotension, impotence, failure to ejaculate
27
dopamine receptor blockade side effects
Parkinsons, EPS
28
histamine receptor blockade side effects
weight gain, sedation
29
hyperprolacinemia side effects
infertility, impotence, amenorhhea
30
typical/first gen antipsychotics
increased EPS and tardive dyskinesia
31
phenothiazine structure
32
chlorpromazine
1st antipsychotic, antihistamine side effects
33
which drugs for N/V
promethazine prochlorperazine
34
thioridazine
many SEs anticholinergic, sedation, cardiovascular
35
1st gens with EPS
fluephenazine thiothixene haloperidol molindrone
36
perphenazine
combo with anticholinergic
37
atypical/second gen antipsychotics
reduced EPS more metabolic problems enhanced 5HT antagonism
38
which agents linked to diabetes in pts less than 50
olanzapine clozapine
39
clozapine
40
clozapine has a risk of
agranulocytosis and diabetes
41
olanzapine
42
loxapine
43
risperidone
44
which drug has a prodrug and is a partial agonist at 5HT1a
aripiprazole
45
what does aripiprazole do to dopamine activity
brings it down with psychosis brings it up with EPS
46
drugs that are D2/D3 partial agonists
brexiprazole, cariprazine, lumateperone
47
olanzapine
risk weight gain and diabetes
48
quetiapine
antidepressant, hypotension, sedation
49
risperidone
5HT2a/D2 antagonistz
50
ziprasidone
5HT2a/D2 antagonist, prolong QT interval, alpha affinity
51
lurasidone
5HT2A/D2, reduced metabolic effects, rapid titration
52
aripiprazole
partial agonist activity 5HT2a/D2 affinity
53