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Weeks 7-11 > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

What is the common property of all antipsychotics?

A

Antagonise dopamine in the brain

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2
Q

What are positive symptoms associated with schizophrenia?

A

Hallucinations
Delusions
Thought disorder

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3
Q

What are the negative symptoms associated with schizophrenia?

A

Withdrawal from social contact

Flattening of emotional responses

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4
Q

Give the evidence backing up the dopamine theory of schizophrenia

A
  • Amphetamines produce symptoms almost indistinguishable from schizophrenia
  • D2 agonists exacerbate symptoms in humans and strong correlation between potency of antipsychotic and D2 blocking actions
  • Increased dopamine content in amygdala of schizophrenics
  • Increased dopamine synthesis and secretion in the striatum of schizophrenics
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5
Q

Name the 4 dopamine pathways in the brain

A

Tuberohypophyseal
Mesolimbic
Mesocortical
Nigrostriatal

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6
Q

Give the evidence backing up the glutamate theory of schizophrenia

A
  • NMDA receptor antagonists (e.g. ketamine, PCP) produce psychotic symptoms
  • Decreased glutamate and receptor density reported in post-mortem schizophrenic brains
  • Transgenic mice with decreased receptor expression show stereotypic schizophrenic behaviours and decreased social interactions
  • Glutamate and dopamine exert excitatory and inhibitory effects respectively on GABAergic strial neurons which project to the thalamus and constitute a sensory gate
  • Too little or too much dopamine disables the ‘gate’ allowed uninhibited sensory input to reach cortex
  • Excess dopamine –> positive symptoms, decreased glutamate –> negative symptoms
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7
Q

Name the 3 categories of classical/ 1st generation antipsychotics

A

Phenothiazines
Butyrophenones
Thioxanthines

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8
Q

Name 3 phenothiazines

A

Chlorpromazine
Fluphenazine
Pipotiazine

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9
Q

Name a butyrophenone

A

Haloperidol

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10
Q

Name 2 thioxanthines

A

Flupentixol

Zuclopenthixol

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11
Q

What are the 3 categories of atypical/2nd generation antipsychotics?

A

Benzamides
Dibenxodiazepines
Others

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12
Q

Name a benzamide

A

Amisulpride

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13
Q

Which receptors do benzamides inhibit?

A

D2

D3

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14
Q

Name 2 dibenzodiazepines

A

Clozapine

Olanzapine

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15
Q

Name the 4 other atypical antipsycotics

A

Risperidone
Paliperidone
Quetiapine
Aripiptrazole

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16
Q

Which receptors does aripiprazole inhibit?

A

Dopamine

5-HT

17
Q

Name an antipyschotic that inhibits alpha adrenoreceptors

A

Quetiapine

18
Q

What are the benefits of the atypical antipsychotics?

A

Overcome some of the problems of classical
Slow efficacy in treatment-resistant patients
Improve negative and positive symptoms
Less extrapyramidal side effects

19
Q

What are the behavioural effects of antipsychotics?

A

Apathy and reduced initiative
Display few emotions
Drowsiness
Agressive tendencies inhibited

20
Q

What are the two motor distrubances associated with antipsychotics?

A

Extrapyramidal

Tardive dyskinesia

21
Q

What causes extrapyramidal, Parkinson-like symptoms?

A

Block of nigro-striatal dopamine receptors

22
Q

What is tardive dyskinesia?

A

Involuntary movements of the limbs and face

23
Q

What are the features of tardive dyskinesia?

A

Appears after months/years of treatment
Associated with proliferation of dopamine receptors in the corpus striatum
Treatment generally unsuccessful

24
Q

What are some of the other unwanted effects of antipsychotics?

A 
Increased prolactin secretion 
Anti-muscarinic
Orthostatic hypotension
Sedation 
Weight gain 
Agranulocytosis
Leukopenia
25
Q

What is the last resort antipsychotic?

A

Clozapine

26
Q

Which antipsychotics are used in Hungtinton’s disease?

A

Olanzapine
Risperidone
Quetiapine

27
Q

Which antipsychotics are used for manic episodes?

A

Chlorpromazine

Haloperidol

Weeks 7-11 (22 decks)

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