Antipsychotics

Question 1

Chlorpromazine effects (4)

Answer 1

1. Reduces the amount of anesthetic needed for surgery
2. Sedation
3. Calmness
4. Lack of interest in and detachment from external stimuli

Question 2

Chlorpromazine: brand name type, class

Answer 2

Thorazine; phenothiazine; 1st gen

Question 3

3 positive symptoms of schizophrenia

Answer 3

delusions
hallucinations
thought disorders

Question 4

3 negative symptoms of schizophrenia

Answer 4

anhedonia
withdrawal
blunting of emotional expression

Question 5

3 phases of schizophrenia

Answer 5

1. premorbid
2. prodromal
3. full syndrome

Question 6

premorbid

Answer 6

subtle motor, cognitive, or social impairments

Question 7

prodromal

Answer 7

mood symptoms, cog symptoms, social withdrawal, obsessive behaviors

Question 8

full syndrome

Answer 8

substantial functional deterioration in self-care, work, and relationships

Question 9

5 pieces of evidence for DA theory

Answer 9

1. stimulant drug abuse
2. APs are DA antagonists
3. APs have affinity for D2
4. affinity for D2 is best predictor of dose
5. psychosis in parkinson’s patients treated with increased DA

Question 10

why can’t you use a drug with the highest possible D2 affinity?

Answer 10

need DA in basal ganglia for normal movement

Question 11

tardive dyskinesia (6)

Answer 11

involuntary, repetitive, purposeless body movements

1. grimacing
2. lip pursing
3. tongue movement
4. blinking
5. lip-smacking
6. lip-puckering

Question 12

neuroleptic

Answer 12

APs, major tranquilizers

Question 13

neuroleptic state

Answer 13

state of apathy, lack of initiative, and limited range of emotion

Question 14

pharmacokinetics

Answer 14

how drugs are handled by the body

Question 15

goal of pharmacokinetics

Answer 15

predicting time course of active drug in blood that is available at receptor sites

Question 16

absorption

Answer 16

movement of drug from site of administration to the blood

Question 17

distribution

Answer 17

movement of drug from blood to rest of body

Question 18

metabolism

Answer 18

breakdown of drug

Question 19

elimination

Answer 19

removal of drug’s metabolic waste products from the body

Question 20

pharmacodynamics

Answer 20

the study of what drugs do to the body

Question 21

Side effects of Chlorpromazine

Answer 21

1. tachycardia
2. impotence
3. dizziness
4. sedation
5. weight gain

Question 22

Second-generation antipsychotics

Answer 22

1. More selective than the typical neuroleptics.
2. They bind to dopamine D2, 5-HT2, and a2 adrenergic receptors.
3. Little or no affinity for D1 receptors.

Question 23

Somatic side-effects of AP´s

Answer 23

1. Cardiac effects- orthostatic hypertension, prolongation of QTC/sudden cardiac death.
2. Hematological effects
3. Peripheral anticholinergic effects- blurred vision, constipation, urinary retention, dry mouth.
4. Weight gain
5. Metabolic side effects- high blood sugar, diabetes
6. Sexual side effects- decreased libido/impotence, inhibited orgasm
7. Hormonal disturbance- Prolactin increased -> breast enlargement, menstrual cycle disturbance

Question 24

Neurological side-effects of AP´s

Answer 24

Parkinsonism- rigidity/tremor
Acute dystonia
Acute akathisia 
Tardive dyskinesia 
Neuroleptic malignant syndrome
Sedation

Question 25

Acute dystonia

Answer 25

abnormal positioning/spasm of muscles of the head/neck/limbs or trunk

Question 26

Avolition

Answer 26

Difficulty, or inability to initiate and persist in goal-directed behavior. Inappropriate social skills and social isolation.

Question 27

MAIN DOPAMINERGIC PATHWAYS

Answer 27

1. Mesocortical pathway 2. Nigrostriatal pathway 3. Mesolimbic pathway 4. Tuberoinfundibular pathway

Question 28

Mesocortical pathway

Answer 28

Hypoactivity: negative symptoms, cognitive impairment

Question 29

Nigrostriatal pathway

Answer 29

Part of extrapyramidal motor system

Question 30

Mesolimbic pathway

Answer 30

Hyperactivity: positive symptoms

Question 31

Tuberoinfundibular pathway

Answer 31

Inhibits prolactin release

Question 32

MECHANISM OF ACTION – FGA (first generation)

Answer 32

The efficacy is thought to be due to antagonism of dopamine receptors in the mesolimbic/mesofrontal systems.

Question 33

Why causes APs weight gain?

Answer 33

Adverse effects include and sedation and weight gain, due to histamine H1 receptor blockade

Question 34

Antidepressants can be used on which diseases?

Answer 34

``` Psychotic disorders and psychotic states Bipolar disorder Treatment-resistant depression Severe agitation/violent behavior Movement disorders - Huntington disease; Tourette syndrome GAD, PTSD Insomnia; OCD Borderline personality disorder Dementia ```