Day 4.1 Psych Flashcards Preview

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Flashcards in Day 4.1 Psych Deck (185):
1

Voluntarily choosing not to think of bad news

Suppression
Mature, bc it's voluntary

2

Using comedy to express discomfort

Humor
Mature

3

Arsonist donates money to fire dept

altruism
mature

4

Using your aggression to succeed in business ventures

sublimation
mature

5

realistically planning for future discomfort

anticipation
mature

6

consciously postponing inner conflict until after big project is complete

suppression
mature

7

Redirecting impulses toward socially favorable object

sublimation
eg hitting pillow when angry
mature

8

Not acknowledging bad news as if it weren't said

denial

9

Involuntary withholding of a feeling from conscientious awareness

repression
(immature bc it's involuntary)

10

Veteran that can describe horrific war details without any emotion

isolation

11

child abuser who was abused as a child

identification

12

Man yells at family when had bad day at work

Displacement
this is immature bc it's redirecting impulses to a socially unfavorable thing (vs sublimation to a favorable thing eg punching bag)

13

Closet homosexual hates homosexuals for the way the "make" him feel

projection

14

using intellectual processes to avoid affective expression

intellectualization

15

belief that ppl are either all good or all bad

splitting
borderline personality disorder pts do this

16

expressing anger thru passivity, masochism, and turning against self

passive-aggressive

17

believing external source is responsible for unacceptable inner impulse

projection

18

changing one's character/personal identity to avoid emotional distress

dissociation

19

returning to earlier level of maturation to avoid conflict at current maturational level
eg stressed kids wet bed

regression

20

offering an explanation for an unacceptable attitude/belief/bhvr

rationalization

21

a thought that is avoided is replaced by an unconscious emphasis on the opposite

rxn formation

22

converting mental conflicts into bodily symptoms

somatization

23

temporarily inhibiting thinking but continuing to build more tension

blocking
schizophrenic pts do this

24

avoiding interpersonal intimacy to resolve conflict and obtain gratification

schizoid fantasy

25

extreme forms of this can result in multiple personalities

dissociation

26

chronically giving into impulse to avoid tension from an unexpressed unconscious wish; tantrums

acting out

27

Electrolyte chgs in pts who vomit a lot (eg bulemics)

hypokalemic, hypochloremic metabolic alkalosis

28

NT chgs in depression

decreased NE, serotonin, dopamine
(opp is mania)

29

NT chgs in anxiety

Increased NE
Decreased GABA and serotonin

30

NT chgs in Huntington's

Decreased GABA and ACh

31

NT chgs in Alzheimers

Decreased ACh

32

NT chgs in schizophrenia

Increased dopamine

33

NT chgs in Parkinson's

Decreased dopamine
Increased ACh

34

IQ

Stanford-Binet: IQ = mental age/chronological age x 100

WAIS III uses 14 subtests- can quantify intellectual decline

WISC is for kids 6-16yo

Mean IQ = 100, st dev = 15

35

IQ dx for MR

IQ <20 profound

36

Habituation, Sensitization

Habituation = repeated stimulus leads to decreased response
Senitization = repeated stimulation leads to increased response

37

Classical conditioning

Pavlov
Natural response (salivation) is elicited by a condition/learned stimulus (bell) that was presented together with an unconditioned stimulus (food).

38

Operant conditioning

Action is elicited bc it produces reward.
Positive reinforcement- desired reward produces action (press button, get food)
Negative reinforcement- do an action to remove a bad thing/avoid something bad (press button to avoid shock)
Punishment- adverse stimulus extinguished unwanted bhvr
Extinction- discontinuation of reinforcement eliminates bhvr

39

Reinforcement schedule

Pattern of reinforcement determines how quickly a bhvr is learned or extinguished.
Continuous- reward after every response. rapidly extinguished (vending machine)
Variable ratio- reward received after a random number of responses. slowly extinguished (slot machine)

40

Transference
Countertransference

Transference: pt projects feelings abt formative or other imp person onto doc (eg psychiatrist = parent)
Countertransference: doc projects onto pt

41

Goal of Freudian psychoanalysis

Mk pt aware of what is hidden in their unconscious

42

Id

Primal urges, food, sex, aggression.
Id drives Instinct
Entirely subconscious
"I want it"

43

Ego

Mediator bt primal urges and bhvr accepted in reality.
"Take it and you will get in trouble"

44

Superego

Moral values, conscience
Can lead to self-blame and attacks on ego
"You know you can't take it, taking it is wrong"

45

Erikson's stgs of psychosocial development

8 stgs of normal devt, each posing a new crisis. unsuccessful completion of a stage can manifest as psychosocial maladaption later in life.
Oral sensory stg 0 to 12-18mo (crisis = trust vs mistrust)
Adlescence stg 12-20 yrs (crisis - identity vs role confusion)

46

Ego defenses

unconscious mental processes of the ego used to resolve conflict and prevent anx and deprsn. can be immature or mature

47

Acting out

unacceptable thoughts/feelings expressed through actions.
tantrums

48

Dissociation

Temporary, drastic chgs in personality, memory, consciousness, motor bhvr, to avoid stress
Extreme forms = dissociative id disorder (mult personality)

49

Denial

Avoidance of awareness of a painful reality
Common newly-dx'd in cancer and AIDS pts

50

Displacement

Avoided ideas/feelings are txfrd to a neutral person or object (vs projection)
Mom blames kids bc she's angry at husband

51

Fixation

Partially remaining at a more childish level of devt (vs regression)
Men fixating on sports games

52

Identification

Modeling behavior after another person who is more powerful (tho not nec admired)
Abused child is an abuser

53

Isolation of affect

Separation of feelings from ideas/events
Describing murder in graphic detail w no emotional response

54

Projection

Unacceptable internal impulse is attributed to an external source
Man who wants another woman think his wife is cheating

55

Rationalization

Proclaiming logical reasons for actions actually performed for other reasons, usu to avoid self-blame
After getting fired, saying job wasn't imp anyway.

56

Reaction formation

Warded-off idea/feeling is replaced by an unconsciously derived emphasis on its opposite
pt w high libido enters monastery

57

Repression

Involuntary withholding of idea/feeling from conscious awareness
Not remembering conflictual/traumatic experience, pressing bad thoughts into unconscious

58

Regression

Turning back maturational clock and going back to earlier modes of dealing w the world
kids under stress (bedwetting)
pts on dialysis (crying)

59

Splitting

belief that ppl are all gd or bad at different times due to intolerance of ambiguity.
Seen in borderline personality disorder
Pt says all nurses are insensitive but all docs are friendly

60

Altruism

Guilty feelings alleviated by unsolicited generosity toward others
Mafia boss mks donation toward charity
Mature

61

Humor

Appreciating the amusing nature of an anx-provoking/ adverse situation
Nervous med student jokes abt boards
Mature

62

Sublimation

Replacing unacceptable wish w course of action that is similar to the wish but does not conflict w one's value system
Actress using experience of abuse to enhance her acting.
mature

63

Suppression

Voluntary withholding of an idea or feeling from conscious awareness (vs repression, which is involuntary)
Choosing not to think abt USMLE until week of exam
Mature

64

Mature ego defenses (4)

Mature women wear a SASH:
Sublimation
Altruism
Suppression
Humor

65

Infant deprivation effects

Long-term deprivation results in:
1. decrsd musc tone
2. poor lang skills
3. poor socialization skills
4. lack of basic trust
5. anaclitic deprsn
6. weight loss
7. physical illness
Severe deprivation can result in infant death.
4 W's weak, wordless, wanting, wary
If deprivation >6 mo, irrev chgs

66

Child abuse signs

healed fractures on x-ray
cigarette burns
subdural hematoma
mult bruises
retinal hemorrhage/detachment
sexual: genital/anal trauma, STDs, UTIs

67

Child abuse epi

abuser usu female and primary caregiver
3000 deaths/yr in USA

if sexual:
abuser usu male and known to victim
peak incidence 9-12 yo (prepuberty)

68

Child neglect

failure to provide adequate food, shelter, supervision, education, affection
most common form of childhood mistreatment.
evidence: poor hygiene, malnutrition, withdrawal, impaired social/emotional devt, FTT
Must be reported to authorities
More common than overt abuse

69

Anaclitic deprsn (hosptialism)

Deprsn in infant d/t continued separation from caregiver. Infant withdrawn, unresponsive.
Reversible, but prolonged separation can result in FTT or devt disturbances - delayed speech.

70

Regression in children

Regression to younger bhvr patterns under condition of stress- physical illness, punishment, new sibling, fatigue.
eg bedwetting

71

ADHD

limited attn span, poor impulse control.
onset <7yo
hyperactivity, motor impairment, emotional lability
normal intelligence but difficulties in school
cont to adulthood in 50%
assoc w decreased frontal lobe volume

72

Rx for ADHD

methylphenidate (ritalin)
amphetamines (dexedrine)
atomoxetine (non-stimulant SNRI)

73

Conduct disorder

repetitive, pervasive bhvr violating social norms- physical aggression, destruction of property, theft.
After 18yo is antisocial personality disorder
Disregard for rights of others
Cruelty to animals

74

Oppositional defiant disorder

pattern of hostile, defiant bhvr toward authority
but, not serious violation of social norms
don't disregard rights of others

75

Tourette's synd

sudden rapid reccurent non-rhythmic sterotyped motor mvmts or vocalizations- tics.
persist for >1year
Lifetime prev .1-1% of general pop
Coprolalia (obscene speech) found in 20%
assocd w OCD
onset <18yo

76

Rx for Tourette's

antipsychotics
old (in FA): haloperidol
now (in DIT): anti-dopamine agents- fluphenazine, pimozide, tetrabenazine

77

Separation Anx Disorder

overwhelming fear of separation from home or loss of attachment figure. may lead to faking illness to stay home from school
age 7-9 onset

78

Autistic disorder

MR
severe lang impairment, poor social interactions, greater focus on obj than ppl.
repetitive bhvr
savants rarely
M>F
Rx: bhvrl therapy and supportive therapy to improve communication and social skills

79

Asperger's disorder

Normal intelligence
milder autism. all-absorbing interests, repetitive bhvr, problems w social relationships
no verbal or cognitive deficits, no lang impairment

80

Rett's disorder

X-linked dominant, so affects girls only (boys die in-utero/after birth)
Normal to age 4, the regression- loss of devt, MR, loss of verbal abilities, ataxia, stereotyped midline handwringing.

81

Childhood disintegrative disorder

Marked regression in multiple areas of fn'g after at least 2 years of apparently normal devt. Loss of expressive or receptive lang skills, social skills, adaptive bhvr, bowel/bladder control, play, motor skills.
Common onset 3-4 yo
M>F

82

Orientation

order of loss:
first lose time, then place, then person.
(can also lose circumstances- don't know why they're in the hospital. lose this last)
Common causes of loss of orientation:
alch/drugs, fluid/electrolyte imbalance, head trauma, hypoglycemia, nutritional deficit

83

Retrograde amnesia

can't remember what occurred before CNS insult

84

Anterograde amnesia

no new memory- can't remember what occur after CNS insult

85

Korsakoff's amnesia

anterograde amnesia (no new memory) caused by thiamine deficiency.
leads to bilateral destruction of mammillary bodies.
can also lead to retrograde amnesia
seen in alcoholics, assocd w confabulations

86

Dissociative amnesia

inability to recall imp personal info, usu subsequent to severe trauma or stress

87

Delirium

Waxing/waning lvl of consciousness
Acute onset (hrs/days)
Rapid decrease in attn span and lvl of arousal
Acute chg in mental status, disorg'd thinking, hallucinations (often visual), illusions, misperceptions, disturbance in sleep-wake cycle, cogntv dysfn
Often reversible
Most common psych illness in hospital
Abn EEG

88

2 most common causes of delirium:

Drugs (esp those w anti-ACh side effects)
UTIs

89

Dementia

Gradual decline in cognition (wks/mo/yrs)
NO chg in lvl of consciousness
Mem deficits, aphasia, apraxia, agnosia, loss of abstract thought, bhvr/personality chgs, impaired judgement
Pt is alert.
Increased incidence w age
Normal EEG
Irreversible

90

Pseudodementia

In elderly pts, depression presenting like dementia.
If you are depressed you have memory loss and you know you have memory loss
Pts w actual dementia don't know they have memory loss.
So if pt himself complains of mem loss, it's not dementia, may be deprsn.

91

Cause of Dementia

Alz dz
Vascular thrombosis/hemorrhage (esp multi-infarct thrombosis)- can have acute or subacute onset
HIV
Pick's dz
Substance abuse (esp alch)
CJD

92

Drugs used in ADHD

Methylphenidate (ritalin) and dextroamphetamine (adderall) are amphetamines- they increase pre-synaptic NE rls
Atomoxetine is a NE reuptake inhibitor

93

Uses of stimulants (NE releasers, NE uptake inhibitors)

ADHD
Narcolepsy (modafinil)
Obstructive sleep apnea (excessive daytime sleepiness)
Mjr depressive disorder- bridge until other drugs start working

94

Most common genetic causes of MR

Downs
Fragile X
Rett synd

95

Non-genetic prenatal causes of MR

Congenital hypothyroidism
FAS (most common)
Prenatal toxin exposure (lead, merc, valproate- anticonvulsant, mood stabilizer)

96

Non-genetic postnatal causes of MR

trauma/abuse
CNS hemorrhage
hypoxia (near drowning)
toxins
psychosocial deprivation
malnutrition
intracranial infection
CNS malignancy

97

Trichotillomania

Compulsive nervous hair-pulling
young girls
wire-brush feel, pattern of broken hair
Rx: education, CBT
only if those don't work: fluoxetine or clomipramine

98

Hallucination

see something that's not there (absence of external stimuli)
schizophrenic- auditory
alch withdrawal- tactile
dementia- visual

99

Illusion

See things that are there but misinterpret them

100

Delusion

false belief not shared w others of culture.
maintained in spite of proof to contrary

101

Loose associations

disorders in form of thought/way ideas are tied together.

102

Gender identity disorder

cross-gender identification. persistent discomfort/anx w one's sex
transsexual- chg body w surgery to relieve the anx
not transvestite

103

Anorexia nervosa

excessive dieting
can be with or w/o purging
commonly coexists w depression
rx CBT

104

Bulemia nervosa

binge eating
can be w or w/o purging
use laxitives
assoc w parotitis bc increased salivary amylase (systemically)
russell's sign- hand callus from inducing vom
electrolyte disturbances, alkalosis
rx SSRIs

105

What electrical disturbances happen when you vom a lot?

Vomit = get rid of HCl, so you have hypochloremia and metabolic alkalosis
Also get hypokalemia: cells have H+/K+ countertransporter. To counteract the alkalosis, cells put acid into serum, which means they pull the K+ out of serum and into cells.
Hypochloremic, hypokalemic metabolic alkalosis.

106

Why do Down Syndrome pts have an increased risk of Alz?

familial form early-onset Alz is assoc'd with APP gene, which is on chromosome 21. Down syndrome pts have 3 copies of chr 21.
APP = amyloid precursor protein

107

Genes assoc'd with Alz

Familial form (10% of Alz) is assoc'd with:
Early-onset: APP on Chr 21
Presenilin-1 on Chr 14
Presenilin-2 on Chr 1
Late-onset: ApoE4 on Chr 19 (Apo E4 is a chaperone protein that helps induce B-sheet formation)

Protective gene:
ApoE2 on Chr 19

108

Histological findings in Alz

Diffuse widespread cortical atrophy
Decreased ACh
Senile plaques (extracellular B-amyloid core)- can cause amyloid angiopathy, leading to intracranial hemorrhage (AB-amyloid is synth'd by cleaving amyloid)
Neurofibrillary tangles

109

What are neurofibrillary tangles?

Intracellular, abnormally phosphorylated tau protein, making insoluble cytoskeletal elements.
Tangles correlate with degree of dementia

110

High potency neuroleptic (antipsychotic)

Haloperidol
Fluphenazine
Thiothixene
Trifluoperazine (can also be considered moderate potency)
High potency means more EPS side effects, less anti-ACh side eff

111

Moderate potency neuroleptic (antipsychotic)

Molindone
Loxapine
Trifluoperazine (can also be considered high potency)

112

Low potency neuorleptic (antipsychotic)

Chlorpromazide
Theoridazine
Low potency means less EPS side effects, but more anti-ACh side effects (hot as a hare, dry as a bone, etc)

113

Atypical antipsychotics

Olazapine
Risperidone
Quetiapine
Clozapine
Aripiprazole

114

Halperidol

High potency neuroleptic

115

Molindone

Moderate potency neuroleptic

116

Loxapine

Moderate potency neuroleptic

117

Fluphenazine

High potency neuroleptic

118

Risperidone

Atypical antipsychotic

119

Clozapine

Atypical antipsychotic

120

Thiothixene

High potency neuroleptic

121

Theoridazine

Low potency neuroleptic

122

Olanzapine

Atypical antipsychotic

123

Trifluoperozine

High/moderate potency neuroleptic

124

Chlorpromazine

Low potency neuroleptic

125

Quetiapine

Atypical antipsychotic

126

Apiprazole

Atypical antipsychotic

127

Alz dz epi

More common in elderly, down synd pts have increased risk.
10% familial

128

Pick's dz

Frontotemporal dementia.
Change in personality, behavior (1st), then dementia, aphasia, parkinsonian sympt
Spares parietal lob and posterior 2/3 of superior temporal gyrus, but pt has frontotemporal atrophy.
Pick bodies

129

What are Pick Bodies?

intracellular (inside of neurons), aggregated tau protein
Stain with silver
seen in Pick's dz (frontotemporal dementia)

130

In which dz's are Lewy bodies seen?

Lewy body dementia
Alzheimer's (the diffuse lewy body type of Alz)
Parkinson's

131

Lewy Body Dementia

Parkinsonism plus dementia and visual hallucinations, with repeated falls and syncopal episodes.
alpha-synuclein defect
see lewy bodies

132

CJD

Prion dz- infections proteins chg alpha helix to beta sheet, which are resistant to proteases and heat
Rapidly progressive dementia (wks-months) with myoclonus
Causes spongiform cortex

133

Causes of dementia

Alz, Pick's, Lewy body, CJD
Multi-infarct (2nd most common in elderly)
syphilis
HIV
B12 deficiency
Wilson's dz (copper accumulations)

134

Drugs for Alz

Memantine
Donepezil
Galantamine
Rivastigmine

135

Donepezil

Anti-AChE
for Alz

136

Memantine

NMDA receptor antagonist
for Alz

137

Galantamine

AChE inhibitor
for alz

138

Rivastigmine

AChE inhibitor (indirect muscarinic agonist)
for alz

139

Haloperidol

dopamine receptor antagonist
neuroleptic
for Huntington's

140

Memantine- mech, toxicity

Used for Alz
NMDA (glutamate) receptor antagonist
helps prevent excitotoxicity (mediated by Ca2+)
Toxicity: dizziness, confusion, hallucinations

141

Donepezil, Galatamine, Rivastigmine

Used for Alz
ACh-E inhibitors
Toxicity: nausea (start low, go slow!)
also dizziness, insomnia

142

Sumitriptan

Serotonin 1b/1d agonist
use for acute migrane, cluster headaches

143

Schizophrenia pos sympt

Adding something:
Delusions
Hallucinations (esp auditory)
Disorganizes speech (loose assoc)
Disorganized/catatonic bhvr

144

Schizophrenia neg sympt

Takes something good away:
flat affect
social withdrawal
lack of motivation
lack of thought, speech (alogia)
thought blocking (abruptly halt train of thought)
poor grooming

145

Dx of schizophrenia

req's 2 of 5 things (the 4 pos sympt + negative symptoms counts as 1)

146

Brief psychotic disorder

<1month
usu stress related

147

Schizophreniform disorder

1-6months
6mo = schizophrenic

148

Schizoaffective disorder

at least 2 wks of STABLE mood w psychotic sympt
plus a mjr depressive, manic, or mixed (depressive+manic) episode
2 subtypes:
bipolar
depressive

149

Schizophrenia

Periods of psychosis and disturbed bhvr with a decline in functioning
>6mo
Associated with increased dopaminergic activity (too much dopamine) and decreased dendritic branching
Mj use is a risk factor in teens

150

5 subtypes of schizophrenia

paranoid (delusions)
disorganized (wrt bhvr, speech, affect)
catatonic (automatisms)
undifferentiated (elements of all types)
residual

151

Which is more imp for schizophrenia, genes or env?

Genes

152

Schizophrenia epi

Lifetime prev 1.5% (!!)
M = F
Black = white
Presents earlier in men (late teens- early 20s)
than women (late 20s/early 30s)
Pts are at increased risk for suicide

153

List the neuroleptics/antipsychotics (typical)

Haloperidol
Trifluoperazine
Fluphenazine
Thioridazine
Chlorpromazine
(haloperidol + -azine)

154

How do neuroleptics work?

They block D2 dopamine receptors, thereby increasing cAMP.
Schizophrenia is increased dopamine, so it's good to block the receptors.
D2 = Gi, which decreases cAMP. Block the inhibitor to increase cAMP.

155

Use of neuroleptics

Schizophrenia (mainly pos sympt)
psychosis
acute mania
Tourette's synd
to decrease agitation in delerium, dementia

156

Toxicity of neuroleptics

1. slowly removed from body (bc highly lipid soluble so stored in body fat)
2. EPS side effects
3. endocrine side effects (D2 receptor antagonism means dopamine no longer suppresses prolactin, so hyperprolactinemia, so galactorrhea)
4. side eff from blocking muscarinic receptors (dry mouth, constipation), alpha receptors (hypotension), and histamine receptors (sedation)
5. NMS, Tardive dyskinesia

157

What is Neuroleptic malignant syndrome (NMS)?

Rigidity, myoglobinuriam autonomic instability, hyperpyrexia
Caused by neuroleptics.
Breakdown of muscle --> myoglobinura -->kidneys clog (rhabdomyolysis) --> renal failure
For NMS think FEVER:
Fever
Encephalopathy
Vitals unstable
Elevated enz
Rigidity of muscles

158

Rx for NMS

Dantrolene
Dopamine agonists (bromocriptine)

159

What is tardive dyskinesia?

Stereotypical oral-facial mvmts d/t long-term anti pscyhotic use.
Often irrev

160

Low potency neuroleptic side effects

low potency = less EPS side effects but more anti-ACh side effects
Chlorpromazine- Corneal deposits
Thioridazine- reTinal deposits

161

EPS extra pyrimidal symptoms

4hrs- acute dystonia (muscle spasm, stiffness, oculogyric crisis-rotating eyeballs, torticollis-neck twisting

4days- akinesia (parkinsonian sympt)

4wks- akathisia (restlessness, can't stop mvmt)

4mo-tardive dyskinesia

162

List the atypical antipsychotics

OLanzapine, CLOzapine, QUETIapine, RISPERidone, Aripiprazole, Ziprasidone
It's atypical for OLd CLOsets to QUIETly RISPER from A to Z

163

How do the atypical antipsychotics work?

They block serotonin, alpha, H1, and dopamine receptors.
Have less side effects bc they block both dopamine and serotonin, but do get alpha and H1 side effects

164

Schizophrenia sympt for <1mo

brief psychotic disorder, usu stress related

165

Schizophrenia sympt for 1-6mo

Schizophreniform disorder

166

Schizoid

Avoidant

167

Schizotypal

Odd thinking

168

Schizophrenic sympt >6mo + bipolar or depressive mood disorder

Schizoaffective

169

Schizophrenic sympt >6mo

Schizophrenia

170

visual hallucinations

delerium

171

auditory hallucinations

schizophrenia

172

olfactory hallucinations

aura of psychomotor epilepsy
esp burning rubber smell

173

tactile hallucinations

alch withdrawal
formication-ants crawling in skin
also seen in cocaine abuse - cocaine bugs

174

hypnagogic hallicinations

when going to sleep

175

hypnopompic hallucinations

while waking up from sleep

176

delusional disorder

>1mo fixed persistent NON-bizarre belief system
functioning not impaired
often self limited
strange thoughts, but not outside scope of reality

177

shared psychotic disorder

folie a deux
devt of delusions in a person in a close relationship w someone else w delusional disorder.
often resolves upon separation

178

dissociative identity disorder

mult personality disorder
presence of 2 or more distinct identities or personality states
F>M, assoc w hx of sexual abuse

179

depersonalization disorder

persistent feelings of detachment or estrangement from oneself

180

dissociative fugue

abrupt chg in geographic location w inability to recall past, confusion abt personal identity, or assumption of new identity
assocd w traumatic circumstances (natural disaster, wartime, trauma)
leads to significant distress/impairment
not the result of substance abuse or medical condition

181

Clinical use for atypical antipsychotics

Schizophrenia (both pos and neg sympt)
Olazapine is used for OCD, anx disorder, depression, mania, bipolar, Tourette's, depression
Quetine can treat psychosis d/t parkinson's

182

Toxicity of atypical antipsychotics

Fewer EPS and anti-ACh side effects than traditional antipsychotics (haloperidol and the -azines), but olanzapine, clozapine, quetine can cause signficant weight gain (and DM bc of it).
Clozapine can cause agranulocytosis and req's weekly monitoring of WBCs
Since they block alpha receptors, there can be some HTN, sedation, dizziness
The H1 blockage is responsible for the weight gain, and also sedation.
Rx for side effects: Amantidine (Parkinson's med)

183

Dantrolene

Drug used for malignant hyperthermia and NMS- neuroleptic malignant syndrome.
Prevents rls of Ca2+ from Sarcoplasmic Reticulum of skel musc, therefore stopping muscle contraction.

184

Malignant hyperthermia

Uncontrolled increase in skeletal muscle oxidative metabolism- causing high temp, incrsd HR and respi rate, increased O2 consumption with increased CO2 production, acidosis, rigid muscles (contraction), rhabdomyolysis.
Caused by concomitant use of inhalation anesthetics (the -anes, except N2O) and succinylcholine (NMJ blocker).

185

Genes involved in malignant hyperthermia

Autodom gene mutation in RYR1 gene, which makes the skeletal muscle's ryanodine Ca2+ receptor