EXAM #3: ANTIPSYCHOTICS Flashcards Preview

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Flashcards in EXAM #3: ANTIPSYCHOTICS Deck (34):
1

What is psychosis?

Variety of mental disorders that are characterized by:
1) Delusions-- false beliefs
2) Hallucinations-- auditory, visual, tactile, and olfactory

2

What is Schizophrenia?

A neurodevelopmental disorder characterized by severe psychosis

3

What are "positive" symptoms in Schizophrenia?

Manifestations of abnormal behavior including:
- Delusions
- Hallucinations
- Agitation
- Paranoia
- Aberrant thinking
- Intrusion of throughts

4

What are the "negative" symptoms of Schizophrenia?

Absence of normal behavior including:
- Flat affect
- Social withdrawal
- Inattentiveness

5

What is the "Dopamine Hypothesis" of Schizophrenia?

HYPERACTIVITY of the mesolimibic/ mesocortical DA system causes psychosis

6

What NTs have been implicated in Schizophrenia aside from DA?

1) 5-HT hyperactivity
2) Hypofunction of Glutamate (NMDA) receptors

7

What is the main mechanism of action of antipsychoitc drugs?

D2 receptor blockers (antagonists)

8

What is the main side effect of antipsychotic medications?

Extraparyamidal Symptoms

9

What are the two categories of antipsychotics?

Typical vs. Atypical

10

What are the clinical indications for antipsychotic agents?

1) Schizophrenia
2) Psychotic behavior
3) Severe mania (Bipolar)
4) Antiemetic

11

List the typical antipsychotics.

Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol

12

List the atypical antipsychotics.

Clozapine
Olanzapine
Risperiodone
Aripiprazole
Quetiapine
Ziprasidone

13

What is the difference between the metabolism of the typical and atypical antipsychotics?

Typical= metabolism into INACTIVE metabolite

Atypical= metabolism into ACTIVE metabolite

14

What receptor do the antipsychotics block?

D2 (mainly)

15

How does the mechanism of action of atypical antipsychotics differn from typical?

Atypical agents antagonize D2 AND 5-HT2A receptors

16

What is the relationship between D2 affinity and potency antipsychotic drugs?

Higher affinity for D2= more potent

17

What antipsychotic has high 5-HT affinity?

Clozapine

18

What is the relationship between receptor binding and EPS?

D2 antagonism is associated with more EPS

19

What receptor is associated with orthostatic hypotension?

Alpha-1

20

What receptor is associated with sedation in antipsychotics?

Histmaine

21

What can be expected from a drug with a high D2/5-HT2A ratio?

EPS symptoms

22

Antipsychotic action in what part of the brain produces antiemetic effects?

Medullary periventricular area

23

What are the different types of EPS?

1) Parkinson-like Syndrome
2) Akathesia (motor restlessness and anxiety)
3) Dystonia
4) Tardive Dyskinesia

24

What are the endocrine effects of antipsychotics?

Hyperprolactinemia

Males:
- Gynecomastia
- Decreased libido

25

What two antipsychotics are highly associated with weight gain?

Clozapine and Olanzapine

26

What type of antipsychotics are associated with weight gain?

Atypical/ newer antipsyhotics

27

What is Neuroleptic Malignant Syndrome?

Life-threatening HTN and Hyperthermia seen with antipsychotic administration

28

What type of antipsychotic is associated with LESS orthostatic hypotension/ alpha-1 effects?

Atypical antipsychotics

29

What atypical antipsychotic is most associated with EPS?

Risperidone

30

What atypical agents are least associated with EPS?

Clozapine
Quetiapine

31

What patients are more susceptible to tardive dyskinesia?

Elderly patients i.e. older than 65

32

What type of antipsychotics are associated with the development of Parkinson-like symptoms?

Typical antipsychotics

33

Which atypical antipsychotics are associated with an increased risk of DM?

Clozapine
Olanzapine

*****These are the drugs that are also most associated with weight gain*****

34

What are the common reasons that patients will stop taking antipsychotic medications?

1) Lack of efficacy
2) Unwilling to tolerate side effects
3) Weight gain
4) Sexual side effects

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