L01-02 Antipsychotics Flashcards Preview

Pharmacology III > L01-02 Antipsychotics > Flashcards

Flashcards in L01-02 Antipsychotics Deck (28):
1

Give the drug class for:

haloperidol

first-generation, high-potency antipsychotic

2

Give the drug class for:

perphenazine

first-generation, high-potency antipsychotic

3

Give the drug class for:

chlorpromazine

first-generation, low-potency antipsychotic

4

Give the drug class for:

thioridazine

first-generation, low-potency antipsychotic

5

Give the drug class for:

aripiprazole

second-generation ("atypical") antipsychotic

6

Give the drug class for:

clozapine

second-generation ("atypical") antipsychotic

7

Give the drug class for:

olanzapine

second-generation ("atypical") antipsychotic

8

Give the drug class for:

risperidone

second-generation ("atypical") antipsychotic

9

Give the drug class for:

ziprasidone

second-generation ("atypical") antipsychotic

10

Why is the schizophrenic lifespan significantly abbreviated?

Schizophrenics die a decade sooner compared to the general population due to:

  • poor cardiovascular health
  • high suicide rate:
    • 5% commit suicide over their lifetime
    • 10% of completed suicides are among people with schizophrenia

11

What conditions often accompany schizophrenia?

  • deficits in neurological processing:
    • right-left confusion
    • astereognosia
    • agraphesthesia
  • depressive disorders
  • social anxiety disorder
  • PTSD
  • OCD
  • substance abuse
  • metabolic disturbances:
    • insulin-resistance
    • hyperlipidemia
  • early death

12

Define:

astereognosia

The inability to identify objects by touch alone.

13

Define:

agraphesthesia

The inability to recognize letters or numbers traced on the skin, usually on the left palm.

14

True or False:

Schizophrenia is the same as split/multiple personality disorder.

False. The term 'schizophrenia' is derived from the Greek, meaning "splitting of mental functions". This has led to the misconception that schizophrenia is synonymous with split/multiple personality disorder. 

15

Describe the epidemiology of schizophrenia.

  • 0.3-0.7% prevalence regardless of gender, race, socioeconomic class, and geography.
  • First psychotic episode occurs in early adulthood:
    • Males: early 20s
    • Females: late 20s
  • Requires lifelong care.
  • Top 10 illnesses contributing to the global burden of disease.
  • Only 10% are married.
  • Only 15% are employed.

16

Describe the etiology and molecular pathophysiology of schizophrenia.

  • Strongly driven by genetics:
    • concordance rate: identical twins - 50; fraternal twins - 13; first-degree relative - 10%
    • chromosomes: 1, 6, 15, 22
  • Environmental factors are important in utero:
    • hypoxia, low birth weight, malnutrition, infection, high glucocorticoids, traumatic birth
  • Other factors:
    • Toxoplasmosis infection

17

Describe the dopamine hypothesis of schizophrenia.

  1. Efficacy of antipsychotic medication corresponds to potency of dopamine receptor antagonism.
  2. Elevating dopamine activity in normal individuals produces schizophrenic-like symptoms.
    • i.e., cocaine, amphetamines, L-DOPA
  3. Schizophrenics are worsened by dopamine-raising drugs.

18

Why is the dopamine hypothesis of schizophrenia insufficient?

It does not explain irregularities with 5-HT, glutamate, and other neurotransmitters.

Second generation antipsychotics that also block 5-HT receptors are considered by some to be the most effective and safest.

19

List the positive symptoms of schizophrenia.

  • delusions
  • auditory hallucinations
  • paranoia/suspicion
  • conceptual disorganizations (inferred from speech)

20

List the negative symptoms of schizophrenia.

  • alogia (poverty of speech)
  • flattened affect
  • anhedonia (inability to experience pleasure)
  • avolition (lacking motivation)

21

List the cognitive symptoms of schizophrenia.

  • impaired attention
  • impaired working memory
  • impaired executive function

22

Describe the symptomology of schizophrenia.

Symptoms are often intermittent and individuals may show different symptom combinations.

Patients with predominantly negative and cognitive symptoms have poorer prognosis and higher rates of medicine failure.

23

Describe the DSM-V diagnostic criteria for schizophrenia.

  1. Delusions
  2. Hallucinations
  3. Disorganized Speech
  4. Grossly Disorganized/Catatonic Behavior
  5. Negative Symptoms

The person must have at least 2/5 categories represented AND one of the first three; active for at least 1 month AND continuous signs of illness for > 6 months; usually indicated by decline in social/occupational functioning.

24

Define:

schizophreniform disorder

Schizophrenia criteria that has been met for a period less than 6 months.

25

Define:

brief psychotic disorder

Sudden onset schizophrenic symptoms lasting at least 1 day, but less than 1 month.

26

Define:

schizoaffective disorder

A disorder that involves manic or depressive episodes with psychosis.

27

Define:

delusional disorder

A disorder with elements of schizophrenia, marked by plausible delusions with relatively normal functioning.

28