Module 5 antipsychotics

Question 1

Dopamine pathway responsible for positive symptoms of schizophrenia

Answer 1

Mesolimbic:

VTA of brainstem to nucleus accumbens in ventral striatum

Question 2

Hyperactivity of mesolimbic DA pathway leads to _____

Answer 2

positive symptoms of schizophrenia or drug-induced psychosis

Question 3

Dopamine pathway regulating cognition and executive function

Answer 3

Mesocortical:

VTA to prefrontal cortex

Question 4

Pathway that regulates emotions and affect

Answer 4

Mesocortical:

VTA to ventromedial prefrontal cortex

Question 5

Deficit of dopamine activity in mesocortical pathway leads to _____

Answer 5

negative symptoms such as cognitive decline, anhedonia, avolition, isolation, agolia

Question 6

positive symptoms of schizophrenia/psychosis

Answer 6

delusions, hallucinations, out of touch with realilty

Question 7

neurotransmitters involved in schizophrenia hypotheses

Answer 7

excess glutamate
deficient GABA
Decreased function of NMDA receptor

Question 8

method of action of first-generation antipsychotics

Answer 8

block D2 receptors

Decreasing neurotransmission of all four dopamine pathways

Question 9

high potency FGA

Answer 9

haloperidol (Haldol)

fluphenazine (Prolixin)

Question 10

Mid-potency FGAs

Answer 10

perphenazine (trilafon)

loxapine (Loxitane)

Question 11

Low -potency FGA

Answer 11

chlorpromazine (thorazine)

Question 12

safe and effective managing agitated psychiatric patients

Answer 12

Haldol IM 2-5 mg

low-dose, high potency

Question 13

give for akathisia

Answer 13

propanolol
Inderal
Benzodiazepines

Question 14

give for TD

Answer 14

diphenhydramine
deutetrabenazine (Austedo)
valbenazine (Ingrezza)

Question 15

give for pseudoparkinsonism

Answer 15

trihexyphenidyl

benztropine

Question 16

potential side effect of blocking tuberoinfundibular tract

Answer 16

elevated prolactin levels

Question 17

give if develops elevated prolactin

Answer 17

serotonin 2A antagonist

results in neutral effect of prolactin

Question 18

Benefits of atypical antipsychotics

Answer 18

lower EPS risk
effective against cognitive and negative symptoms
Lack of prolactin elevation

Question 19

another name for FGAs

Answer 19

neuroleptics

Question 20

serotonin-dopamine antagonists

Answer 20

second-generation antipsychotics (SGAs)

Question 21

Dopamine partial agonists

Answer 21

third-generation antipsychotics

aripiprazole/Abilify

Question 22

EPS: restless, jittery, involuntary movements

Answer 22

akasthisia

can cause agitation

Question 23

EPS: without movement/pill rolling/rigidity

Answer 23

akinesia

Parkinsonism

Question 24

Irreversible constant involuntary movement of periorbital muscles

Answer 24

tardive dyskinesia

Question 25

antipsychotic with high risk of hyperprolactinemia

Answer 25

Risperidone

Question 26

symptoms of neuroleptic malignant syndrome

Answer 26

``` confusion agitation hyperthermia muscle rigidity seizures ```

Question 27

targets DA, Ach, NE, and HIS

Answer 27

chlorpromazine (Thorazine)

Question 28

can lead to corneal deposits

Answer 28

chlorpromazine (thorazine)

Question 29

common SGAs

Answer 29

``` Clozapine (Clozaril) Olanzapine (Zyprexa) risperidone (Risperdal) Seroquel (quetiapine) Geodon (ziprasidone) Abilify (aripiprazole) ```

Question 30

severe side effect of clozapine

Answer 30

agranulocytosis

Question 31

Obtain ANC first and throughout first year

Answer 31

clozapine (clozaril)

Question 32

Good first-line treatment for schizophrenia

Answer 32

Olanzapine

Question 33

Negative SE of olanzapine

Answer 33

metabolic syndrome (obesity)

Question 34

less sedating SGA

Answer 34

risperidone (Risperdal)

Question 35

prolongs QT interval

Answer 35

Geodon

Question 36

dopamine and serotonin partial agonist | used to augment antidepressant (off label)

Answer 36

Abilify (aripiprazole)