Pharmacology of Antipsychotic Drugs

Question 1

What disease do antipsychotic drugs treat

Answer 1

Schizophrenia

Question 2

How do ALL antipsychotic drugs control symptoms

Answer 2

Inhibit dopamine transmission

Question 3

What are the receptors in the D1 family

Answer 3

D1 receptors, D5 receptors

Question 4

Which type of antipsychotics block the D1 receptors

Answer 4

Phenothiazines

Question 5

What receptors are located in the limibc system, amygdala

Answer 5

D3 and D5, D4

Question 6

What are the receptors in the D2 family

Answer 6

D2 receptors, D3 receptors, D4 receptors

Question 7

What receptors in the D2 family are blocked by all antipsychotics

Answer 7

D2 receptors

Question 8

T/F: The dopamine receptors that are encountered for schizophrenia are all post synaptic

Answer 8

True

Question 9

Which dopamine receptor does clozapine have the highest affinity for

Answer 9

D4

Question 10

Are dopamine autoreceptors post-synpatic or pre-synaptic, what happens when encountered with an agonist, antagonists

Answer 10

Pre-synaptic, inhibits release of dopamine, increases dopamine release

Question 11

What is the pathophysiology of schizophrenia

Answer 11

Hyperactivity of dopamine in the mesolimbic pathway (positive symptoms) and hypoactivity of dopamine in the mesocortical pathway

Question 12

What are the 4 most used phenothiazines

Answer 12

Chlorpromazine, thioridazine, trifluoperazine, fluphenazine

Question 13

What is the thioxanthene used in schizophrenia

Answer 13

Thiothixene

Question 14

What is the butyophenones, what receptors does it interact with

Answer 14

Haloperidol, alpha-1 and D2

Question 15

What are the antipsychotics considered others

Answer 15

Molindone, loxapine, reserpine

Question 16

What are the mixed antagonists antipsychotics

Answer 16

Clozapine, Olanzapine, quetiapine

Question 17

What are the seotonin dopamine antagonists, which has alpha-1 activity

Answer 17

Risperidone, plaiperidone, ziprasidone, iloperidone, asenapine, lurasidone/ risperidone

Question 18

What are the dopamine partial agonist and 5-HT2A antagonists

Answer 18

Aripiprazole, Brepiprazole, Cariprazine

Question 19

T/F: Antipsychotics cure scizophrenia

Answer 19

False: Antipsychotics supress psychotic behavior but DO NOT CURE IT

Question 20

How long does it take for antipyschotics to have full onset of action, which takes up to 12 weeks

Answer 20

2-6 weeks, clozapine

Question 21

How does serotonin affect dopamine

Answer 21

The more serotonin available the less dopamine available

Question 22

What is the MOA of atypical APs, How is this special

Answer 22

5HT2 antagonism increases dopamine release in prefrontal cortex (mesocortical pathway), NO 5HT2 antagonism/link in mesolimbic pathway therefore only D2 antagonism in the Mesolimbic pathway

Question 23

Why are the extrapyramidal side effects (shaking and slow movement) using APs

Answer 23

Blockade of D2 receptors in nigrostriatal pathway leading to excess acetylcholine

Question 24

What drugs can be given to counter EPS side effects

Answer 24

Antimuscarinics: cover the ACH receptors on the GABA system causing less side effects
5HT2 antagonists: increases release of dopamine to outcompete the D2 antagonism keeping ACH and dopamine in balance

Question 25

What is the mechanism of tardive dyskinesia, which antipsychotics cause this

Answer 25

Prolonged blockade of D2 receptors leads to hypersensitivity of D2 receptors, typical

Question 26

What are the antimuscarnic side effects of antipsychotics

Answer 26

Urinary retention, constipation, blurred vision, dry mouth drowsiness

Question 27

What are the antiadrenergic effects of antispychtics

Answer 27

Decreased blood pressure, dizziness, drowsiness

Question 28

What are the antihistamine effects of antipsychotics

Answer 28

Weight gain and sedation

Question 29

What AP causes agranulocytosis

Answer 29

Clozapine

Question 30

T/F: All antipsychotics lower the seizure threshold with clozapine needing the most caution

Answer 30

True

Question 31

What does blocking dopamine in the tuberoinfundibular pathway cause

Answer 31

elevate prolactin

Question 32

What are the effects of pure D2 antagonism in the mesolimbic pathway, mesocortical pathway, nigrostriatal pathway, tuberoinfundibular pathway

Answer 32

Reduced positive symptoms of schizophrenia and lack of pleasure and reward, increased negative symptoms of schizophrenia, parkinsonism (EPS), elevated prolactin

Question 33

What are the benefits of of using serotonin anatagonists in schizophrenia patients and dopamine partial agonist

Answer 33

NO parkinsonism, No elevated prolactin, reduces positive symptoms and reduced negative symptoms