Psychopath lecture 2 Flashcards Preview

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Flashcards in Psychopath lecture 2 Deck (59):
1

What are the physical findings in a person with Schizophrenia?

-Enlarged ventricles
-Changes in prefrontal cortex perfusion

2

What is the neurochemistry of Schizophrenia?

-Dopamine related phenomenon with too much stimulation of the D2 receptors
-5HT (serotonin)/glutamate
-Nicotine

3

What is the genetic predisposition of Schizophrenia?

1% of population have schizophrenia
-If one identical twin has schizo, then the other twin has a 40-50% chance
-Environment plays a role, there seems to be a link between influenza during pregnancy leading to schizophrenia

4

What are the pharmacological treatments for schizophrenia?

-Block D2 receptors (typical antipsychotics)(D2 antagonist)
-Block 5HT2 receptors (atypical antipsychotics)

5

What are the clinical benefits of schizophrenia treatment?

-Reduce psychotic symptoms
-Enhance cognition and executive functioning
-Alleviate depression

6

What are the social benefits of schizophrenia treatment?

-Made outpatient management of these patients possible

7

What are the side effects of schizophrenia treatment from a D2 receptor blocker?

-Orthostatic hypotension
-Sedation
-Xerostomia
-Extrapyramidal side effects (Parkinson-like)

8

What are the side effects of schizophrenia treatment from the atypical antipsychotics (5HT2 receptor blockers)?

-Severe agranulocytosis
-Fewer side effects

9

What are the extrapyramidal side effects the antipsychotics can cause?

-Tardive dyskinesias
-Parkinson's like tremors

10

What are the psychologica/physical effects of antipsychotics?

-Sleepiness
-Restlessness
-Disrupt endocrine
-Can cause pseudo-depression
-weight gain

11

What are phenothiazines?

-Typical Antipsychotic drug
-Chlorpromazine
-Thioridizine

12

What causes the weight gain from phenothiazines?

-Anticholinergic effect

13

Which class of antipsychotics have less extrapyramidal side effects?

-Phenothiazines

14

What are Butyrophenones?

-Typical Antipsychotic drug
-Haloperidol (Can cause tardive dyskinesias)

15

What antipsychotic drug class has high extrapyramidal side effects?

-Butyrophenones

16

What do atypical antipsychotic drugs block?

-D2 receptors
-5HT2A receptors

17

What class of antipsychotic drugs are more effective against negative symptoms of schizophrenia?

-Atypical antipsychotics

18

What is Clozapine?

-Atypical antipsychotic drug

19

What can Clozapine cause?

-Serious agranulocytosis

20

What is Quetiapine (Seroquel)?

-atypical antipsychotic

21

What is Olanzepine (Zyprexa)?

-atypical antipsychotic

22

What are atypical antipsychotic drugs??

-Clozapine
-Quetiapine
-Olanzepine

23

What is acute psychotic disorder?

- It is Temporary schizophrenia type and situation dependent

24

What is Schizoaffective?

-Schizophrenia and depression
-Schizophrenia and mania

25

What is the background of mood disorders?

-5%
-Depression and mania are the two sides of mood disorders

26

In mood disorders can mania present by itself?

-Not typically, depression can but mania is typically coupled with depression

27

What is the usual affective process of Mood disorders?

-Sadness
-Simple unhappiness
-Grief
-Bereavement

28

What are the minor affective disorders of mood disorders?

-Depression-dysthymia
-Cyclothymia

29

What is depression-dysthymia?

-Last longer than 2 years
-Can function though
-Do not respond well to drugs
-Female dominant

30

What is cyclothymia?

-Minor bipolar that lasts longer than 2 years
-don't medicate
-Need behavior management

31

What two things do you see in mood disorders?

-Manic
-Depression

32

What are the subtypes of Major depression?

-Postpartum

33

Major depression has variable expressions, what are they?

-Profound to Vegetative
-May have several episodes throughout life

34

When does postpartum show up?

1-4 weeks after delivery

35

What is SADS?

-Season Affective Disorder Syndrome

36

When are some common features of the treatment for major depression?

-Delayed onset (it takes a little while to work)
-70% effectiveness

37

What are the drug categories to treat Major depression?

-Monoamine Oxidase Inhibitors
-Tricyclic antidepressants

38

What was the 1st modern antidepressants?

-Monoamine Oxidase Inhibitors

39

What are the side effects of Monoamine Oxidase Inhibitors?

-Alter autonomic system activity
-Orthostatic hypotension
-Weight gain

40

What do MAOIs do?

-increase 5HT, DA, NE

41

What might monoamine oxidase inhibitors interact with?

-foods that contain tyramine such as cheeses and beer
-OTC cold decongestants

42

What are two examples of MAOI's?

-Phenelzine
-Selegiline

43

What are the characteristics of tricyclic antidepressants?

-Long half life/single daily dose
-Block the uptake of NE and varying affinity for 5HT transporter

44

What are the side effects of Tricyclic antidepressants?

-Dry mouth (anticholinergic effect)
-Histamine blockade
-Orthostatic hypotension
-Withdrawal with abrupt discontinuation

45

What are examples of tricyclic antidepressants?

-Amytriptyline
-Desipramine
-Doxepin

46

What do monoamine uptake blocker work on?

-5HT
-NE
-DA

47

What are the properties of monoamine uptake blockers?

-Better tolerated
-Mixture of selectivity
-Minimal withdrawal

48

What do 5HT (SSRIs) cause for side effects?

-GI upset
-Sexual dysfunction
-Depression in adolescents
-Headaches
-Can cause weight loss)

49

Is there anticholinergic activity in SSRIs?

-No

50

What are the SSRI drugs?

-Fluoxetine (prozac)
-Sertraline (Zoloft)

51

What are the NE or mixed transport blocker drugs?

-Venlafaxine (effecxor)
-Duloxetine (Cymbalta)

52

What is bipolar referred to as?

-Manic/Depressive

53

What are the types of bipolar?

-Cyclothymia (mild type)
-Major manic depressive

54

What is major manic depressive?

-The mania can cause major compromised function
-Poor decision making abilities
-Impulsivity
-Unrealistic

55

What are the medications used to treat Bipolar disorder?

-Lithium carbonate
-Antiepileptic drugs

56

What antiepileptic drugs are used to treat bipolar?

-Valproic acid
-Carbamazepine
-Lamotrigine

57

What are the general properties of lithium carbonate?

-Slow onset
-Alters 2nd messenger systems
-Often Combined with an antidepressant
-Potent mood stabalizers

58

What are the side effects of lithium carbonate?

-Narrow therapeutic window
-Tremors common
-Potential kidney damage
-Weight gain
-Edema
-High rate of compliance problems

59

What are the biological theories of mood disorders?

-Catecholamine theory
-imbalance of DA, NE, or 5HT activity

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