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Bio58 Midterm 2 > Psychosis > Flashcards

Psychosis Flashcards

1
Q

What is the definition of psychosis?

A

Impaired mental function which INTERFERES with an individual’s ability to meet ordinary life demands

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2
Q

What are the symptoms of psychosis similar to?

A

those of depression

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3
Q

What the 2 KEYS to psychosis symptoms?

A

A form of mental illness that produces:

  1. bizarre behavior
  2. deterioration of personality
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4
Q

What is a common type of psychosis?

A

Schizoprenia

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5
Q

What sex is psychosis more common in?

A

Males

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6
Q

How much of the US population suffer?

A

1-2%

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7
Q

What are the symptoms and how many do you have to have and for how long?

A

2 of the following 7 symptoms for more than 4 weeks:

  1. Disorganized Speech/Behavior
  2. Delusions
  3. Impaired Sense of Reality
  4. Thought or emotional disturbances
  5. Confusion
  6. Hallucinations (auditory and/or visual)
  7. Negative Symptoms (5 A’s)
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8
Q

What are the 5 negative symptoms and what are they?

A
  1. Alogia: poverty of speech/verbal expression
  2. Avolition: lack of motivation
  3. Anhedonia: lack of interest in normal activities
  4. Affective Blunting: lack of emotional expression/flat face
  5. Attention Impairment: lack of focus or easily distracted
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9
Q

What is the typical age of onset for psychosis?

A

late teens - early 20’s

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10
Q

What are the 3 prodromal (early) symptoms?

A
  1. social withdrawal
  2. loss of interest in work/school
  3. deterioration in hygiene
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11
Q

Which of the 3 prodromal symptoms is the most telling?

A

deterioration in hygiene

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12
Q

NOT ON MIDTERM 2

What are the 2 typical courses of psychosis?

A
  1. periods of exacerbation and remission

2. chronic illness

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13
Q

NOT ON MIDTERM 2

What is common with chronic illness?

A

an incomplete recovery from an acute episode with persistent dysfunction & deterioration

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14
Q

NOT ON MIDTERM 2

What is effective treatment for psychoses?

A
  1. immediate acute treatment
  2. maintenance drugs
  3. psychotherapy
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15
Q

What is the physical cause of psychosis?

A

EXCESSIVE dopamine transmission

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16
Q

What are the 2 MOA’s for psychosis drugs?

A
  1. Blockade of dopamine receptors

2. Blockade of serotonin and catecholamine receptors

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17
Q

What are the 2 dopamine receptors?

A
  1. D1 - blockade results in partial antipsychotic activity

2. D2 - blockade results in FULL antipsychotic activity

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18
Q

Which blockade is most effective?

A

D2

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19
Q

Which blockade causes EPS?

A

D1

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20
Q

What is EPS?

A

Extra-pyramidal Syndrome, aka pseudoparkinsonism

21
Q

What 2 things do we evaluate when choosing an antipsychotic drug?

A
  1. patient profile (age, current disease, symptoms)

2. drug profile (therapeutic and side effects)

22
Q

What are the 3 classes of anti-psychotic drugs?

A
  1. Phenothiazines
  2. Non-phenothiazines
  3. Atypical Antipsychotics
23
Q

NOT ON MIDTERM 2

What are the general side effects of all 3 categories?

A
  1. Photosensitivity
  2. Orthostatic hypotension/impotence
  3. Weight Gain
  4. Dry mouth/constipation/urinary retention
24
Q

NOT ON MIDTERM 2

What are the OTHER 5 SE known?

A
  1. EPS
  2. TD
  3. Dystonia
  4. Akathisia
  5. Tourette’s Syndrome
25
Q

What is the 1 large ADVERSE affect?

A 
NMS - Neurolyptic Malignant Syndrome
Rare but lethal and involves
1. muscle rigidty
2. fever
3. delirium
26
Q

What is EPS?

A

extra-pyramidal syndrome, aka pseudoparkisonism

  1. Bradykinesia (slow movement)
  2. Rigidity
  3. Abnormal reflexes
  4. Tremors at Rest
  5. Drooling
27
Q

What is TD?

A

Tardive Dyskinesia

  1. Eye rolling
  2. Lip Smacking
  3. Uncontrollable tongue movement
28
Q

Which drug is TD uncontrollable tongue movement common with?

A

Thioridazine

29
Q

What is dystonia?

A

Constant neck and back muscle spasms

30
Q

What is Akathisia?

A

feeling of intense restlessness

  1. pacing
  2. agitation
  3. fidgeting
31
Q

What is Tourette’s Syndrome?

A

uncontrollable

  1. noises
  2. obscenities/foul words
32
Q

What are the 3 phenothiazine drugs to know?

A
  1. Chloropromazine
  2. Thioridazine
  3. Trifluoperazine
33
Q

What is the MOA of phenothiazines?

A

Block D2 receptors (full block) and some

serotonin, NE and EPI

34
Q

What are low doses of phenothiazines used for?

A
  1. HIccups
  2. Nausea
  3. Vomiting
35
Q

What are high doses of phenothiazines used for?

A
  1. Anxiety
  2. Agitation
  3. Psychosis
36
Q

What are the non-phenothiazines common to in structure?

A

phenothiazines

37
Q

What is a common serious SE of non-phenothiazines?

A

EPS

38
Q

Why is EPS a side effect of non-phenothiazines?

A

Because the MOA of non-phenothiazines is to block D1 receptors (partial antipsychotic activity)

39
Q

What are the 2 non-phenothiazine drugs?

A
  1. Thiothixene

2. Haloperidol

40
Q

Which of the 2 non-phenothiazine drugs causes low to no sedation?

A

Thiothixene

41
Q

What are the 4 atypical antipsychotics to know?

A
  1. Clozapine
  2. Olanzapine
  3. Risperidone
  4. Quetiapine
42
Q

What is commonly NOT a SE of atypical antipsychotics?

A

EPS

43
Q

If a patient has WHAT set of symptoms does Quetiapine seem to work best for?

A 
Negative Symptoms (5 A's):
alogia
avolition
anhedonia
affective blunting
attention impariment
44
Q

In what age group do atypical antipsychotics work best and why?

A

late teen - early 20’s

less SE’s

45
Q

What is a particular SE of clozapine?

A

aggranulocytosis - low WBC

46
Q

What is a particular SE olanzapine?

A

weight gain

47
Q

What is a particular SE of risperidone?

A

increased suicide ideation

48
Q

Which of the 4 drugs are SISTER drugs?

A

olanzapine
risperidone
quetiapine

Bio58 Midterm 2 (16 decks)

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