Flashcards in Schizophrenia Deck (34):
a characteristic ( a little odd but not that big of a deal)
a mental state or symptom, a now descriptor ( responding to inner voices, hallucinations, aggression)
a diagnosis of a complex and usually chronic illness
What is the first goal of treatment?
What is the second goal(s) of treatment?
-reduce agitation, hostility, anxiety, tension, aggression
-normalize sleeping and eating pattern
-convey empathy and caring
What are the MAJOR goals of therapy?
-bring thoughts under the patient's control
-restore contact with reality
-maximize functional recovery
Is schizophrenia the same as split or multiple personality syndrome?
NO NO NO
What is the difference between an odd characteristic, a disordered state, and a chronic condition?
neurosis - psychosis - schizophrenia
Describe who this disease affects and when
0.5 to 1% of population
M = F
M: 19-25 yrs old
F: 24-32 yrs old
In what many ways can this disease originate (etiology) ?
-genetic - 45% if both parents are positive, 5-10% if one parent is positive
-biologic - dopamine imbalance
-developmental - 2nd trimester
-psychosocial - stress, socioeconomic
-brain asymmetry - abnormal neuronal pruning
List the criteria for diagnosing someone with SZP
-deterioration of function
-6 month duration of symptoms
-onset before 45 years old
-first must rule out affective disorders developmental disorders, organic disorders and substance abuse
List some SZP positive symptoms
ideas of reference
What makes a symptom positive?
Things that are there that should NOT be there or they should not be there to that extent
What is a neologism?
A made up word
What makes a symptom negative?
Things that should be there but aren't or are there in only minimal amounts
List some negative symptoms associated with SZP
-immobile facial expression
-lack of pleasure in everyday life
-cannot initiate or sustain planned activity
-speaking infrequently and with minimal and simplistic content
-anhedonia (lack of finding enjoyment in things)
-poor insight and judgement
List some cognitive symptoms associated with SZP
-cognitive impairment (means they can't remember)
-impaired of executive function, sustained attention, working, memory, etc.
Chlorpromazine is a drug (antipsychotic) used in treating SZP. Why does it work?
this drug blocks the stimulant-induced movement. Dopamine blockage populated as a key mechanism.
Any drug that is a dopamine ______ has potential to be an antipsychotic.
What do all first generation antipsychotics do??
-all primarily target blockade of dopamine, specifically the D2 receptor
-vary in receptor affinity and in affinity for other receptors
-continue to be optimal therapy for people with schizophrenia
_____ is the first target of antipsychotic drugs
What type of neurotransmitter is dopamine?
It is an inhibitory neurotransmitter, meaning that when it finds its way to its receptor sites, it blocks the tendency of that neuron to fire.
What other neurotransmitter systems does dopamine interface with?
T or F: patient needs to have blood work done regularly if on clozapine
What is the main receptor involved in second generation antipsychotics ?
5HT2 receptor (serotonin) and many more
What makes an antipsychotic medication very favourable and effective?
if it has affinity for BOTH serotonin and dopamine receptors
What is the affinity for serotonin receptor key for?
reducing the movement disorders
What drug can induce a psychotic state and upon repeated use, individuals can acquire a chronic state that is very similar with SZP?
crystal meth (methamphetamine)
How do we ensure maximal safety of the use of antispychotics ?
-monitor: HR, BP, sedation, movement, weight, waist circumference, lipids, blood sugar, prolactin
Do antipsychotics and benzo's work quickly or slowly when receiving positive symptoms?
can work quickly!
Approximately how long does it take for these drugs to releive all anti-schizophrenia effects?
anywhere from 4 to 8 weeks, but improvement may continue over months or years
Why is optimal management of this disease so difficult to achieve?
-voices tell them to quit
-there could be side effects
-people stop taking medication when they feel better even though they should stay on meds to prevent any further problems
-long-term adherence is difficult for many reasons
What 2 things does adherence do?
1. allows for ongoing improvements
2. reduces risk of relapse