Schizophrenia Pharmacology

Question 1

what are the 2 pathways implicated in schizophrenia

Answer 1

mesolimbic and mesocortical

Question 2

the antipsychotics used in schizophrenia have what general MOA

Answer 2

DA2 and 5-HT2A antagonists

Question 3

in schizophrenia, what happens to NMDA receptor function

Answer 3

diminished NMDA receptor function in the frontal and parietal lobes of the cortex

Question 4

3 drug receptor activities of antipsychotics

Answer 4

antimuscarinic
a1 blocker
antihistamine

dopamine and serotonin antagonist

Question 5

6 atypicals

Answer 5

clozapine
quetiapine
pimozide
olanzapine
ziprasidone
risperidone

Question 6

clozapine has low affinity for what receptor

Answer 6

DA2

also quetiapine

Question 7

is aripiprazole an atypical

Answer 7

yes

Question 8

aripiprazole MOA

Answer 8

DA2 and 5HT1A partial agonist
5-HT2A antagonist

Question 9

brexpiprazolne is similar to aripiprazole except….

Answer 9

brexpiprazole has a lower risk of EPS

Question 10

“5HT2A inverse agonist”

Answer 10

pimavanserin

Question 11

D2/D3 partial agonist

Answer 11

cariprazine (vraylar)

Question 12

SE of blocking D1

Answer 12

impaired cognitive function

Question 13

benefit and harm in blocking D2

Answer 13

antipsychotic and relieves positive symptoms of schizophrenia

however, EPS, increased prolactin

Question 14

a 5HT1A agonist has what effect

Answer 14

antidepressant/anxiolyitc

Question 15

a 5HT2A ANTAGONIST has what effects (negative and positive)

Answer 15

improves the negative symptoms of schiz

causes cognitive impairment

reduced EPS

Question 16

a ____ antagonist will have antiemetic action

Answer 16

5HT3 antagonist

Question 17

SE of an a1 antagonist

Answer 17

orthostasis, sedation, hypotension, reflex tachycardia

Question 18

how does an alpha2 antagonist help in schiz

Answer 18

improves depression and negative symptoms

Question 19

SE of an H1 antagonist

Answer 19

sedation, weight gain

Question 20

SE of an M1 antagonist

worse or better for causing EPS

Answer 20

anticholinergic

reduced incidence of EPS

Question 21

what controls EPS tremor

Answer 21

benztropine

Question 22

general side effects of antipsychotics

Answer 22

EPS
restlessness
synchronization of EEG (pro epileptogenic)
high lipids, high glucose (risk lower with newer drugs)

altered thermoregulation
elevated prolactin
risk of agranulocytosis

Question 23

how do antimuscarinic drugs affect thermoregulation

Answer 23

decreased sweating

thus, inability to lose body heat

Question 24

what is neuroleptic malignant syndrome and what is used to treat it

Answer 24

muscle rigidity. generates body heat - can be life threatening

dantrolene is used - it’s an intracellular muscle relaxant

Question 25

most antipsychotic drugs do what? (in terms of dopamine)

Answer 25

block D2 receptors

Question 26

antipsychotic drugs are typically....

Answer 26

D2 antagonists or partial agonsits

Question 27

in general, differentiate between the typicals and atypicals

Answer 27

typicals - antagonists at D2 and serotonin atypicals - dopamine and serotonin partial agonists. also affect a lot of other receptors (alpha, histamine) leading to side effects!

Question 28

FUTURE atypical antipsych research is focused on what

Answer 28

A2A (adenosine)

Question 29

**which antipsychotic has NO antimuscarinic effects

Answer 29

risperidone

Question 30

*antimuscarinic

Answer 30

true

Question 31

effect of blocking histamine on weight

Answer 31

gain weigh

Question 32

*true or false aripiprazole and brexpiprazole are antagonists at DA2 and 5HT1A receptors

Answer 32

FALSE - partial agonists

Question 33

*MOA cariprazine (vraylar)

Answer 33

S2/D3 partial agonist

Question 34

**primavanserin MOA and usage

Answer 34

5HT2A antagonist/inverse agonist used in parkinsons disease psychosis. really an anti hallucinogen - not really an antipsychotic. used for delusion