Session 12 - Schizophrenia Flashcards Preview

Semester 5 - Farmocology > Session 12 - Schizophrenia > Flashcards

Flashcards in Session 12 - Schizophrenia Deck (22)
1

What is the lifetime risk of paranoid Schizophrenia?

1%

2

Lifetime risk of Schizophrenia with 1 parent who has it?

10%
2 - 45%

3

What is a key features of Schizophrenia

Psychosis

4

What is psychosis?

Lack of contact with reality

5

Give three conditions other than Schizophrenia with psychotic features

mania
severe depression
delirium

6

What are the symptoms of Schizophrenia broken up into?

Postive symptoms
Negative symptoms

7

Give three positive symptoms of Schizophrenia

Delusions
Hallucinations (auditory)
Catatonia

8

Give three negative symptoms

Anhedonia
Withdrawal from social contacts
Flattening of emotional response

9

What is a delusion?

 A fixed false belief that is out of keeping with someone’s cultural or religious beliefs

10

What is the dopamine theory for schizophrenia?

o Some evidence of increased dopamine function in schizophrenics
o Dopamine antagonists are the best treatment for schizophrenia
o Amphetamine causes symptoms similar to positive symptoms of schizophrenia
o But:
 Amphetamines do not cause negative symptoms
 Dopamine antagonists do not treat negative symptoms
 Changes in dopamine function may be a response to long term drug treatment

11

Give four pathways which use dopamine and their functions

Main Dopamine Pathways
Mesolimbic – emotional response and behaviour
Meso-cortical – important in arousal and mood
Nigrostriatal – key pathway damaged in Parkinson’s disease
Tuberoinfundibular – in hypothalamus and pituitary gland

12

What do we want to inhibit in schizophrenia?

Mesolimbic

13

What are two types of anti-psychotics?

Typical and atypical

14

What is the first line treatment for schizophrenia?

Atypical

15

How do typical antipsychotics work

 Dopamine D2 Receptor Antagonist
 Sedation – Within hours
 Tranquilisation – Within hours
 Antipsychotic – Several days or weeks

16

Give 6 ADRs of typcial antipsycjotics

 Extrapyramidal effects – Hours or days
 Neuroleptic malignant syndrome – Severe rigidity, hyperthermia, autonomic instability, cognitive changes (delirium). Associated with elevated plasma creatine phosphokinase (CPK). Extremely rare, but very serious ADR of all antipsychotics.
 Weight gain
 Postural hypotension
 Endocrine changes (e.g. prolactinaemia)
 Pigmentation

17

What occurs in anti-psychotic toxicity?

 CNS depression
 Cardiac toxicity
 Risk of sudden death with high dose
 Prolonged QT interval  Torsades de points
 Risk of sudden death with large dose

18

How do atypical antipsychotiocs work?

 Higher affinity for 5-HT2A receptors than Dopamine D2 Receptors
 Sedation – Within hours
 Tranquilisation – Within hours
 Antipsychotic – Several days or weeks

19

Why do antipsychotics cause weight gain?

Supressed full signals

20

Give two main symptoms of atypical anti-psychotics

 Extrapyramidal side effects at high doses

21

What occurs in anti-psychotic toxicity?

 CNS depression
 Cardiac toxicity
 Risk of sudden death with high dose
 Prolonged QT interval  Torsades de points
 Risk of sudden death with large dose

22

Why are atypical anti-psychotics first line?

Have less extrapyramidal side effects