Term
| What are the major dopaminergic pathways |
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Definition
Nigro/Striatal: Substantial Nigra to Globus pallidus
Mesolimbic: Ventral Tegmental to Nucleus accumbens
Mesocortical: Ventral tegmental to cortex
Tuberoinfundibular: Hypothalamus to a. pituitary |
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Term
What are the high medium and low potency typical antipsychotics
Which have the most anti-cholinergic/anti-histaminergic activity?
What are the major side effects? |
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Definition
High: Haloperidol, Fluphenazine
Medium: Perphenazine
Low(Most Antichol/Hist): Chlorpromazine, Thioridizine
Adverse
Acute Dystonia(4 hrs) Anticholinergics or diphenhydramine
Parkinsonism(4 days)Anticholinergics or amantidine
Akanthisia(4 wks) Urge to move. Propranol
Tardive Dyskinesia(3 months, Some times irriversible) Lower dose, switch to atypical |
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Term
| What are some side effects specific to Thioridazine |
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Definition
Arrythmias
Retinal Deposits |
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Term
| What is Neuroleptic Malignant syndrome and how is it treated? |
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Definition
Antipsychotic induced malignant hyperthermia
Tx: Dantrolene, Bromocryptine |
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Term
What is the mechanism of atypical antipsychs?
What are the main atypical antipsychs?
Which cause prolactinemia?
Which has no extrapyrimidal symptoms?
Which cause weight gain?
Which causes agranulocytosis?
Which causes long QT?
Which is more effective than the typicals? |
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Definition
Mechanism:
Less potent D2 block
D2 partial Agonism
5HT1 partial Ag
5HT2A antagonism
Drugs
Risperidone: Prolactin, Weight gain
Olanzapine: Wieght gain
Clozapine: Weight gain, Agranulocytosis, more effective then typicals
Quetiapine: no extrapyrimidal
Ziprasidone: Long QT
Aripiprazole |
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Term
| What are the advantages of the atypical antipsychotics over the typical? |
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Definition
Low extrapyramidal syptoms
Effect both positive and negative symptoms of schizophrenia |
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Term
| How do the atypical antipsychotics decrease extrapyramidal symptoms, reduce negative symptoms, reduce positive symptoms, prevent prolactinemia |
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Definition
EPS: 5HT2A block induces more dopamine release directly and through GABA interneurons which competes with the anti-D2 effect of the drug
Negatives: 5HT2A block increases dopamine in mesocortical pathway
Positives: 5HT2A block in pyramidal cells decrease activation of the mesolimbic pathway
Prolactin: 5HT2A block reduces prolactin release |
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Term
| What is the drug of choice for patients exhibiting tardive dyskinesia |
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Definition
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Term
| What can be done to increase patient compliance with anti-psychotic meds |
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Definition
Use injectibles
Haloperidol, Fluphanazine
Risperidone, Ziprasidone |
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Term
| Besides schizophrenia what other diseases are anti-psychotics used for |
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Definition
Manic, Depressed, Bipolar
Dementias, Alzheimer's
Autism
Tourettes
Agitated Mentally retarded |
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Term
| What is the mechanism of the typical anti-psychotics |
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Definition
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Term
| What anti-psychotics are metabolized by the P450 system |
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Definition
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Term
| What neuroleptic is more effective than the typical antipsychoatics at treating psychosis |
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Definition
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