Term
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Definition
Things that are there that should not be there. Hyperactivity of mesolimbic dopa pathway
Delusions, hallucinations, disorganized speech, catatonic behavior |
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Term
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Definition
Symptoms that should be there and aren't
hypoactivity of mesocorticaldopa path
flat affect, lack of speech (alogia), avolition |
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Term
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Definition
| insufficient dopa causes EPS, motor symptoms |
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Term
| Tuberinfundibular pathway |
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Definition
| insufficient dopamine increases prolactin level (sexual dys, gynecomastia, milk secretions, menstrual cycle dist.) |
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Term
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Definition
| excess dopamine contributes to positive sx |
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Term
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Definition
| insuff dopa contributes to neg sx |
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Term
| insufficiency in frontal cortex also results in ADHD. Stimulants used to prevent reutake and increase release |
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Definition
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Term
Antagonize d2 receptors in all CNS Dopaminergic Pathways |
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Definition
Typical antipsychotics
aka: 1st gen |
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Term
D2 receptor antagonism
causing...
EPS
Tardive dyskinesia-
Neuro malig syndrome
Increased prolactin
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Definition
Typical Antipsychotic On target A/E
Higher potency cause this more often |
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Term
antagonism at muscarinic and alpha receptor
causing...
Anticholinergic effects
Hypotension
Failure to ejaculate
Sedation
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Definition
Typical antipsychotic Off target A/E
Lower potency drugs cause this more |
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Term
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Definition
Effective in treating negative sx (except risperidone)
Antagonism of 5HT2, D2 , and poss D4 antagonism
Dissociate quickly from D2 dont help positive sx but cause LESS EPS
A/E: agent specific
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Term
| Typical antipsych examples |
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Definition
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Term
| Percentages of D2 saturation that will cause effects |
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Definition
40% akathisia
60% improves positive sx
80% dystonia |
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Term
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Definition
Dystonia (muscle stiffness)-tx with antichol
Akathisia (restlessness)-tx with b-blocker: propanolol is lipophilic crosses BBB
pseudoparkinsonism (rigidity bradykinesia tremor)-anticholinergic, amantadine
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Term
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Definition
Pseudoparkinsonism, tardive dyskinesia
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Term
| Neuroleptic malignant syndrome (NMS) |
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Definition
analogous to serotonin syndrome
fever
muscle rigidity
increased CPK
Delirium
Remove med, treat sx |
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Term
Antagonize effects at 5HT2a and Dopamine
cause less EPS prolactin effects, helps negative sx equally
QT prolongations possible
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Definition
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Term
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Definition
last line due to...
1-2% in 1st 6 months develop agranulocytosis
monitoring cbc important
A/E: orthostatic hypotension, weight gain, hyperglycemia, sedation, constipation
Metabolized: CYP2d6, 3a4, 1a2 (smoking increases metabolism) |
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Term
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Definition
Primary active metabolite of risperidone
Dosing: osmotic delivery do not crush/ chew
Metabolism: RENAL 60%
*can be used with low hepatic function
no IDENTIFIED interactions |
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Term
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Definition
MAE: same
A/E: orthostatic hypotension, qt prolongation
Metabolized: CYP2D6
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Term
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Definition
| enzyme that metabolizes many CNS drugs |
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Term
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Definition
partial agonist at D2 receptors (elicits reduced response compared to natural NT)
Partial agonist at %HT1a
Antagonist at %HT2a, H1, alpha1
Partial agonism leads to unpredictable levels of receptor activity-NOT COMBINED with OTHER DRUGS
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Term
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Definition
Metabolized CYP1A2 (smoking increases metabolization)
coated: if cut use immediately due to rapid oxidation |
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Term
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Definition
Wide dosing range
Drug interactions less clinically significant
Can be used at low doses to sedate
high doses for antipsychotic use |
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Term
| Formulations of Antipsychotic |
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Definition
All PO
Some Liquid
Some ODT: NOT absorbed across mucosa, same as PO efficacy used for noncompliant PO
IM: agitated pts
Depot: long acting 2-4 weeks
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