Term
| DA hypothesis of schizophrenia: |
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Definition
Excessive DA activity in subcortical regions, causing positive sx at the D2 recetpors.
AND
Insufficient DA activity in the cortical regions, causing negative sx at the D1 rectptors. |
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Term
Whats the problem with high potency FGAs?
Whats the problem with low potency FGAs? |
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Definition
High potency FGAs --> high risk of EPS
Low potency FGAs --> high sedation |
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Term
|
Definition
D2 antagonism.
Extrapyramidal nn normally function to dampen motion. |
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Term
| Give an example of a EPS caused by FGAs. |
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Definition
Akathisia (restless leg syndrome):
occurs early in tx |
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Term
| How do you tx Akathisisa? |
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Definition
reduce dose
give anticholinergics --diphenhydramine
(Ach opposes DA action in basal ganglia) |
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Term
| What is dystonia? how do you Tx? |
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Definition
Involuntary spasms (an EPS of FGAs).
Tx same as Akathisia and Rabbit syndrome: reduce dose, give anticholinergic.
or valium (a benzodiazepeine) |
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Term
| What is the worst EPS os FGAs? |
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Definition
Tardive dyskinesia-severe involuntary movements of face, tongue, trunk and limbs.
This can be irreversible and may get worse if you stop the Rx. Prevent by limiting dose. |
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Term
| Whats the Main difference bewteen FGAs and SGAs? |
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Definition
| SGAs have almost all their activity at 5HT receptors. |
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Term
| Why does Clozapine have low risk of EPS? |
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Definition
bc it has very little activity at the D2 receptor.
EPS comes from D2 antagonism. |
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Term
| What does a H1 - histamin antagonist do? |
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Definition
|
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Term
| What does activity at the 5HT receptor do? |
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Definition
|
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Term
| Activity at DA receptors causes what SE? |
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Definition
| Neuroleptic Malignant Syndrome. |
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Term
| Anticholinergics cause what side effect? |
|
Definition
| dry eyes and constipation. |
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Term
| What is the worse SE of Clozapine (the reason its not the 1st line drug for SZ)? |
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Definition
| FDA BBW: High risk of agranulocytosis (drop in WBC). |
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Term
| What SE is caused by activity at alpha1 adrenergic receptor? |
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Definition
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Term
What is the DOC for SZ and bipolar d/o?
Why?
What is the major adverse SE of this drug? |
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Definition
Olanzapine. It is an SGA. It has no activity at D2 (reduced EPS), it has activity at 5HT and some M1(anti M1 reduces EPS). Doesn't cause agranulocytosis (Main difference with Clozapine).
SE: metabolic syndrome, wt gain and DM. |
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Term
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Definition
| SGA with no M1 activity --> higher EPS than Olanzopine. |
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Term
What drug would you give for SZ if you want to avoid dry eyes and constipation (this drug would have to have no anticholinergic activity).
You dont want to give this drug to a pt with a pituatary tumor. Why? |
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Definition
Respiridone: antagonizes 5HT and D2, blocks alpha and H1
Causes hyperprolactinemiea, makes the pituatary tumor grow. |
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Term
How can you treat all of the following?
Akathisia
Acute Dystonia
Rabbit Syndrome |
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Definition
Tx with anticholinergics
Ach opposes DA action in basal ganglia, attenuates DAMPING EFFECTAch opposes DA action in basal ganglia, attenuates DAMPING EFFECT |
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Term
| What group of Rx do Haloperidol and Chlorpromazine belong to? |
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Definition
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Term
| What group of Rx do Olanzapine, Clozapine, Quetiapin,risperidone, aripiprazole, and ziprasidone belong to? |
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Definition
|
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Term
Clozapine (SGA) has activity at 5HT, DA, some alpha1 antagonism, some M1, and some H1.
List the SE. |
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Definition
Agranulocytosis
Siezures
Myocardidtis
Hypotension
Mortality in elderly
Sedation
Wt gain
Constipation
Neuroleptic Malignant Syndrome |
|
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Term
What is Resperidone used to tx?
What are its SEs?
|
|
Definition
Tx Schizophrenia, and bipolar
SE: Sedation, Hyperprolactinemia (D2 antagonist), Rabbit syndrome. Inreased risk of mortality in elderly. |
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Term
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Definition
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