Term
| SCHIZOPHRENIA DSM-V Diagnostic Criteria |
|
Definition
2 or more of these in 1 month period (1 Sx must be 1,2, or 3)
1. Delusions 2. Hallucinations 3. Disorganized Speech 4. Grossly disorganize/Catatonic Behavior[muscular rigidity and mental stupor]
5. Negative symptoms |
|
|
Term
| 2nd Generation antipsychotics better for_____ |
|
Definition
| Negative symptoms of schizo |
|
|
Term
|
Definition
nucleus accumbens-Pos Sxs
involved in addiction |
|
|
Term
DA Hypothesis
Mesocortical |
|
Definition
frontal cortex-NEG Sxs
feeds back to Nac |
|
|
Term
DA Hypothesis
Nigrostriatal |
|
Definition
|
|
Term
DA Hypothesis
Tuberoinfundibular and tuberohypophyseal |
|
Definition
|
|
Term
|
Definition
Too many 5HT2A/C rec in PFC
-Inhibs DA release to cause NEG Sxs |
|
|
Term
|
Definition
| Impaired NMDA receptors= Impaired cognition |
|
|
Term
|
Definition
| abnormal brain develop in fetus |
|
|
Term
| Inc incidenc in elderly & CV/Cerebrovascular side effect mechs of act are _____ |
|
Definition
|
|
Term
| Therapeutic efficacy in 1st and 2nd gen anti psychs |
|
Definition
|
|
Term
|
Definition
D-2 lke rec antag
-Dec pos Sxs via NAC DA signals
-Block post syn D2 like re
-Neg Sxs worsen bc dec PFC signals |
|
|
Term
|
Definition
Thioridazine, Haloperidol, Trifluoperazine
Chlorpromazine, Fluphenazine, Loxapine
Perphenazine, Pimozide, Thiothixene |
|
|
Term
|
Definition
Clozapine, Riperidone,Paliperidone
Iloperidone,Olanzapine,Quetiapine
Ziprasidone,Lurasidone,Asenapine |
|
|
Term
|
Definition
Less sedation and cog impairment
way less mvmnt probs and prolactin SFX
-WORSE metabolicFX (wgt gn,insulin res,hyperlipid) |
|
|
Term
|
Definition
5HT2 and D2 like blockade
-more PFC and Nac D3,4 Block than striatal D2 |
|
|
Term
|
Definition
Chlorpromazine
Haloperidol
CLozapine
Risperidone |
|
|
Term
|
Definition
| Haloperidol CLOZAPINE QUETIAPINE |
|
|
Term
| L-DOPA and anticholinergis inc side effect of |
|
Definition
TD(Tardive Dyskinesia)= Continuous mouth and limb movements when awake
(Sxs Dec 2-5 years after Rx discontinued) |
|
|
Term
| Tardive Dyskinesia is a result of |
|
Definition
D2 antagonism
Dec GABA striatonigral activity
Inc DA activity while mACH still blocked
Tx with Vmat-2 inhibs |
|
|
Term
|
Definition
2nd Gen Antispychs
(Clozapine effective in 35-50% who dont respond to other antipsychs) |
|
|
Term
|
Definition
-Bind D2 low affinity
-less EPS
-More H1,mACH,Alpha1 SFX
-ex: Chlorpromazine, Thioridazine |
|
|
Term
|
Definition
Bind D2 receptor with High Affinity
-inc prolactin stuff
-ex:Haloperidol, Fluphenazine |
|
|
Term
| D-antagonist effects on Meolimbic and Mesocortical tract |
|
Definition
|
|
Term
| D-antagonist effects on Nigrostriatal |
|
Definition
| Mvmnt disorders (parkonsonism,dystonias) |
|
|
Term
| D-antagonist effects on Tuberoinfundibular |
|
Definition
| Hyperprolactinemia,gynecomastia |
|
|
Term
| Tx for Pseudoparkonsonism |
|
Definition
|
|
Term
|
Definition
| Benztropine 2mg or Diphenhydramine 50mg IV or IM |
|
|
Term
|
Definition
-Decreas or discontinue offending agent
-Propranolol 30-90mg/day |
|
|
Term
| Tx for Tardive Dyskinesia |
|
Definition
| Valbenazine (INGREZZA)V-mat2 inhibitor |
|
|
Term
| 2nd Gen w/ significant EPS |
|
Definition
|
|
Term
| CLOZAPINE RISKS limiting use |
|
Definition
-Aganulocytosis 1% of pts
-Neutropenia 3% pts
Available only thorugh REMS |
|
|
Term
| Monitor these with 2nd Gen antipsychs |
|
Definition
Lipids Personal and fam med Hx
HbA1c Waist/Wgt |
|
|
Term
| Longest lasting Injectable Antipsych |
|
Definition
|
|
Term
| 1st TXs for new antipsych |
|
Definition
ZAR
Ziprasidone, Aripiprazole, Risperidone
If resistant try dif antipsych
If still not wrk try clozapine. |
|
|
Term
|
Definition
VD PEC
-BUSPAR,HYDROXYZINE, BDZ |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| PS(both short term,S is long) |
|
|
Term
| Appropriate duration Antidepressant in PTSD |
|
Definition
|
|
Term
| Sleep Nightmares in PTSD Tx with |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Intrusive thoughts/Hypervigilence in PTSD Tx with |
|
Definition
|
|
Term
|
Definition
-Higher doses than MDD
-FFPSC
2nd line = Clomipramine
3rd Line = Risperidone
Best outcomes is when paired with Behavioral Tx |
|
|
