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Schizophrenia
schizophrenia
9
Nursing
Graduate
04/30/2012

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Term
Schizophrenia name denotes
Definition
Name does denote a split between internal/personalized reality and actual external stimuli.
Has a1% incidence in general population.
Term
Schizophrenia Neurobiology Etiology Models
Definition
Genetic Predisposition Example: Faulty serotonin synthesis from tryptophan triggered by chronic stress.
-Normal: Tryptophan to tryptamine to serotonin
-Schizophrenia: Tryptophan to tryptamine to psychomimetic chemical
Gestational Effects Example: Incomplete formation of hippocampus during the second trimester of development resulting in misalignment of pyramidal cells.
Term
Schizophrenia Neurobiology
Definition
Excess of dopamine transmission at dopamine D1 and D2 receptors (There are 5 types of dopamine receptors.).
Increased dopamine release from presynaptic cell and/or dopamine receptor hypersensitivity
Possible causes of increased release or hypersensitivity
Stress–related cortisol activity (i.e. cortisone causes dopamine release)
Action of brain-derived neurotrophic factor (BDNF), a neurotrophin (protein that mediates functioning of neurons)that increases synaptic activity and neurotransmitter release.
Term
Schizophrenia brain areas most affected
Definition
Limbic system: Governs subjective emotional experiences and is associated with mood, motivation, and sensations.
Frontal lobes: Governs emotional experience and expression of mood.
Parietal lobes: Governs reception and evaluation of sensory information.
Term
Positive S & S: Excess D2 Receptor Transmission
Definition
Hallucinations
Delusions
Associative Problems
Disorganized Behavior
Term
Negative S & S: Excess D1 Receptor Transmission
Definition
Autistic thinking with social isolation
Anhedonia
Flat affect
Avolition
Alogia
Ambivalence
Passive attention
Term
Antipsychotic Medication: MOA, Older
Definition
Older antipsychotics block D2 receptors (i.e. target positive signs and symptoms)
Thorazine
Haldol
Mellaril
Prolixin
Stelazine
Term
Antipsychotic Medication: MOA, Atypical
Definition
Atypical newer antipsychotics have a moderate effect on D2 receptors and greater affinity for D1 and serotonin receptors (i.e. target both positive and negative signs and symptoms).
Clozapine (Clozaril)
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Ziprasidone (Zeldox)
Aripiprazole (Abilify)
Term
Older Antipsychotics Side Effects
Definition
Extrapyramidal symptoms (EPS) including dystonias, dyskinesias, and tardive dyskinesa (from blocking dopamine in substantia nigra)
-Use anticholinergics to control EPS
-Examples: cogentin, artane, amantadine
Neuroleptic malignant syndrome (from hypothalamic dopamine receptor blockade)
Hypotension (from blocking alpha-adrenergic receptors)

Clozaril: Agranulocytosis (from toxic effects of a clozapine metabolite on leukocytes causing acceleration of the physiologic cell death cycle)
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