Term
What is thought to be the underlying abnormality of psychoses? |
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Definition
excess dopamine activity in the central nervous system |
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Term
What is the evidence for the hypothesis that dopamine causes psychosis? |
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Definition
drugs that block dopamine receptors are therapeutic in alleviating psychotic symptoms and sympathomimetics drugs which release dopamine (amphetamine) can induce psychosis |
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Term
How are most antipsychotics administered? |
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Definition
orally (IM for certain drugs) |
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Term
What percent of antipsychotics are bound to plasma proteins? |
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Definition
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Term
T/F antipsychotics are in general subject to an extensive "first pass" heapatic metabolism |
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Definition
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Term
What are the half-lives of antipsychotics like? |
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Definition
generally long halfe lives (chlorpromazine t1/2=30 hours) |
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Term
What percent of psychotic patients respond to typical antipsychotics? |
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Definition
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Term
Aministration of antipsychotics leads to characteristic physical and psychological effects known as _______. |
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Definition
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Term
What are the symptoms of neuroleptic syndrome? |
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Definition
sedation, emotional quieting, psychomotor slowing, affective indifference |
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Term
What are the MOA of phenothiazines? |
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Definition
predominately dopamine type 2 antagonists |
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Term
What are the three types of phenothiazines? |
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Definition
aliphatics, piperidines, piperazines |
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Term
What is the MOA of the aliphatics? |
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Definition
low affinity D2 antagonists that pose an increased risk for autonomic side effects |
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Term
Name some drugs that are aliphatics. |
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Definition
chlorpromazine, promazine, triflouropromazine |
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Term
Name the least effective aliphatic? |
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Definition
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Term
What is the MOA of piperdines? |
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Definition
when compared to aliphatics these drugs have a higher affinity for the D2 receptor; however these drugs now have a black box warning on the labeling because they can produce a quinidine-like effect on the heart |
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Term
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Definition
mesoridazine and thioridazine |
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Term
What is the MOA of piperazines? |
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Definition
high affinity D2 antagonists that pose an increased risk for extrapyramidal side effects; least sedating of the D2 antagonists |
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Term
What class of drugs are the least sedating of the D2 antagonists? |
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Definition
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Term
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Definition
fluphenazine, perphenazine, triflouperazine |
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Term
What is another name for haloperidol? |
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Definition
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Term
What is the MOA of haloperidol? |
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Definition
high to intermediate affinity for the D2 receptor and tehrefore poses increased risk of extrapyramidal side effects; decanoate formulation available |
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Term
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Definition
chlorprothixene and thithixene |
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Term
What is the MOA of the thioxanthenes? |
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Definition
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Term
Name the three broad clases of typical antipsychotics. |
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Definition
phenothiazines, butyrophenone, thioxanthenes |
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Term
What's different about the second generation antipsychotics? |
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Definition
only weakly antidopaminergic so this reduces the potential for tardive dyskinesia and drug-induced parkinsonism |
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Term
What are dibenzodiazepines? |
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Definition
second generation antizychotics that are heterocyclic compounds with extrordinarily mixed receptor binding profiles |
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Term
Name some dibenzodiazepines. |
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Definition
clozapine, loxapine, olanzapine |
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Term
What is clozapine especially useful for? |
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Definition
helps with negative antipsychotic symptoms |
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Term
What are the side effects of clozapine? |
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Definition
agranulocytosis, cardiovascular complications such as myocarditis and cardiomyopathy from chronic treatment |
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Term
If a patient is experiencing agranulocytosis with clozapine, you can switch them to another dibenzodiazepine without that effect, namely ______. |
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Definition
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Term
What are the sieffects of olanzipine? |
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Definition
case reports have described incidents of sleepwalking |
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Term
What is the MOA of benzisoxazole? |
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Definition
relatively selective 5-HT2A receptor antagonists, but at higher doses have ahloperidol like effects |
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Term
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Definition
risperidone, paliperidone, ziprasidone |
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Term
What is teh primary active metabolite of risperidone? |
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Definition
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Term
Name the heterocyclic antipsychotics that do not fit into a category. |
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Definition
molindone, pimozide, quetiapine |
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Term
What is the MOA of aripiprazole? |
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Definition
partial dopamine receptor agonist |
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Term
Why might a partial dopamine agonist be a better treatment than a dopamine antagonist? |
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Definition
you reduce the incidence of neurolepsis, parkinsonism-like effects and tardive dyskinesias |
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Term
What other receptors are affected by antipsychotics besides dopamine receptors? |
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Definition
many antipsychotics can block peripheral muscarinic receptors, alpha0-adrenergic receptors, and histmaine-1 rectpros |
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Term
T/F Many antipsychotics can result in weight gain |
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Definition
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Term
Which antipsychotic is often used as an antiemetic? How does it work as an antiemetic? |
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Definition
promethazine (because of its antihistaminic effects) |
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Term
T/F DA plays a substantial role in the chemoreceptor trigger zone. |
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Definition
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Term
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Definition
unpleasant, subjective responses often characterized as "nervous energy" |
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Term
T/F Akathisias strongly contribute to noncompliance of antipsychotics. |
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Definition
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Term
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Definition
distinct absence of movement |
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Term
T/F Tardive dyskinesiasa can occur after taking only a few doses of antipsychotics. |
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Definition
false; symptoms develop after extended periods of time on antipsychotic drug therapy |
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Term
What percent of patients taking antipsychotic drug therapy get neuroleptic malignant syndrome? |
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Definition
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Term
What percent of patients who get neuroleptic malignant syndrome end up dying from it? |
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Definition
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Term
T/F Neuroleptic malignant syndrome can occur at therapeutic doses. |
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Definition
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Term
How long after starting to take antipsychotic meds can you develop neuroleptic malignant syndrome? |
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Definition
within hours of starting treatment to months of treatment |
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Term
What are the symptoms of neuroleptic malignant syndrome? |
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Definition
muscular rigidity, impaired breathing or ventilation, autonomic hyperactivity, extremely high temperatures |
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Term
What kinds of endocrine abnormalities can be caused by antipsychotics? |
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Definition
increased serum prolactin, which can lead to amenorrhea, dysmenorrhea, and gynecomastia |
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Term
What are the cardiovascular effects of taking antipsychotics? |
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Definition
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Term
What are the two most common drug interactions with antipsychotics? |
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Definition
the potentiation of CNS depressants such as alcohol, an interaction with OTC meds such as antihistamines |
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Term
What are contraindications for "typical antipsychotic therapy"? |
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Definition
blood dyscrasias, parkinsonism, chronic alcoholism, liver disease |
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