Term
When does schizophrenia usually present |
|
Definition
Late adolescence to adulthood |
|
|
Term
What are positive symptoms Schizophrenia |
|
Definition
Hallucinations Delusions Aggressive behavior |
|
|
Term
What are Negative symptoms Schizophrenia |
|
Definition
Lack of speech difficult emotional expression withdrawal |
|
|
Term
What are cognitive symptoms Schizophrenia |
|
Definition
Difficult concentration and memory Problems executive decision making |
|
|
Term
Some complications w/ Schizophrenia |
|
Definition
High suicide rate Homelessness Poor compliance w/ drug therapy |
|
|
Term
Typical Antipsych examples |
|
Definition
Chlorpromazine Haloperidol |
|
|
Term
Typical Antipsych mechanism of action |
|
Definition
Dopamine especially D2 receptor blocker especially in mesocortical and mesolimbic area |
|
|
Term
Typical Antipsych, other receptor binding |
|
Definition
HAMS: Histamine a1 adrenergic muscarinic serotonin |
|
|
Term
Typical Antipsychs- 2 limitations |
|
Definition
1/3 don't respond, "treatment refractory" small amount of improvement only in negt. and cognitive symps |
|
|
Term
|
Definition
1. EPS 2. Hyperprolactemia 3. Sedating |
|
|
Term
Atypical antipsychs definition |
|
Definition
reduced cause EPS and Hyperprolactemia |
|
|
Term
Atypical antipsychs characterized by |
|
Definition
1. weak D2 dopamine receptor blocker 2. Serotonin 2A (5HT 2A) receptor antagonism |
|
|
Term
How do atypical antipsychs partially rescue dopamine transmission |
|
Definition
blocks D2 receptors in striatum and serotonin receptors so more dopamine released from nigostriatal neurons Less EPS |
|
|
Term
Bad SE with atypical antipsychs |
|
Definition
|
|
Term
Examples atypical antipsychs |
|
Definition
1. clozapine 2. olanzapine 3. quetiapine 4. risperidone 5. ziprasidone 6. aripiprazole |
|
|
Term
How atypical antipsychs work |
|
Definition
all have different mechanism of action |
|
|
Term
How select which antipsych for pts? |
|
Definition
More based on anticipated SEs than effectiveness |
|
|
Term
What else can use antipsychs for? |
|
Definition
acute psychosis schizoaffective disorder Acute manic episode in bipolar tourette's huntington's autistic disorders |
|
|
Term
SEs of Dopamine antagonists |
|
Definition
-Positive symptoms- mesocortical and mesolimbic -Parkinson like symptoms- Nigrostriatal pathway,EPS -Hyperprolactemia- tuberoinfundibular, amenorrhea, galactorrhea, impotence, infertility |
|
|
Term
SEs of muscarinic antagonists |
|
Definition
dry mouth, urinary retention, blurred vision cognitive defects Anti-EPS (tx parkinson's) |
|
|
Term
SEs of a1 adrenergic antagonist |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
satiety blockade (weight gain) |
|
|
Term
|
Definition
1. Parkinsonism 2. Tardive dyskinesia 3. Neuroleptic malignant syndrome |
|
|
Term
|
Definition
-Parkinson's Disease -Tx anti-muscarinics (except L-DOPA) |
|
|
Term
Tardive Dyskinesia symptoms |
|
Definition
-Stereotyped, repetitive involuntary choreoathetoid movements of face, hands, eyelids, extremities, trunk -Can be irreversible in adults, most important concern long term antipsych use -Unknown mechanism -No Tx |
|
|
Term
Neuroleptic malignant syndrome |
|
Definition
-Life threatening -Marked muscle rigidity, fever, leukocytosis -mechanism: believe from extensive rapid blockade of postsynaptic dopamine receptors -Tx: immediately stop medication, give dopamine agonist and muscle relaxant |
|
|
Term
|
Definition
-prototype neurolyptic drug -inexpensive -Anti-muscarinic and anti-alpha adrenergic |
|
|
Term
|
Definition
Many SE's including autonomic -Highly sedative |
|
|
Term
|
Definition
-inexpensive -potent -less autonomic SEs |
|
|
Term
|
Definition
severe EPS and Hyperprolactemia |
|
|
Term
|
Definition
-Most efficacious -Less EPS (better compliance) -Only for pts resistant to typical drugs -must monitor WBCs |
|
|
Term
|
Definition
-Small chance of agranulocytosis - very dangerous -Weight gain, sedation, hyperlipidemia -LOWER SEIZURE THRESHOLD |
|
|
Term
|
Definition
-2nd most efficacious -one of most prescribed -Strong Histamine H1 blocker |
|
|
Term
|
Definition
-Sedation -Metabolic Syndrome -LOWERS SEIZURE THRESHOLD |
|
|
Term
|
Definition
-similar structure to clozapine -Strong Histamine H1 receptor antagonist |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Strongest D2 receptor blockert of atypicals -less anti-muscarinic |
|
|
Term
|
Definition
-EPS and Hyperprolactemia at high doses |
|
|
Term
|
Definition
Less affinity for muscarinic, Histamine H1, and alpha 1 adrenergic |
|
|
Term
|
Definition
-Less sedation, weight gain, and postural hypotension
Contraindicated for Heart problems- prolongs QT interval |
|
|
Term
|
Definition
D2 receptor Partial agonist- high affinity but only 30% activity -Serotonin 5HT 2A antagonist |
|
|
Term
|
Definition
|
|