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1

What are the 6 essentials of diagnosis for schizophrenia? 

Social withdrawal, usually slowly progressive; deterioration in personal care

Loose thought associations; often slowed thinking and rapid shifting from topic to topic

Autistic absorption in inner thoughts; frequent sexual or religious preoccupations

Auditory hallucinations, often of a derogatory nature

Delusions, frequently of a persecutory nature

Symptoms of at least 6 months’ duration

2

Schizophrenic disorders are characterized by what? 

a loss of contact with reality 

3

What characterizes a delusional disorder? 

persistent delusions with minimal impairment of daily functioning

4

What characterizes a schizoaffective disorder? 

affective symptoms (either a major depressive episode, manic episode, or hypomanic episode) that precede or develop concurrently with psychotic manifestations

5

What characterizes a schizophreniform disorder? 

Symptoms similar to schizophrenic disorders except that the duration of prodromal, acute, and residual symptoms is longer than 1 week but less than 6 months.

6

What characterizes a brief psychotic disorder? 

Result of psychological stress and last less than 1 week

7

Hypotheses of schizophrenia: 

___________ receptor and possibly _______ stimulation was the basis for the hallucinatory effects of LSD and mescaline. 

5-HT2A receptor and possibly 5-HT2C stimulation was the basis for the hallucinatory effects of LSD and mescaline. 

8

Hypotheses of Schizophrenia: 

_______ receptor blockade is a key factor in the mechanism of action of the main class of atypical antipsychotic drugs

5-HT2A

9

Hypotheses of Schizophrenia:

Dopamine: 

______________ in the central nervous system in the mesolimbic and striatal-frontal system. 

Blockade of postsynaptic D2 receptors in the central nervous system in the mesolimbic and striatal-frontal system

10

Hypotheses of schizophrenia: 

Glutamate: 

Hypofunction of _________ located on GABAergic interneurons leads to diminished __________ on neuronal function. 

Hypotheses of schizophrenia: 

Glutamate: 

Hypofunction of NMDA receptors located on GABAergic interneurons leads to diminished inhibitory influences on neuronal function. 

11

T/F: Glutamate can lead to hyperstimulation of cortical neurons 

True 

12

What type of sx are involved with the mesolimbic dopaminergic pathways? 

Positive sx

13

What type of sx are involved wih the mesocortical dopaminergic pathways? 

negative sx

14

What type of sx are observed with the nigrostriatal dopaminergic pathways? 

EPS & Tardive dyskinesia

15

What type of sx are involved with tuberohypophyseal dopaminergic pathways

hyperprolactinemia 

16

Suspiciousness

Unusual thought content (delusions)

Hallucinations

Conceptual disorganization

Disorganized speech

Catatonia

These are which sx cluster in schizophrenia? 

Positive behavior sx cluster

17

Affective flattening (blunted)

Alogia (aphasia, “poverty of speech”)

Anhedonia (inability to experience pleasure)

Avolition (decreased motivation)

Withdrawal 

Which type of Schizophrenia symptom cluster? 

 

Negative (affect) 

18

Impaired attention

Impaired working memory

Impaired executive function

Which type of schizophrenia sx cluster is this? 

Cognitive (Cognition) 

19

What 3 moods do schizophrenic pts feel? 

Dysphoria

Suicidality 

Hopelessness

20

Which antipsychotic has the most weight gain? 

Chlorpromazine

21

Which drug has significant QTc prolongation? 

Thioridazine

22

Sublingual only, no food or drink for 10 minutes after administration of the dose

Which 2nd generation antipsychotic? 

Asenapine

23

Due to long half-life, steady-state is not reached for several weeks

Which 2nd generation antipsychotic drug? 

Cariprazine

24

Take with food; ≥350 calories 

Which 2nd gen antipsychotic? 

Lurasidone

25

Avoid in first episode because of weight gain

Which drug? 

Olanzapine

26

Dose related weight gain

Which drug? 

Quetiapine

27

Hyperprolactinemia; use in mania

Which drug? 

Risperidone

28

Take with food, ≥500 calories 

 Which 2nd generation antipsychotic? 

Ziprasidone

29

What are the overall PK of antipsychotics? 

Well absorbed

Lipid soluble

Allows entry into the CNS

Extensively bound to plasma proteins

Metabolized by liver enzymes:  to active metabolites: CYP2D6 and CYP3A4

Long plasma half-lives

Further prolonged utilizing LAI

Renally eliminated

30