Psychiatry Chapter on Antipsychotics
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Questions and Answers

Which atypical antipsychotic is known for having a lower likelihood of causing extrapyramidal symptoms (EPS)?

  • Olanzapine
  • Risperidone
  • Chlorpromazine
  • Clozapine (correct)

    • Blocking which dopamine receptor subtype is primarily associated with the promotion of extrapyramidal symptoms?

  • D1
  • D4
  • D2 (correct)
  • D3

    • What is a common treatment option for Acute Dystonia caused by antipsychotics?

  • Anticholinergic drugs (correct)
  • Beta-blocker
  • SSRIs
  • Mood stabilizers

    • Which symptom is NOT associated with Pseudoparkinsonism?

    <p>Muscle spasms of the face</p> Signup and view all the answers

    Which side effect is a significant concern with Clozapine use?

    <p>Agranulocytosis</p> Signup and view all the answers

    What percentage of patients may develop Tardive Dyskinesia after taking typical antipsychotic drugs for more than one year?

    <p>20%-30%</p> Signup and view all the answers

    Which medication is NOT listed as a treatment option for Tardive Dyskinesia?

    <p>Antidepressants</p> Signup and view all the answers

    Which group of patients typically requires a lower dose of antipsychotics?

    <p>Older adults</p> Signup and view all the answers

    What is a key feature of Neuroleptic Malignant Syndrome (NMS)?

    <p>May be fatal</p> Signup and view all the answers

    How long does it typically take to observe a therapeutic response after starting antipsychotic treatment?

    <p>7 to 10 days</p> Signup and view all the answers

    What type of symptoms do typical antipsychotics primarily help to manage?

    <p>Positive symptoms</p> Signup and view all the answers

    Which of the following is classified as a conventional antipsychotic?

    <p>Haloperidol</p> Signup and view all the answers

    Which of these is a characteristic of negative symptoms in schizophrenia?

    <p>Blunted affect</p> Signup and view all the answers

    Which is a key distinction between typical and atypical antipsychotics?

    <p>Typical antipsychotics focus on positive symptoms, while atypical treat both types.</p> Signup and view all the answers

    What is the common route of administration for Haloperidol?

    <p>Slow release via injection every 2-4 weeks</p> Signup and view all the answers

    Which of the following is a common side effect of lithium use?

    <p>Dry mouth and increased urination</p> Signup and view all the answers

    What is the therapeutic serum range for lithium levels?

    <p>0.8-1.2 mEq/L</p> Signup and view all the answers

    Which substance should be avoided due to potential neurological risks when taking MAOIs?

    <p>Cheese</p> Signup and view all the answers

    In the context of mood stabilizers, which condition is primarily treated by lithium?

    <p>Bipolar affective disorder</p> Signup and view all the answers

    What is a likely consequence of lithium levels exceeding 2.0 mEq/L?

    <p>Marked agitation and seizures</p> Signup and view all the answers

    What is the primary mechanism of action of benzodiazepines?

    <p>Enhance the action of GABA</p> Signup and view all the answers

    Which of the following is NOT a common side effect of benzodiazepines?

    <p>Agitation</p> Signup and view all the answers

    What is the appropriate response for someone experiencing a benzodiazepine overdose?

    <p>Give Flumazenil IV</p> Signup and view all the answers

    Buspirone hydrochloride primarily interacts with which neurotransmitters?

    <p>Serotonin and dopamine</p> Signup and view all the answers

    Which type of anxiety is typically not managed with anxiolytics?

    <p>Secondary anxiety due to physical problems</p> Signup and view all the answers

    What is a significant risk associated with long-term use of barbiturates?

    <p>Drug tolerance and dependence</p> Signup and view all the answers

    Which demographic is more likely to experience depression according to the content?

    <p>Women between the ages of 25 and 45</p> Signup and view all the answers

    What characterizes major depression from the other types mentioned?

    <p>Persistent feelings of sadness and worthlessness</p> Signup and view all the answers

    What are the two primary mood states experienced in bipolar disorder?

    <p>Euphoric and dysphoric</p> Signup and view all the answers

    What is a common side effect of Tricyclic Antidepressants (TCA)?

    <p>Sedation</p> Signup and view all the answers

    Which neurotransmitter is not mentioned as being insufficient in bipolar disorder?

    <p>GABA</p> Signup and view all the answers

    Which of the following antidepressants is classified as an SSRI?

    <p>Escitalopram</p> Signup and view all the answers

    What is a potential side effect of the serotonin-norepinephrine reuptake inhibitor (SNRI) Venlafaxine?

    <p>Euphoria</p> Signup and view all the answers

    Which herbal supplement is mentioned as a complementary alternative medicine (CAM) for depression?

    <p>St. John’s Wort</p> Signup and view all the answers

    What is a known caution regarding the use of second-generation antidepressants?

    <p>Should not be taken with MAOIs</p> Signup and view all the answers

    What action do Selective Serotonin Reuptake Inhibitors (SSRIs) primarily perform?

    <p>Block the reuptake of serotonin</p> Signup and view all the answers

    Study Notes

    Mental and Behavioral Health Drugs

    • Antipsychotics (Neuroleptics/Psychotropics): Drugs used to treat psychosis, a loss of contact with reality. Symptoms include disorganized thoughts, delusions, hallucinations, and difficulties processing information.

    • Anxiolytics (Antianxiety Drugs/Sedative-Hypnotics): Used to treat anxiety disorders.

    • Psychosis: A loss of contact with reality. Characterized by difficulties with information processing, disorganized thoughts, delusions, hallucinations, potentially aggressive or violent behavior.

    • Schizophrenia: A chronic psychotic disorder. Includes cognitive symptoms (disorganized thinking, memory problems), positive symptoms (exaggerated normal functions, hallucinations, delusions), and negative symptoms (decreased motivation, blunted affect).

    • Antipsychotics: Improve thought processes and behavior in patients with psychotic symptoms, particularly schizophrenia.

    Categories of Antipsychotics

    • Typical (First-Generation): Conventional or traditional antipsychotics, often effective for positive symptoms.

    • Phenothiazines: Examples include chlorpromazine hydrochloride, fluphenazine, and thioridazine.

    • Nonphenothiazines: Example includes Haloperidol with a dose range of 0.5-5mg and Chlorpromazine 10-25mg. Administration methods and precautions are for slow release injections every 2-4 weeks noting that injection sites should not be massaged.

    • Atypical (Second-Generation): Effective for both positive and negative symptoms.

    • Clozapine: First atypical antipsychotic; less likely to cause EPS (extrapyramidal symptoms) but may have side effects of seizures or agranulocytosis (a serious blood condition) requiring strict WBC monitoring.

    • Olanzapine, Risperidone, Aripiprazole: Atypical antipsychotics with lower risk of EPS compared to typical antipsychotics. Aripiprazole shows a stronger affinity for D4 receptors.

    Mechanisms of Action

    • Antipsychotics: Block the action of dopamine, dopamine antagonist
    • Subtypes of dopamine receptors: D1-D5. D2 receptor blocking promotes EPS (e.g., pseudo-parkinsonism)
    • Atypical antipsychotics: Generally show weaker D2 receptor affinity, associated with fewer EPS. May have stronger affinity for D4 and a block on the serotonin receptor.

    Adverse Reactions (Extrapyramidal Syndrome)

    • Pseudoparkinsonism: Symptoms like shuffling gait, tremors, and rigidity, often seen with typical antipsychotics.
    • Acute Dystonia: Muscle spasms of the face, neck, and back.
    • Akathisia: Restlessness, pacing, often described as being unable to sit still.
    • Tardive dyskinesia: Involuntary movements (in the mouth, torso, arms, or legs), a potentially irreversible side effect associated with long-term use of typical antipsychotics.

    Anxiolytics

    • Benzodiazepines: Enhance GABAergic (inhibitory) neurotransmission, leading to calming effects. Alprazolam, Chlordiazepoxide, Diazepam, Clorazepate dipotassium, Lorazepam are examples.
    • Buspirone: Binds to serotonin and dopamine receptors. Effective for anxiety disorders.

    Antidepressants and Mood Stabilizers

    • Types of depression: Includes reactive (sudden onset), major (loss of interest and concentration), and bipolar disorder.
    • Depression Pathophysiology: Associated with insufficient monoamine neurotransmitters (serotonin, norepinephrine).
    • Mood stabilizers: Often use Lithium as an example. Therapeutic serum range of 0.8-1.2mEq/L.
    • Classes of antidepressants: Tricyclic Antidepressants (TCAs), Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Atypical antidepressants
    • Potential side effects: Orthostatic hypotension, sedation, anticholinergic effects, cardiotoxicity, and seizures. Some drugs have specific potential side effects like Fluoxetine's dry mouth, possible suicidal ideation effects, and orthostatic hypotension.

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    Mental And Behavioral Health Drugs PDF

    Description

    Test your knowledge on antipsychotic medications, their side effects, and management of related symptoms. This quiz covers topics such as extrapyramidal symptoms, treatment options for acute dystonia, and the characteristics of neuroleptic malignant syndrome. Perfect for students of psychiatry and mental health disciplines.

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