Psychopharmacology of Antipsychotics
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Questions and Answers

Which of the following statements about serotonin and psychedelic drugs is true?

  • Antagonism at 5-HT2 receptors improves the side effect profile of newer antipsychotic medications. (correct)
  • The recurring hypothesis suggests NMDA receptor hypofunction is unrelated to serotonin activity.
  • Serotonin agonists are effective for both positive and negative symptoms in schizophrenia.
  • LSD acts as an antagonist at 5-HT2 receptors.

What is a typical side effect of first-generation antipsychotics?

  • Severe mood swings.
  • Development of cognitive deficits.
  • Delay of ejaculation. (correct)
  • Hallucinations.

What is a suggested consequence of NMDA receptor hypofunction according to the content?

  • Excessive release of excitatory neurotransmitters causing potential cortical damage. (correct)
  • Increased serotonin levels leading to hallucinations.
  • Enhanced dopamine receptor activity leading to paranoid ideation.
  • Complete blockage of 5-HT2 receptors reducing hallucinations.

Which statement accurately describes the pharmacokinetics of first-generation antipsychotics?

<p>They possess long half-lives, enabling infrequent dosing. (A)</p> Signup and view all the answers

What symptoms are primarily associated with the NMDA antagonists like ketamine?

<p>Negative symptoms and cognitive deficits. (A)</p> Signup and view all the answers

What is one notable side effect associated with Clozapine?

<p>Extreme weight gain (D)</p> Signup and view all the answers

Which of the following antipsychotic medications has the least prescribed status due to side effects?

<p>Risperidone (B)</p> Signup and view all the answers

Which medication is primarily an antagonist of the 5-HT2 receptor?

<p>Serindole (B)</p> Signup and view all the answers

What is a common side effect of Olanzapine?

<p>Weight gain (A)</p> Signup and view all the answers

Which of the following describes Clozapine’s mechanism of action?

<p>Antagonizes multiple types of receptors including D2, D3, and 5-HT1A (B)</p> Signup and view all the answers

What does Risperidone increase at higher doses?

<p>Risk of extrapyramidal symptoms (A)</p> Signup and view all the answers

What is a characteristic side effect unique to Clozapine compared to other antipsychotics?

<p>Decrease in seizure threshold (D)</p> Signup and view all the answers

What are the positive symptoms characteristic of schizophrenia?

<p>Hallucinations and delusions (D)</p> Signup and view all the answers

Which antipsychotic medication is primarily used for treatment-resistant schizophrenia?

<p>Clozapine (A)</p> Signup and view all the answers

During which phase of schizophrenia does the patient experience mood symptoms and social withdrawal?

<p>Prodromal phase (A)</p> Signup and view all the answers

Which neurotransmitter is primarily associated with the dopaminergic theory of schizophrenia?

<p>Dopamine (B)</p> Signup and view all the answers

What is one of the primary roles of antipsychotic drugs in treating schizophrenia?

<p>Blocking dopamine receptors (C)</p> Signup and view all the answers

Which of the following symptoms would be classified as a negative symptom of schizophrenia?

<p>Anhedonia (D)</p> Signup and view all the answers

What is a significant risk associated with the combination of antipsychotic drugs and antidepressants?

<p>Potential for serious adverse effects (B)</p> Signup and view all the answers

Which of the following is a symptom of tardive dyskinesia?

<p>Involuntary hyperkinetic movements (C)</p> Signup and view all the answers

What is the potential irreversibility percentage of tardive dyskinesia in patients receiving FGAs?

<p>10-20% (D)</p> Signup and view all the answers

Which neurotransmitter receptor does haloperidol primarily block to exert its effects?

<p>D2 receptor (A)</p> Signup and view all the answers

What are the emotional and cognitive functions primarily associated with the mesolimbic and mesocortical pathways?

<p>Emotional regulation and rewarding behaviors (D)</p> Signup and view all the answers

Which second-generation antipsychotics (SGAs) block serotonin receptors more effectively than D2 receptors?

<p>Olanzapine and Risperidone (B)</p> Signup and view all the answers

Which of the following drugs is primarily used for tics in Tourette’s Syndrome?

<p>Haloperidol (A)</p> Signup and view all the answers

Which antipsychotic has a lower risk of tardive dyskinesia compared to others?

<p>Clozapine (A)</p> Signup and view all the answers

What is the mechanism of action for Quetiapine?

<p>5-HT2/D2 receptor blocking action (C)</p> Signup and view all the answers

Which of the following conditions is NOT a typical use of Quetiapine?

<p>Generalized anxiety disorder (A)</p> Signup and view all the answers

Which potential side effect is associated with Ziprasidone?

<p>Heart failure (B)</p> Signup and view all the answers

What distinguishes Aripiprazole in terms of hormonal effects?

<p>It does not cause prolactin elevation. (A)</p> Signup and view all the answers

Which of the following describes a pharmacokinetic property of both Quetiapine and Ziprasidone?

<p>Short biological half-life of approximately 6 hours (C)</p> Signup and view all the answers

Which of the following is an off-label use for Aripiprazole?

<p>Control of aggression and tantrums (B)</p> Signup and view all the answers

Which side effect is NOT commonly associated with Quetiapine?

<p>Severe skin rash (D)</p> Signup and view all the answers

What characteristic of Aripiprazole makes it favorable in terms of weight management?

<p>Does not cause weight gain (A)</p> Signup and view all the answers

What is the primary factor that leads to the development of neuroleptic-induced parkinsonism?

<p>Dopamine receptor blockade (B)</p> Signup and view all the answers

Which symptom is commonly associated with akathisia?

<p>Restlessness and pacing (D)</p> Signup and view all the answers

What are the effects of blocking D2 receptors in the context of psychopharmacology?

<p>Dry mouth and cognitive dysfunction (C)</p> Signup and view all the answers

Which of the following represents a side effect linked to norepinephrine-hypotension?

<p>Sedation, blurred vision, and dry mouth (D)</p> Signup and view all the answers

What condition is typically the first acute extrapyramidal symptom that appears shortly after initiating treatment?

<p>Acute dystonia (C)</p> Signup and view all the answers

Which of the following is a consequence of dopaminergic blockade related to hormonal changes?

<p>Breast enlargement and lactation (A)</p> Signup and view all the answers

What potential consequence could arise from the subjective feeling of anxiety associated with akathisia?

<p>Increased risk for suicide (C)</p> Signup and view all the answers

What is a common physiological manifestation of neuroleptic-induced parkinsonism?

<p>Tremors at rest and rigidity (A)</p> Signup and view all the answers

Flashcards

Positive Symptoms

Symptoms that involve an excess or distortion of normal functions. They include hallucinations, delusions, and thought disorder.

Negative Symptoms

Symptoms that involve a decrease or absence of normal functions. They include blunting of emotional expression, alogia, avolition, anhedonia, and social withdrawal.

Dopaminergic Theory of Schizophrenia

This theory suggests that schizophrenia is caused by an overactivity of dopamine in certain brain regions, particularly the mesolimbic pathway.

Amphetamines and Schizophrenia

Abuse of stimulant drugs like amphetamines can increase dopamine levels, causing symptoms similar to paranoid schizophrenia.

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Antipsychotic Drugs and Dopamine

Antipsychotic drugs block dopamine receptors in the brain, particularly D2 receptors, to reduce symptoms.

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Extrapyramidal Symptoms (EPS)

Neurological side effects that can occur with antipsychotic medications, impacting movement and coordination.

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5-HT2 Receptor Antagonism

Blocking the activity of serotonin receptors, particularly the 5-HT2 subtype, which may reduce certain neurological side effects of antipsychotics.

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NMDA Receptor Hypofunction

A theory suggesting that reduced activity of NMDA receptors (for glutamate) is involved in psychosis, potentially leading to imbalances in brain activity.

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Dopamine D2 Receptor Blockade

Blocking dopamine receptors, particularly the D2 subtype, is a common mechanism of action for antipsychotics, helping to reduce symptoms.

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First-Pass Metabolism

The breakdown of a drug in the liver before it reaches the bloodstream, affecting its bioavailability.

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D2 Receptor Blockade

The drug blocks dopamine receptors (D2) in the brain, leading to various side effects.

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Acetylcholine Effects

Blocking D2 receptors affects acetylcholine, leading to side effects like dry mouth, blurred vision, and constipation.

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Histamine Effects

Blocking D2 receptors influences histamine, causing sedation and antiemetic effects.

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Serotonin Effects

Blocking D2 receptors affects serotonin, contributing to the therapeutic effect but also causing sedation and weight gain.

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Norepinephrine-Hypotension

The drug's effect on norepinephrine can lead to low blood pressure (hypotension), sedation, and other side effects.

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Acute Dystonia

An acute extrapyramidal symptom characterized by involuntary muscle contractions, leading to strange postures and movements.

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Neuroleptic-Induced Parkinsonism

A Parkinsonism-like state caused by the drug, characterized by tremors, rigidity, and slowed movement.

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Akathisia

A restless syndrome causing inner anxiety and constant movement, increasing the risk of non-adherence to the drug.

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Quetiapine (Seroquel)

An antipsychotic drug that blocks 5-HT2/D2 receptors, similar to haloperidol, but with fewer extrapyramidal side effects. It has little to no affinity for histamine receptors.

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Quetiapine's Cardiac Risk

Quetiapine can adversely affect the heart, potentially leading to serious cardiac arrhythmias (irregular heartbeat).

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Aripiprazole: Additional Uses

Aripiprazole is often used in conjunction with mood stabilizers or neuromodulators to manage various conditions.

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Ziprasidone (Geodon): Pharmacokinetics

Ziprasidone has a half-life of 6 hours and is administered intramuscularly.

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Tardive Dyskinesia

A serious movement disorder that can occur with long-term use of antipsychotic drugs. It involves involuntary movements of the face, tongue, trunk, and limbs.

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FGAs (First-Generation Antipsychotics)

Antipsychotic drugs that primarily block dopamine receptors. They are effective for treating positive symptoms of schizophrenia but can lead to side effects like Parkinsonism and tardive dyskinesia.

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SGA (Second-Generation Antipsychotics)

Newer antipsychotics that block both dopamine and serotonin receptors, often with a lower risk of extrapyramidal side effects compared to FGAs.

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Mesolimbic Pathway

A pathway in the brain connecting the VTA (ventral tegmental area) to the nucleus accumbens, amygdala, and hippocampus. It plays a role in motivation, reward, and addiction.

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Mesocortical Pathway

A pathway in the brain connecting the VTA to the prefrontal cortex. It is involved in higher cognitive functions, such as planning, decision-making, and working memory.

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Positive Symptoms of Schizophrenia

Symptoms of schizophrenia that involve an excess or distortion of normal functions, such as hallucinations and delusions.

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Negative Symptoms of Schizophrenia

Symptoms of schizophrenia that involve a reduction or absence of normal functions, such as flat affect, alogia, avolition, and anhedonia.

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Atypical Antipsychotics

A class of antipsychotics that have a lower risk of extrapyramidal side effects compared to traditional antipsychotics. They work by blocking dopamine and serotonin receptors in the brain.

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Clozapine (Leponex)

First atypical antipsychotic with a high efficacy in treating resistant schizophrenia and suicidal behaviors. It has a lower risk of EPS but can cause significant weight gain.

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Agranulocytosis

A rare but serious side effect of clozapine. It is characterized by a drastic decrease in white blood cells, putting the patient at risk for infections.

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Risperidone (Risperdal)

Second atypical antipsychotic, often used for its low risk of EPS at lower doses. It is associated with elevated prolactin levels.

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Olanzapine (Zyprexa)

Atypical antipsychotic with a similar clinical effect to clozapine but without the risk of agranulocytosis. It can cause significant weight gain.

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Serindole (Serdolex)

Atypical antipsychotic that primarily blocks serotonin receptors, with less impact on dopamine receptors.

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Pharmacokinetics

The study of how the body absorbs, distributes, metabolizes, and eliminates drugs.

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