Psychopharmacology & Advanced Mental Health Exam 1 Flashcards

A set of vocabulary flashcards covering psychosis hypotheses, dopamine pathways, and the identification and management of Neuroleptic Malignant Syndrome (NMS).

Dopamine hypothesis

The theory that excess dopamine activity contributes to positive symptoms of psychosis.

Serotonin hypothesis

The theory that dysregulation of 5HT2A receptors contributes to psychosis.

Glutamate hypothesis

The theory that NMDA receptor hypofunction contributes to psychosis.

Mesolimbic pathway

The dopamine pathway responsible for positive symptoms.

Mesocortical pathway

The dopamine pathway responsible for cognition and negative symptoms.

Nigrostriatal pathway

The dopamine pathway responsible for movement regulation.

Tuberoinfundibular pathway

The dopamine pathway responsible for prolactin regulation.

Neuroleptic Malignant Syndrome (NMS)

A life-threatening antipsychotic reaction caused by the blockade of central dopamine D2 receptors, leading to hyperthermia, rigidity, autonomic instability, altered mental status, and elevated CK.

FEVER Mnemonic

A tool for identifying NMS clinical presentation: [F]ever (Hyperthermia $>100.4^{\circ }\text{F}$ or $>104^{\circ }\text{F}$), [E]ncephalopathy (altered mental status), [V]itals unstable (autonomic instability), [E]levated enzymes (high CK), and [R]igidity (lead-pipe).

Lead-pipe rigidity

The generalized muscle rigidity characteristic of Neuroleptic Malignant Syndrome (NMS).

NMS Management: Immediate Discontinuation

The first step in managing NMS where the offending agent is stopped instantly; if caused by withdrawal of a Parkinson's drug, that medication must be immediately restarted.

Dantrolene

A skeletal muscle relaxant used in severe NMS cases that inhibits calcium release from the sarcoplasmic reticulum to reduce rigidity and heat production.

Bromocriptine / Amantadine

Dopamine agonists used in severe NMS to reverse the central D2 blockade.

Benzodiazepines (Lorazepam)

Psychotropics used in NMS for acute agitation and to help relax mild muscle rigidity.

Myoglobinuria

A condition resulting from rhabdomyolysis in NMS; kidneys must be protected from this through aggressive fluid resuscitation.

NMS Reintroduction Safety Parameters

Wait at least 2 weeks after symptom resolution, switch to a structurally unrelated class, select an agent with low D2 affinity (e.g., Quetiapine or Clozapine), titrate slowly, and avoid long-acting injectables.