PSYCHOSIS + ANTIPSYCHOTIC DRUGS

Psychosis is a variety of mental disorders w/ presence of the following:

_____________________

_____________________

_____________________

delusions

visual or auditory hallucinations

disorganized thinking

a symptom of psychosis that is having “false belief”

delusions

a type of delusion that is impossible

bizarre

a type of delusion that is possible but has a very slim chance of occuring

non-bizarre

is the most comon psychotic disorder

schizophrenia

Schizophrenia is a neurodevelopment disorder characterized by ________________ but a _______________________-

clear sensorium

marked thinking and perceptual disturbance

schizophrenia is a (COMMUNICABLE / GENETIC) disorder with (LOW / HIGH) heritabiity

genetic

high

give types under schizophrenia

catatonic or schizoaffective

a type of schizophrenia that have symptoms that do not correlate with schizophrenia but more with CATATONIA

catatonic schizophrenia

what type of schizophrenia is this?

rigidity or stupor that lasts for hours even days

performing strange movements

staying in uncomfortable positions without shifting

erratic and extreme movements

echolaliia nd repetition of words or behaviors

catatonic schizophrenia

what type of schizophrenia is this?

thinking you are being controlled

hallucinations

disorganized thinking

delusions

schizoaffective disorder

the hypothesis that is the basis for most drug therapies or psychosis

dopamine hypothesis

Dopamine Hypothesis involves drugs that block the _____________ receptors in CNS especially in mesolimbic and striatal, and frontal systems

postsynaptic D2 receptors

according to the dopamine hypothesis,

(INCREASE / DECREASE) in the dopaminergic activity can aggregate psychosis

increase

according to the dopamine hypothesis,

untreated schizophrenic patients have (INCREASED / DECREASED) DA receptor densities in (ALL / CERTAIN) brain regions

increased

certain

according to the dopamine hypothesis,

successful treatment of schizophrenic patients changes the amount of __________

homovanillic acid (HVA)

based from the dopamine hypothesis,

what are the three dopaminergic tracts?

mesocortical-mesolimbic tract

nigrostriatal tract

tuberoinfundibular tract

this is dopaminergic tract is known to be the executive; responsible for cognitive memorr; aka REWARD PATHWAY (short term happiness)

mesocortical-mesolimbic tract

dopamine elicits (SHORT / LONG) term happiness

short term

serotonin elicits (SHORT / LONG) term happiness

long term

is the dopaminergic tract known to be the motor pathway; have extrapyramidal functions

nigrostriatal tract

is the dopaminergic tract known to be the endocrine pathway; controls prolactin release

tuberoinfundibular tract

(INCREASE / DECREASE) in dopamine, decreases prolactin levels and milk production

increase

(INCREASE / DECREASE) in dopamine, increases prolactin levels and milk production

decrease

according to the serotonin hypothesis,

(INCREASE / DECREASE) of serotonin can lead to hallucination effects

increase

what does 5HT (serotonin) stand for?

5-hydroxytryptamine

according to the serotonin hypothesis,

the blockage of ________ receptors is key mechanism of action of ______________

5HT2A

atypical antipsychotics

according to the serotonin hypothesis,

the stimulation of _____________ receptors can lead to inhibition of release of dopamine in the _________________ regions

5HT2C

cortical and limbic

according to the glutamate hypothesis,

____________ is the major excitatory neurotransmitter in the brain

glutamate

according to the glutamate hypothesis,

____________ is the major inhibitory neurotransmitter in the brain

glycine

according to the glutamate hypothesis,

(INCREASE / DECREASE) in glutamate induces psychosis and anxiety

increase

according to the glutamate hypothesis,

glutamate binds with the ________ receptors

N-methyl-D-aspartate (NMDA) receptors

a type of psychosis that is a mental disorder where the patient has both psychosis and depression

psychotic depression

an type of psychosis that involves depressive or paranoid delusions due to degenration of te brain in old age

serile psychosis

a type of psychosis that involves strucutual brain changes or damages

various organic psychosis

various organic psychosis is due to __________, ___________, ___________, ________, _________, or ___________

alcohol, narcotics, trauma, infections, tumors, or drugs

a type of psychosis due to anticholinergic agents

drug induced psychosis

what is the diagnostic criteria fo schizophrenia?

2 or more of the following symptoms for at least 1 month

what are the signs symptoms of schizophrenia (SCHaND)

speech

catatonic or disorganized behavior

hallucination

negative symptoms

delusion

When dopamine (INCREASES / DECREASES) in the (MESOCORTICAL / MESOLIMBIC) pathways, it elicits POSITIVE symptoms

increases

mesolimbic

When dopamine (INCREASES / DECREASES) in the (MESOCORTICAL / MESOLIMBIC) pathways, it elicits NEGATIVE symptoms

decrease

mesocortical

what are the POSTIVE symptoms of schizophrenia (btchdd)

bizarre behaviors

thought disorders

combativeness

hallucinations

delusions

disorganized behaviors

what are the NEGATIVE symptoms of schizophrenia (a7)

alogia

affective

avolition

apathy

anhedonia

asociality

attention impairment

negative symptom of schizophrenia where the patient does not speak

alogia

negative symptom of schizophrenia where the patient lacks affection

affective

negative symptom of schizophrenia where the patient lacks motivation

avolition

negative symptom of schizophrenia where the patient lacks concern

apathy

negative symptom of schizophrenia where the patient does not experience pleasure

anhedonia

negative symptom of schizophrenia where the patient refuses social interaction

asociality

First gen antipsychotics are also known as _______________

Typical antipsychotics

Second gen antipsychotics are also known as _______________

Atypical antipsychotics

give the receptors blocked by,

TYPICAL ANTIPSYCHOTICS: _________
ATYPICAL ANTIPSYCHOTICS: _________

D2

5HT2A

can each of these classes of antipsychotics treat positive symptoms of schizophrenia?

TYPICAL ANTIPSYCHOTICS: _________
ATYPICAL ANTIPSYCHOTICS: _________

yes
yes

(TYPICAL / ATYPICAL) antipsychotics are more effective in treating negative symptoms of schizophrenia.

atypical

Typical antipsychotics are (MORE / LESS) likely to cause EPS / extrapyramidal / parkinson-like symptoms

more

Atypical antipsychotics are (MORE / LESS) likely to cause EPS / extrapyramidal / parkinson-like symptoms

less

Typical antipsychotics generally have a (HIGH / LOW) occurrence of tardive dyskinesia symptoms

high

Atypical antipsychotics generally have a (HIGH / LOW) occurrence of tardive dyskinesia symptoms

low

(LOW / HIGH) potency refers to a type of typical antipsychotic drugs which cause sedation and anticholinergic effects

low potency

name the classifications under low potency typical antipsychotics:

aliphatic
piperidine

a classification under low potency typical antipsychotics that are deemed to have the lowest potency

aliphatic

a classification under low potency typical antipsychotics that are known for their antihistamine and antiemetic effects

aliphatic

name all low potency typical antipsychotics under ALIPHATIC classification “prom”:

chlorpromazine (Thorazine-US, Largactil-France)
promethazine
trifluopromazine

name all low potency typical antipsychotics under PIPERIDINE classification: “rid”

thioridazine (Mellaril)
mesoridazine

(LOW / HIGH) potency refers to a type of typical antipsychotic drugs which causes EPS

high potency

name the classifications under high potency typical antipsychotics: ptb

piperazine
thioxanthine
butyrophenones

a classification under high potency typical antipsychotics that are known to be anti-emetics

piperazine

name all high potency typical antipsychotics under PIPERAZINE classification: “phen” - fcpat

fluphenazine (Modecate, Prolixin)
carphenazine
perphenazine
acetophenazine
trifluoperazine (Stelazine)

name all high potency typical antipsychotics under THIOXANTHINE classification: “thixene”

thiothixene (Novane)

a classification under high potency typical antipsychotics that are known to be the highest dopamine blockers

butyrophenones

name all high potency typical antipsychotics under BUTYROPHENONES classification: “ridol” hpd

haloperidol (Haldol)
pimozide (Orap)
droperidol (inapsine)

name the classifications under atypical antipsychotics:

dibenzamine
benzamide

name all atypical antipsychotics under DIBENZAMINE classification: “apine” - cloq

clozapine (Clorazil)
loxapine (Loxitane, Adasuve)
olanzapine (Zyprexa)
quetiapine (Seroquel)

name all atypical antipsychotics under BENZAMIDE classification: rrza

remoxipride (Roxiam)
risperidone (Risperidal, Risdin)
ziprasidone (Geodon)
aripiprazole (Abilify)

an atypical antipsychotic that is not a PROTON PUMP INHIBITOR, but an antipsychotic drug under benzamide classification

aripiprazole (Abilify)

an antipsychotic drug that treats psychosis by blocking the recycling of phospholipids, leading to the DECREASE of IIP3 and DAG

lithium (Lithase, Eskalith)

list other new antispychotic agents that are used to treat psychosis: CaLaVa

carbamazepine (Tergetrol)
lamotrigine (Lamictal)
valproic acid (Depakole, Convalex)

a brain disorder that causes unusual shift in mood, energy and activity levels

bipolar disorder

bipolar disorder is also known as __________________

manic-depressive illness

in bipolar disorder, symptoms during the MANIC phase include the ff:

becomes overly ___________________
talks very _______________
becomes (more/less) irritable
makes many _______________
requires (more/less) sleep
believes that he/she has __________
has racing ____________
may impulsively engage in ____________

elated and energetic
quickly
more
grand plans
less
powers or a special mission
thoughts
dangerous behaviors

in bipolar disorder, symptoms during the DEPRESSION phase include the ff: plhesns

feels ________
feels ________
feels ________
feels ________
feels ________
feels ________
experiences disturbances in _____________

persistently sad
lethargic
hopeless
excessively sad
suicidal
negative
sleep and appetite

name psychiatric clinical applications for typical antipsychotics

for schizophrenia and bipolar disorder

name nonpsychiatric clinical applications for typical antipsychotics that are under anticholinergic effects

anti-emesis

name nonpsychiatric applications for typical antipsychotics that are under antihistaminic effects

for preopeative sedation
for pruritus

typical antipsychotic drugs under BUTYROPHENONES are typically used for _______________ and _________________

huntington’s chorea and tourette syndrome

_________ (antipsychotic) + _______________ = neurolept analgesia

droperidol + fentanyl (Innovar)

_____________ + _______________ = neurolept anesthesia

neurolept analgesic + general anesthetic (NITROUS OXIDE)

(TYPICAL / ATYPICAL) antipsychotics are generally used to improve both positive and negative symptoms of schizophrenia

atypical

_________________ are atypical antipsychotics that are used for bipolar disorder; adjunct to lithium

olanzapine
risperidone

_________________ are atypical antipsychotics that are used for refractory schizophrenia

clozapine
olanzapine

list the autonomic adverse effects that happen when TYPICAL antipsychotics block the muscarinic receptors: cxuc
_____________(dilation of pupils)
____________ (dryness of mouth)
___________
___________

cyclopegia
xerostonia
urinary retention
constipation

list the autonomic adverse effects that happen when TYPICAL antipsychotics block the alpha receptors: oif
_____________
_____________
_____________

orthostatic hypotension
impotence
failure to ejaculate

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that pertains to difficulty in staying still; restlessness

akathesia

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that pertains to uncontrollable muscle contraction

dystonia

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that involve the following symptoms:

dragging leg
cramping of feet
involuntary pulling of neck
speech difficulties

dystonia

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that involve the following symptoms:

slow-pill rolling fingers
tremors
mask-like face
weakened voice
absence of arm swing
stiff
stooped posture
impaired shuffling gait

Parkinsonism / Pseudoparkinsonism / EPS

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that pertains to uncontrollable, stiff, jerky movements of face and body; it also includes symptoms like:

blinking of eyes
sticking out of tongue

tardive dyskinesia

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that is due to the excessive blockade of DA receptors

neuroleptic malignant syndrome

an adverse effect that occurs in the CNS when using TYPICAL antipsychotics that involve the following symptoms:

muscle rigidity, impaired or excessive sweating, sialorrhea

neuroleptic malignant syndrome

these drugs are used as treatment for neuroleptic malignant syndrome:
______________ (DA agonist)
______________

bromocriptine
dantrolene