10 - Psychotherapeutic Drugs

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TYPICAL

Ratio: Prochlorperazine is a 1st Generation Anti-Psychotic | ANTI-EMETIC

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TYPICAL

Ratio: Prochlorperazine is a 1st Generation Anti-Psychotic | ANTI-EMETIC

ATYPICAL OR TYPICAL?

  1. Prochlorperazine

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DOC for Hiccups

Uses of the drug:

  1. Chlorpromazine

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Antihistamine

Uses of the drug:

3. Promethazine

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Management of Irritability for Autistic

Uses of the drug:

  1. Aripiprazole

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For tardive dyskinesia

Uses of the drug:

  1. Clozipine

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a. Haloperidol

  1. Which of the ff drug has the highest Dopamine-2 Receptor blockade?

    a. Haloperidol

    b. Clozapine

    c. Aripiprazole

    d. Chlorpromazine

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b. Atypical Anti psychotic

  1. Clozapine is a

    a. Typical antipsychotic

    b. Atypical Anti psychotic

    c. anti seizure

    d. anti-parkinsonism

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b. Olanzapine

  1. Atypical anti-psychotic

    a. Chlorpromazine

    b. Olanzapine

    c. Haloperidol

    d. Thioridazine

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PSYCHOSES/SCHIZOPRENIA

exhibit gross disturbances in their comprehension of reality, as evidenced by false perceptions (hallucinations) and false beliefs (delusions)

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mesoCORTICAL pathway

  • Dopamine travels from the midbrain to the prefrontal lobe cortex

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↓ neurotransmission of DA

Problem w/ mesoCORTICAL pathway

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  • anhedonia,

  • alogia,

  • apathy

mesoCORTICAL pathway can result to (-) symptoms:

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increase DA neurotransmission by giving atypical

Goal therapy for mesoCORTICAL pathway’s problem:

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mesoLIMBIC pathway

Dopamine travels from the midbrain tegmental area to the nucleus accumbens

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↑neurotransmission of dopamine

Problem w/ mesoLIMBIC pathway

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  • agitation,

  • delusion,

  • disorganized thinking,

  • speech,

  • schizophrenia

mesoLIMBIC pathway can result to (+) symptoms:

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decrease DA neurotransmission by giving typicals

Goal therapy for mesoLIMBIC pathway’s problem:

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NIGROSTRIATAL PATHWAY

The pathway from the substantia nigra to the striatum (involved in the coordination of body movements)

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Inhibition of this pathway causes the extrapyramidal side effects of antipsychotic drugs (typicals)

Problem w/ NIGROSTRIATAL PATHWAY

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TUBEROINFUNDIBULAR PATHWAY

The pathway from the hypothalamus to the pituitary inhibits the release of prolactin.

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HYPERPROLACTINEMIA

Inhibition of TUBEROINFUNDIBULAR PATHWAY pathway leads to:

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D2 > 5HT2

Typical receptor blockade

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5HT2 > D2

Atypical has a great affinity in

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Effective

Effective or Not Effective

Typical in positive symptoms

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Effective

Effective or Not Effective

Atypical in positive symptoms

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Less effective

Less effective or more Effective

Typical in negative symptoms

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More effective

Less effective or more Effective

Atypical in negative symptoms

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More case

Less effective or more Effective

Typical in Extrapyramidal effects

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Less case

Less effective or more Effective

Atypical in Extrapyramidal effects

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More case

Less effective or more Effective

Typical in Tardive Dyskinesia

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Less case

Less case or more case

Atypical in Tardive Dyskinesia

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TRUE

TRUE or FALSE

Atypical agents is beneficial to schizophrenia but it’s expensive

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Haloperidol

highest activity to block dopamine 2

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ANTIPSYCHOTIC DRUGS

  • reduce psychotic symptoms and improve the behavior of schizophrenic patients

  • aka neuroleptic drugs because they suppress motor activity and emotional expression

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neuroleptic drugs

ANTIPSYCHOTIC DRUGS is also known as _ because they suppress motor activity and emotional expression

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Typical Antipsychotic Agents

1st generation Antipsychotic Agents

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  • EPS,

  • Tardive dyskinesia,

  • Anticholinergic effects (Thioridazine),

  • Neuroleptic malignant syndrome

A/E of Typical Antipsychotic Agents

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  • Fluphenazine

  • Trifluoperazine

  • Thiothixene

  • Haloperidol

High Potency Typical Antipsychotic Agents

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  • Chlorpromazine

  • Thioridazine

Low Potency Typical Antipsychotic Agents

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  • Loxapine

Intermediate Potency Typical Antipsychotic Agents

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  • Clozapine

  • Olanzapine

  • Risperidone

  • Aripiprazole

2nd generation Antipsychotic Agents

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Clozapine

  • the first of a new generation of atypical antipsychotic drugs

  • less EPS

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sedation & autonomic side effects, potentially fatal Agranulocytosis

Clozapine A/E:

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Olanzapine

  • causes fewer ANS

  • NO agranulocytosis reports

  • S/Es: sedation, weight gain

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sedation, weight gain

Olanzapine S/E

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Risperidone

  • properties similar to olanzapine, but it appears to cause less sedation

  • S/Es: orthostatic hypotension cardiotoxicity (QT interval prolongation

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Aripiprazole

  • partial agonist at dopamine and 5-HT1A receptors

  • first drug approved to treat irritability in autistic children

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orthostatic hypotension cardiotoxicity (QT interval prolongation)

Risperidone S/Es:

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Chlorpromazine

DOC for hiccups

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Haloperidol

Tx for Tourette

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Clozapine

5HT2 = D4 > D2

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