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What is the cause of Schizophrenia unknown, but deals with excessive dopamine and possibly serotonin in brain, it is genetic and biological
How effective are Antipsychotics in improving symptoms of Schizophrenia? >60% of patients improve and maybe more w/ 2nd generations drugs
What are symptoms of an acute schizophrenic episode? delusions (religous, grandiose, or persecutory) and hallucinations consisting of voices arguing or commenting on behavior
After acute schizophrenic episodes, what may remain? residual symptoms including suspiciousness, anxiety, and diminsed judgement which make it difficult to maintain close relationship and employment
What are the most common 2nd Generation (Atypical) Antipsychotics? Aripiprazole (abilify), Clozapine (Clozaril), Quentiapine (Seroquel), and Risperidone (risperdal)
What is the Antipsychotic drug of choice? 2nd Generation Antipyschotics because they have lower incidence of adverse effects, (especially EPSE) and improved efficacy
What is the MoA of 2nd Generation Antipsychotics? Block serotonin and dopamine receptors block alpha 1, h2, and muscarinic
what is the main difference between 1st and 2nd generation antipsychotics? 2nd gen block serotonin receptors more than D2 receptors causing lower risk of extrapyramidal SE and less adverse effects while being more efficient
What is the therapeutic use of 2nd Generation antipsychotics/ FDA approved for schizophrenia, schizoaffective disorder, bipolar, treatment-resistant depression, agitations, rritability, and aggression in autism
What are some adverse effects of the 2nd generation Antipsychotics sedation, sexual dysfunction, poor blood glucose controle, risk of type 2 diabetes, antiholinergic SE, hyperprolactinemia, EPSE, weight gain, torsods, fatal dysrhythmia, ortho hypotention
What are EPSE (extrapyramidal side effects)usually caused by? Dopamine blockade which happens in 2nd gen. antipsychotics
What are the EPSE in order from least effective to most Acute dystonia, akathisia, parkinsonism-like movement disorders, tardive dyskinesia
what is acute dystonia EPSE develops within first days of antipsychotic therapy with symptoms of severe spasms of tongue, face, neck or back muscles
Is acute dystonia a medical emergency? Yes, call 9-1-1 and treat with anticholinergic drugs
What is Akathisia? EPSE occuring within first few months of therapy, showing symptoms of pacing, dquirming and need to be in motion. Mistaken for anxiety or exacerbation of psychoses
What is Parkinsonism-like movement disorders? occurs within first few months causing bradykinesia, drooling, tremor, rigidity, shuffling gait, cogwheeling, stooped posture overall slowness of movement and looks like parkinsons disease
How is Akathisia treated? May respond to anticholinergic drugs
How is Parkinsonism-like movement disorder treated? anticholinergic drugs, amantadine, or propranolol antiparkinson drugs (levodopa or bromocriptine) counteracts EPSE but worsens schizophrenia
What is Tardive Dyskinesia EPSE long-term therapy causes involuntary movement of tongue or face (rapid blinking, facial tics, lip-smacking, tongue twisting, tongue flicking out of mouth
What effects can tardive dyskinesia have if not recognized early? symptoms can be irriversible, can effect eating
how is tardive dyskinesia treated? if early: switch to 2nd gen agent or reduce doses, cannot use anticholinergic or anti-parkinsons drugs to reverse symptoms
what are common 1st Generations (typical) Antipssychotics Haloperidol (Haldol)
What is the MoA of 1st generation antipsychotics? block dopamine receptors (mainly D2) which increases orthostatic hypotension and hyper pholactinimia
What is the therapeutic use of 1st gen antipsychotics similar to 2nd gen. but less used for off-label uses, antiemetic
What are the adverse effects of 1st gen antipsychotics? same as 2nd gen with increased risk of EPSE and anticholinergic SE, orthostatic hypo, anticholinergic SE and sedation education
Created by: aamoore2245



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