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pharm quiz 4.3

Schizophrenia & Anti-psychotics

QuestionAnswer
Schizophrenia is thought to involve what? excessive dopamine & possibly serotonin in the brain, has a genetic component
How frequent is is schizophrenia in the US? How does this change with a second degree relative or a first degree relative with schizophrenia? If both parents have schizophrenia? 1% of the population; second degree relative- increases to 3%, first degree relative- increases to 10%; both parents- 40%
When does Schizophrenia develop/emerge? Emerges in adolescence and early adulthood or after age 40
How effective are anti-psychotics in improving symptoms? over 60% of patients see improvement, and 2nd generation drugs show more promising effects
Clinical features of schizophrenia? Acute episode- delusions and hallucinations which are typically religious, grandiose, or persecutory; Auditory hallucinations may include voices arguing or commenting on one's behavior; Residual symptoms may remain, including suspiciousness, anxiety
Positive symptoms of Schizophrenia? -5 Hallucinations (Auditory >> visual), delusions, agitation, tension, paranoia
Negative symptoms of Schizophrenia? -5 Lack of motivation, blunted affect, poor self-care, social withdrawal, little speaking
Cognitive symptoms of Schizophrenia? -4 Impaired attention, short-term memory, executive function, verbal fluency
2nd Generation Antipsychotics *examples* -4 clozapine (Clozaril), olanzepine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal)
Mechanism of Action of 2nd generation antipsychotics? Block serotonin and various dopamine receptors, also a varying degree of alpha1 blocking, H2 blocking, and muscarinic blocking properties
Main differences between 1st % 2nd generation antipsychotics? -3 2nd generation bock serotonin and D1&D2 receptors while 1st gen. effect only D2; 2nd gen. have less adverse side effects, especially EPSE, and possible improved efficacy; 2nd gen. are better at relieving negative and cognitive symptoms
Therapeutic uses of antipsychotics? -4 FDA approved, -3 off-lable Schizophrenia, bipolar disorder, treatment-resistance depression, agitation/irritability/&aggression in Autism spectrum disorder; Behav. disorders in dementia and delusion disorders, management of personality disorders, suppression of severe Tourette's
Adverse effects of antipsychotics? -11 Sedation; sexual dysfunction; poor blood glucose control and risk of Type 2 diabetes; weight gain; anticholinergic side effects; hyperprolactinemia; EPSE; increased risk of CVA, QT prolongation, OrthoHTN, Anticholinergic effects
What side effects are included in The Extrapyramidal Side Effects (EPSE) -4 Acute Dystonia (within 1-3 days, spasms); Akathisia (1-3 months, constant motion); Parkinsonism-like movement disorders (1-3 months, slow down); and Tardive Dyskenesia (long term, uncontrolled movement).
Which EPSE symptoms can be treated with anticholinergic drugs? -3 Acute Dystonia, Akathisia, and Parkinsonism-like movement disorders
What specific life-threatening side effect is caused by Clozapine? can cause agranulocytis, a life threatening low level of platelets in the blood
1st Generation Antipsychotics *example* (1) Haloperidol (Haldol)
Mechanism of action for 1st Gen Antipsychotic/Haloperidol? Block dopamine receptors, mainly D2, in certain areas of the brain, effective for positive symptoms, not effective for negative or cognitive symptoms
Therapeutic uses for 1st Gen Antipsychotic/Haloperidol? similar to 2nd gen.; less used for off-lable uses
Adverse effects for 1st Gen Antipsychotic/Haloperidol? Same with 2nd gen, but increased risk of EPSE and anticholinergic side effects, OrthoHypoTN, sedation.
General treatment of Schizophrenia includes: -4 2nd gen. first-line; symptoms begin to resolve 1-2 days, significant improvement in 1-2 weeks, full response after several months, withdrawal associated with relapse, use min. dose
Created by: hcress08
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