Antipsych/Schitzo
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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
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| How effective are Antipsychotics in improving symptoms of Schizophrenia? | >60% of patients improve and maybe more w/ 2nd generations drugs
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| What are symptoms of an acute schizophrenic episode? | delusions (religous, grandiose, or persecutory) and hallucinations consisting of voices arguing or commenting on behavior
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| 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
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| What are the most common 2nd Generation (Atypical) Antipsychotics? | Aripiprazole (abilify), Clozapine (Clozaril), Quentiapine (Seroquel), and Risperidone (risperdal)
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| What is the Antipsychotic drug of choice? | 2nd Generation Antipyschotics because they have lower incidence of adverse effects, (especially EPSE) and improved efficacy
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| What is the MoA of 2nd Generation Antipsychotics? | Block serotonin and dopamine receptors
block alpha 1, h2, and muscarinic
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| 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
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| 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
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| 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
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| What are EPSE (extrapyramidal side effects)usually caused by? | Dopamine blockade which happens in 2nd gen. antipsychotics
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| What are the EPSE in order from least effective to most | Acute dystonia, akathisia, parkinsonism-like movement disorders, tardive dyskinesia
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| what is acute dystonia | EPSE develops within first days of antipsychotic therapy with symptoms of severe spasms of tongue, face, neck or back muscles
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| Is acute dystonia a medical emergency? | Yes, call 9-1-1 and treat with anticholinergic drugs
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| 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
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| 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
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| How is Akathisia treated? | May respond to anticholinergic drugs
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| How is Parkinsonism-like movement disorder treated? | anticholinergic drugs, amantadine, or propranolol
antiparkinson drugs (levodopa or bromocriptine) counteracts EPSE but worsens schizophrenia
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| 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
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| What effects can tardive dyskinesia have if not recognized early? | symptoms can be irriversible, can effect eating
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| 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
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| what are common 1st Generations (typical) Antipssychotics | Haloperidol (Haldol)
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| What is the MoA of 1st generation antipsychotics? | block dopamine receptors (mainly D2) which increases orthostatic hypotension and hyper pholactinimia
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| What is the therapeutic use of 1st gen antipsychotics | similar to 2nd gen. but less used for off-label uses, antiemetic
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| 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
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