Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pharmacology - ABIM
Kaplan Section 4 Chapter 1 CNS Pharm - Antidepressants
| Question | Answer |
|---|---|
| Name the positive symptoms of schizophrenia | 1. thought disorders 2. delusions 3. hallucinations 4. bizarre behavior |
| Name the negative symptoms of schizophrenia | 1. amotivation 2. social withdrawal 3. flat affect 4. poverty of speech |
| What is the dopamine hypothesis for schizophrenia | excess DA in the CNS |
| drugs that activate DA receptors cause what type of sx's? | psychotic sx's |
| drugs that antagonize DA receptors cause what type of sx's? | antipsychotic actions |
| anti-psychotic drugs block 3 types of receptors -- what are they? | D2a, M (atropine-like effects), and a (postural HTN, sexual dysfxn) |
| what are neuroleptics? | antipsychotic drugs |
| what are the effects of low potency vs. high potency antipsychotic drugs? | Low potency (chlorpromazine, thioridazine) -- 100s of mg range --> cause more autonomic dysfxn. High potency (fluphenazine, haloperidol) -- 10 to 50 mg range --> cuase more extrapyramidal side fx (less autonomic dysfxn). |
| what do haloperidol, pimozide, and high-potency phenothiazines have in common? | all have most intense DA receptor block --> reversible pseudo Parkinsonism (bradykinesia, rigidity, tremor), akathisia, acute dystonic rxns |
| What is dystonia? | sustained muscle contractions cause twisting and repetitive movements or abnormal postures |
| What is akathisia? | unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless |
| How do you fix acute dystonias? | Some may respond to botulinum toxin |
| What antipsychotic drugs are least likely to cause extrapyramidal dysfxn? | newer drugs: clozapine, olanzapine because don't block D2a receptors. They are 5HT2 receptor antagonists (serotonin). |
| Drugs that cause extrapyramidal dysfxn also cause what? | Block DA receptors in the pituitary --> inc prolactin --> endocrine dysfxn --> gynecomastia & amenorrhea-galactorrhea |
| Chlorpromazine, thioridazine, & fluphenazine -- what class of drugs? | antipsychotics, DA receptor antagonists |
| what is risperidone? | newer antipsychotic drug that blocks 5HT2 receptors |
| Chlorpromazine | antipsychotic; prototype penothiazine; low potency |
| Thioridazine | antipsychotic; penothiazine; low potency |
| Fluphenazine | antipsychotic; penothiazine; high potency |
| Haloperidol | antipsychotic; butyrophenone; high potency |
| what receptors does clozapine block? | D2c and 5HT2 |
| Why do people on clozapine have to have weekly blood tests? | the drug can cause agranulocytosis |
| Does clozapine cause extrapyramidal dysfunction? | no |
| Olanzapine | blocks 5HT2 receptors; improves negative sx's |
| Risperidone | blocks 5HT2 receptors; improves negative sx's; possible tardive dyskinesia |
| Which antipsychotic causes weight gain? | Clozapine |
| Which antipsychotic causes ocular dysfxn? | chlorpromazine |
| Which antipsychotic causes retinal deposits and cardiotoxicity (torsades - quinidine-like)? | thioridazine |
| Which antipsychotic can be given with long-acting depot forms? | haloperidol |
| Aripiprazole | Partial agonist of D2 receptor; blocks 5HT2 receptor |
| What is tardive dyskinesia? | choreoathetoid-like muscle movement associated with long-term use to DA blockers (esp haloperidol and high-potency phenothiazines) |
| Can tardive dyskinesia be reversed by stopping intake/administration of the DA blocker? | not readily |
| Should people with tardive dyskinesia be given M blockers? | no - will make the TD worse |
| Which two drugs have there been no reports of tardive dyskinesia? | Clozapine and olanzapine (5HT2 receptor blockers) |
| What is neuroleptic malignant syndrome? | life-threatening; extreme muscle rigidity, hyperthermia, CV instability, altered consciousness, enhanced sensitivity of DA receptors to blocking agents |
| How would you treat neuroleptic malignant syndrome? | bromocriptine (DA agonist) and dantrolene (muscle relaxant, treats malignant hyperthermia) + sx management |
| For which diseases would you use anti-psychotics? | schizophrenia, schizoaffective states, bipolar disorder, tourette syndrome, preoperative sedation, drug/radiation emesis, neurolept anesthesia (partially conscious) |
| How long does it take a schizophrenic patient to respond to drug therapy? | several weeks |
| What drug would you use for Tourette Syndrome? | DOC: Pimozide (intense DA receptor antagonist) |
| What drug would you use for preoperative sedation? | promethazine (minimal antipsychotic activity); H1 blocker; sedative |
| What drug would you use for drug/radiation emesis? | Proclorperazine |
| Can tardive dyskinesia be reversed by stopping intake/administration of the DA blocker? | droperidol, fentanyl, nitrous oxide |
Created by:
christinapham
Popular USMLE sets