P2-Anti-Psychotics
Percentage of chronic schizophrenic patients that are employed:
About 15%
"Positive" symptoms as a classification of schizophrenia include which one(s) of the following?
Agitation
#7
Atypical Antipsychotic Drugs and Side Effects
#4
CNS Drug Effects and Receptors
This antipsychotic medication exhibits superior effectiveness in treatment-refractory schizophrenia.
Clozapine
The CNS receptor system thought to mediate the actions of chlorpromazine:
Dopaminergic (D2)
Anxiety and depression, given that they are not associated with schizophrenia, respond better to anxiolytic agents.
False
Cognitive function is one CNS characteristic that remains unaffected by schizophrenia. (T/F)
False
Psychotic presentations involving delirium or dementia require treatment of relatively high antipsychotic drug doses, although these drugs have not been formally approved for dementia-related psychosis.
False
Sedation appears to be a necessary characteristic for antipsychotic drug activity.
False (newer not)
Which one of the following drugs exhibits the higher antipsychotic clinical potency?
Fluphenazine
#2
General Classification and Properties
#6
General Classifications and Properties
This antipsychotic drug is a buterophenone.
Haloperidol
#3
Lithium
Use of this/these agent as monotherapy in bipolar disorder maintenance has/have decreased due to metabolic effects including weight gain, hyperglycemia and hyperlipidemia.
Olanzapine
Least extrapyramidal side effects:
Olanzapine also has a low risk and is safer than clozapine
#5
Phenothiazine and Buterophenones
#1
Side Effects of Antipsychotics
This agent belongs to the phenothiazine derivative class of antipsychotic drugs.
Trifluoperazine
Aliphatic-type phenothiazine derivatives as well as piperidine derivatives are examples of the lease potent phenothiazine-type antipsychotic drugs.
True
For nearly all patients, antipsychotic medications represent the treatment of choice for management of schizophrenia.
True
Hallucinations and delusions represent "positive" symptoms of schizophrenia.
True
Haloperidol is an example of a buterophenone-type antipsychotic drug.
True
The cardiac effective Q-T prolongation has been associated with intramuscular droperidol an IV haloperidol administration. This complication has substantially limited the use of this formulation. ? True
True
The classical, "typical"first-generation antipsychotic medication is chlorpromazine.
True
The principal therapeutic mechanism for typically available antipsychotic medications appears to be either dopamine (D2) receptor blockade or modulation of dopamine activity (aripiprazole).
True
The symptom, hyperprolactinemia, is associated with D2 receptor activation in the tuberoinfundibular pathway.
True
Continuous treatment with antipsychotic medication decreases one-year relapse rate from about 80% among untreated patients to about 15%.
True/False
Patient treated with fluphenazine presents the following day with a unilateral stiff , sore neck and back; What was the neurological reaction--which drug treatments might be appropriate?
acute dystonia: benztropine (Cogentin)
Most common antipsychotic neurological side effect:
akathisia
Lithium carbonate is the preferred treatment for:
bipolar disorder
Accepted first alternative for treating patients with bipolar disorder not adequately responsive to lithium.
carbamazepine (Tegretol)
Associated with a LOW clinical potency but HIGH degree of sedation:
chlorpromazine (Thorazine)
Antipsychotic drug most likely to induce agranulocytosis (around 2% frequency)
clozapine
A schizophrenic patient has been treated with haloperidol, loxapine, thiothixene and lithium. If paranoid delusions persist, what other drug might be tried?
clozapine (Clozaril)
Antipsychotic drug with least extrapyramidal toxicity:
clozapine (Clozaril)
Lithium: polydipsia/polyuria due to:
collecting tubule in adequately responsive to ADH
Blockade of this receptor system most likely associated with akisthisia side effect of antipsychotic treatment:
dopamine
Neurochemical abnormality most closely associated with schizophrenia:
dopaminergic abnormality
At the molecular level, best defined lithium effect:
effect on inositol phosphates
Antipsychotic most appropriate in elderly patients with prostatic hypertrophy and chronic constipation.
haloperidol (Haldol)
Butyrophenone antipsychotic:
haloperidol (Haldol)
Side effects include anti-cholinergic, anti-adrenergic and extrapyramidal
haloperidol (Haldol)
Toxic-confusion states due to antipsychotic medication associated with effects on this receptor system
muscarinic cholinergic
Antipsychotic drug:least hypotensive effect:
olanzapine (Zyprexa)
Least likely to cause an increase in prolactin:
olanzapine (Zyprexa)
An example of an "atypical" antipsychotic agent:
risperidone (Risperdal)
Reasonable pharmacological step(s) to treat tardive dyskinesia:
start high-dose diazepam (30-40 milligrams per day)
Neurological adverse effect associated with antipsychotic drug use: occurs late in therapy
tardive dyskinesia
Ocular complication of antipsychotic drug treatment: causes retinal deposits; resembles an advance cases, retinitis pigmentosa
thioridazine (Mellaril)
Psychological effect of antipsychotic drugs taken by nonpsychotic individuals:
unpleasant, associated with decreased psychomotor performance
Effective in managing rapidly cycling bipolar disorder in lithium non-responding patient populations
valproic acid (Depakene, Depakote)
Concerning depression as a presentation of schizophrenia, which one(s) of the following is/are correct?
•Depression often is exhibited following acute psychotic episodes. •Depression may occur and be present independent of positive symptoms and may occur at any stage of schizophrenia.
Which one(s) of the following may be characteristic presentations of schizophrenia?
•Effective flattering, avolition, alogia •Catatonic behavior •Hallucinations •Delusions •Incoherent speech
Chlorpromazine, as an example, is a direct-acting dopamine D2-receptor blocker. Which one(s) of the following statements is/are correct?
•Excessive dopamine activity in the mesolimbic tract is likely associated with positive symptoms. •Reduced dopamine transmission in the mesocortical tract is likely associated with both "negative" symptoms and cognitive dysfunction.
Which one(s) of the following antipsychotic medications appear preferable in treating individuals presenting with delirium and dementia?
•Haloperidol •Risperidone
With this/these exceptions, atypical antipsychotic agents may be employed for management of acute mania.
•Iloperidone •Clozapine
Which one(s) of the following agents are classified as "typical" antipsychotic drugs?
•Molindone •Pimozide
Which one(s) of the following drugs are phenothiazine derivatives?
•Perphenazine •Fluphenazine
Demented patients unable to swallow tablets may require "oral dissolving tablets" (ODT) for administration of which one(s) of the following appropriate antipsychotic medication(s)?
•Risperidone •Olanzapine •Aripiprazole
Which one(s) of the following pathological states require(s) long-term treatment with antipsychotic drugs?
•Schizophrenia •Schizoaffective disorder •Delusional disorder
Site(s) of chlorpromazine (Thorazine) receptor blockade:
•alpha adrenergic receptor •muscarinic cholinergic receptor •H1 histaminic receptor •serotonin -- 5-HT2 receptor •
Reduction of lithium renal clearance:
•chlorothiazide (Diuril •newer, nonsteroidal anti-inflammatory agents
Antipsychotic endocrine effect(s):
•false-positive pregnancy tests •increased libido in women •decreased libido in men •amenorrhea-galactorrhea
Cardiovascular effects of "high-dose" (low-potency) phenothiazines:
•hypertension •increased peripheral resistance •increased stroke volume •shortening of the Q-T interval
Effective in treating acute dystonia caused by antipsychotic drugs:
•trihexyphenidyl (Artane) •amantidine (Symmetrel) •biperiden (Akineton)
