NURS660 Psychopharm 660 Exam 1 review 2024
For assistance with assignments and revision materials contact informationhimher@gmail.com 1.Positive Symptoms of Schizophrenia: Delusions, hallucinations, distortions, agitation, disorganized speech, disorganized behavior
2.Where do positive symptoms originate?: Mesolimbic dopamine pathway
3.Medications to treat positive symptoms: Antipsychotics
4.Negative symptoms of schizophrenia: Flat affect, alogia, affective blunting, asociality, anhedonia, avolition.
5.Where do negative symptoms originate?: Mesocortical dopamine pathway. May also involve mesolimbic regions such as nucleus accumbens
6.Medications to treat negative symptoms: Vraylar, amisulpride
7.Hypotheses of Schizophrenia: -Mesolimbic pathway is hypothesized to be hy- peractive resulting in excess dopamine at the synapse.
-The gluatamate activity at NMDA receptors is hypofunctional
8.Mesolimbic Pathway Theory of Schizophrenia: Mesolimbic pathway is hy- peractive, resulting in excess dopamine at the synapse which leads to positive symptoms. Hyperactivity of mesolimbic dopamine neurons may also play a role in aggression and hostile symptoms.
9.Five Different Dopamine Pathways in the brain: -Nigrostriatal Dopamine Path- way
-Mesolimbic dopamine pathway
-Mesocorticol dopamine pathway
-Tuberoinfundibular dopamine pathway
-Thalamic dopamine pathway
10.Nigrostriatal pathway: Projects from the substantia nigra to the basal ganglia or striatum.
-Part of the extrapyramidal nervous system
-Controls motor function and movement
-When dopamine is deficient, can cause parkinsonism with tremor, rigidity, and akinesia/bradykinesia
-Excess dopamine- can cause hyperkinetic movements, such as tics and dyskine- sias
11.Mesolimbic dopamine pathway: Projects from the midbrain ventral tegmental area to the
nucleus accumbens (part of limbic system) where many behaviors such as pleasurable
sensations, the powerful euphoria of drug abuse as well as delusions and hallucinations.
12.Mesocortical pathway: Projects from the ventral tegmental area to the pre- frontal cortex
and is important for cognition
13.Tuberofundibular pathway: Projects from the hypothalamus to the anterior pituitary gland
and controls prolaction secretion NURS660 Psychopharm 660 Exam 1 review 2024
For assistance with assignments and revision materials contact informationhimher@gmail.com 14.Thalamic pathway: Arises from multiple sites.
-Function not well known, may be involved in sleep and arousal mechanisms
15.Major neurotransmitters involved in schizophrenia: -Dopamine
-Glutamate
16.Dopamine and Schizophrenia: Major neurotransmitter in schizophrenia Some atypical psychotics block dopamine receptors
Increased in schizophrenia
17.Glutamate and schizophrenia: Considered the "master switch" of the brain. Glutamate is the major excitatory neurotransmitter of the CNS as it can turn on nearly all of the CNS neurons
Decreased in schizophrenia
18.Neuroleptic Malignant Syndrome: -Adverse reaction to antipsychotics with severe "lead pipe" rigidity, FEVER, and mental status changes
-Lab findings- increased CK, leukocytosis, low serum iron
-Caused by dopamine antagonists
-Slower in onset, 1-2 weeks after starting/changing therapy.
-Manage by stopping causative agent, supportive care, ECT, Dantrolene, bromocrip- tine, and amantadine.
19.Serotonin Syndrome: -Caused by serotonergic agents
-Hyperreflexia, myoclonus, ocular clonus
-Manage by stopping all serotonergic agents, supportive care aimed at normaliza- tion of vitals,
sedation with benzos, administration of serotonergic antagonists, and antidote therapy with
cyproheptadine
-Assess need to resume use of causative serotonergic meds after resolution of symptoms
-Symptoms seen within 24 hours of starting/changing therapy.
20.The "-pine" family: Have 5-HT2A and D2 antagonism. Strong potency for H1 and muscarinic receptors Clozapine, Olanzapine, Quetiapine,
21.Clozapine: Atypical Antipsychotic
SE: AGRANULOCYTOSIS- ANC blood testing prior, during. Can be very sedating, excessive
salivation, Increased risk of myocarditis, Greatest degree of weight gain and possibly greatest
cardiometabolic risk
Indications- treatment resistant schizophrenia, reducing suicidal behavior
22.Drug interactions with Clozapine: Potential to increase levels: SSRIS, cipro, cimetidine,
macrolides, caffeine
Potential to decrease levels: Carbamazepine, rifampicin, SJW, Omeprazole, Pheny- toin,
Phenobarbital
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