MSN 671 FINAL STUDY GUIDE
Classic synaptic neurotransmission - Answer -Action potential traveling down the
presynaptic axon. Upon reaching the terminal Ca²⁺ enters through voltage-sensitive
calcium channels, triggering the exocytosis of neurotransmitter-filled vesicles into the
synaptic cleft. The released neurotransmitters (e.g., dopamine, serotonin,
norepinephrine) then bind to postsynaptic receptors, initiating a new electrical signal in
the receiving neuron.
Ligand-gated ion channel - Answer -open upon neurotransmitter binding to allow rapid
ion passage
Voltage-sensitive ion channel - Answer -open in response to electrical changes to
propagate action potentials.
Sodium-charged ion channel - Answer -type of voltage-sensitive channel essential for
depolarization
Presynaptic transporter - Answer -(DAT, SERT, NET) clear neurotransmitters from the
cleft to end the signal
Norepinephrine (NE) - Answer -Regulates attention and arousal; low levels may result
in ADHD/depression, while high levels can lead to anxiety
Acetylcholine - Answer -Crucial for memory and learning; deficiency is linked to
Alzheimer's disease, whereas excess may cause muscle cramps/seizures
Melatonin - Answer -Synthesized in the pineal gland during darkness, it regulates the
circadian rhythm and promotes sleep
Serotonin - Answer -Modulates mood and appetite; its deficiency can cause
depression/anxiety, and excess may trigger serotonin syndrome
Dopamine - Answer -Key for reward and motor control; deficiency is associated with
Parkinson's and depression, while excess is linked to schizophrenia
GABA - Answer -Provides inhibitory control to prevent neuronal overexcitation; low
levels may lead to anxiety and seizures, high levels to sedation
Histamine - Answer -Maintains wakefulness; overactivity can cause insomnia, and
blockade (by some antipsychotics) results in sedation and weight gain
Process of melatonin production - Answer -During darkness, the pineal gland
synthesizes melatonin from serotonin using N-acetyltransferase. Melatonin levels rise at
night, signaling sleep onset by acting on MT1/MT2 receptors to regulate the circadian
rhythm
, Causes Tardive Dyskinesia with an antipsychotic - Answer -Tardive dyskinesia results
from chronic blockade of dopamine D2 receptors (notably by typical antipsychotics like
haloperidol). This leads to dopamine receptor upregulation and supersensitivity, causing
involuntary, repetitive movements
Mechanism of Antipsychotics cause breast discharge - Answer -By blocking D2
receptors in the tuberoinfundibular pathway, antipsychotics reduce dopamine's inhibitory
effect on prolactin secretion, causing hyperprolactinemia and subsequent breast
discharge (galactorrhea)
Antipsychotic metabolic monitoring/labs - Answer -fasting blood glucose, lipid profile,
weight/BMI, waist circumference, and blood pressure. Additional labs such as liver
enzymes and prolactin levels (especially with risperidone)
treatments for bipolar depression - Answer -quetiapine and lurasidone. Quetiapine acts
as a dopamine and serotonin receptor modulator, while lurasidone primarily
antagonizes 5HT2A receptors with partial D2 activity, contributing to mood stabilization
augmenting SSRIs/SNRIs in unipolar depression - Answer -atypical antipsychotics like
aripiprazole and brexpiprazole, and agents such as bupropion, which enhance
dopamine and norepinephrine transmission to improve treatment response
Antipsychotic weight gain risk - Answer -Clozapine highest risk, chlorpromazine
mild/moderate
Antipsychotic sedation risks - Answer -Highest - Clozapine, quetiapine
Moderate - olanzapine
Minimal - risperidone, aripiprazole, ziprasidone
Antispsychotic breast discharge risks - Answer -Risperidone
Antipsychotic: Anticholinergic/Antihistaminic binding activity - Answer -Highest -
Clozapine, olanzapine,
Moderate - quetiapine
Minimal - risperidone, aripiprazole, ziprasidone
Antipsychotic: Motor effects (EPS symptoms) - Answer -Highest: typical antipsychotics,
haloperidol & fluphenazine EPS symptoms
Moderate: Risperidone atypical
Lowest: Atypical clozapine, quetiapine
Antipsychotics: Metabolic risks comparison - Answer -Typical antipsychotics, such as
haloperidol and fluphenazine, generally exhibit a receptor binding profile that results in
fewer metabolic disturbances compared to atypical antipsychotics
Classic synaptic neurotransmission - Answer -Action potential traveling down the
presynaptic axon. Upon reaching the terminal Ca²⁺ enters through voltage-sensitive
calcium channels, triggering the exocytosis of neurotransmitter-filled vesicles into the
synaptic cleft. The released neurotransmitters (e.g., dopamine, serotonin,
norepinephrine) then bind to postsynaptic receptors, initiating a new electrical signal in
the receiving neuron.
Ligand-gated ion channel - Answer -open upon neurotransmitter binding to allow rapid
ion passage
Voltage-sensitive ion channel - Answer -open in response to electrical changes to
propagate action potentials.
Sodium-charged ion channel - Answer -type of voltage-sensitive channel essential for
depolarization
Presynaptic transporter - Answer -(DAT, SERT, NET) clear neurotransmitters from the
cleft to end the signal
Norepinephrine (NE) - Answer -Regulates attention and arousal; low levels may result
in ADHD/depression, while high levels can lead to anxiety
Acetylcholine - Answer -Crucial for memory and learning; deficiency is linked to
Alzheimer's disease, whereas excess may cause muscle cramps/seizures
Melatonin - Answer -Synthesized in the pineal gland during darkness, it regulates the
circadian rhythm and promotes sleep
Serotonin - Answer -Modulates mood and appetite; its deficiency can cause
depression/anxiety, and excess may trigger serotonin syndrome
Dopamine - Answer -Key for reward and motor control; deficiency is associated with
Parkinson's and depression, while excess is linked to schizophrenia
GABA - Answer -Provides inhibitory control to prevent neuronal overexcitation; low
levels may lead to anxiety and seizures, high levels to sedation
Histamine - Answer -Maintains wakefulness; overactivity can cause insomnia, and
blockade (by some antipsychotics) results in sedation and weight gain
Process of melatonin production - Answer -During darkness, the pineal gland
synthesizes melatonin from serotonin using N-acetyltransferase. Melatonin levels rise at
night, signaling sleep onset by acting on MT1/MT2 receptors to regulate the circadian
rhythm
, Causes Tardive Dyskinesia with an antipsychotic - Answer -Tardive dyskinesia results
from chronic blockade of dopamine D2 receptors (notably by typical antipsychotics like
haloperidol). This leads to dopamine receptor upregulation and supersensitivity, causing
involuntary, repetitive movements
Mechanism of Antipsychotics cause breast discharge - Answer -By blocking D2
receptors in the tuberoinfundibular pathway, antipsychotics reduce dopamine's inhibitory
effect on prolactin secretion, causing hyperprolactinemia and subsequent breast
discharge (galactorrhea)
Antipsychotic metabolic monitoring/labs - Answer -fasting blood glucose, lipid profile,
weight/BMI, waist circumference, and blood pressure. Additional labs such as liver
enzymes and prolactin levels (especially with risperidone)
treatments for bipolar depression - Answer -quetiapine and lurasidone. Quetiapine acts
as a dopamine and serotonin receptor modulator, while lurasidone primarily
antagonizes 5HT2A receptors with partial D2 activity, contributing to mood stabilization
augmenting SSRIs/SNRIs in unipolar depression - Answer -atypical antipsychotics like
aripiprazole and brexpiprazole, and agents such as bupropion, which enhance
dopamine and norepinephrine transmission to improve treatment response
Antipsychotic weight gain risk - Answer -Clozapine highest risk, chlorpromazine
mild/moderate
Antipsychotic sedation risks - Answer -Highest - Clozapine, quetiapine
Moderate - olanzapine
Minimal - risperidone, aripiprazole, ziprasidone
Antispsychotic breast discharge risks - Answer -Risperidone
Antipsychotic: Anticholinergic/Antihistaminic binding activity - Answer -Highest -
Clozapine, olanzapine,
Moderate - quetiapine
Minimal - risperidone, aripiprazole, ziprasidone
Antipsychotic: Motor effects (EPS symptoms) - Answer -Highest: typical antipsychotics,
haloperidol & fluphenazine EPS symptoms
Moderate: Risperidone atypical
Lowest: Atypical clozapine, quetiapine
Antipsychotics: Metabolic risks comparison - Answer -Typical antipsychotics, such as
haloperidol and fluphenazine, generally exhibit a receptor binding profile that results in
fewer metabolic disturbances compared to atypical antipsychotics
