Advanced Pharmacology -
Psychopharmacology study guide newest
review
What is the principal indication for antipsychotic medication? - ANS Schizophrenia, but many
are used for Bipolar Disorder as well.
What is schizophrenia? - ANS A chronic illness characterized by disordered thinking and
reduced comprehension of reality.
What 3 types of symptoms does schizophrenia include? - ANS 1. Positive symptoms -
hallucinations, delusions, and agitation. 2. Negative symptoms - blunted affect, poverty of
speech, and social withdrawal. 3. Cognitive dysfunction - disordered thinking, reduced ability to
focus attention, learning and memory difficulties.
What are the 2 groups of antipsychotic drugs called? - ANS 1. First Generation
Antipsychotics (FGA) 2. Second Generation Antipsychotics (SGA).
Which group of antipsychotics are more effective? FGA's or SGA's? - ANS They are equally
effective at treating schizophrenia.
What side effects do you see most often with FGA's? - ANS EPS - Dystonic Reactions,
Parkinsonism, Akathisia and Tardive Dyskinesia.
What is the biggest side effect risk you see with SGA's? - ANS Metabolic Syndromes -
Diabetes, Dyslipidemia, Weight Gain
Can you treat the elderly with dementia-related psychosis with antipsychotic medications? -
ANS No. Both groups increase the risk of mortality in these patients.
How quickly do you see improvement in symptoms with schizophrenia when adding an
antipsychotic drug? - ANS Initially, with adequate dosing, symptoms can begin to resolve
within 1-2 days. However, significant improvement takes 1-2 weeks and a full response may
take several months.
How do FGA's work? - ANS Strong blockade of D2 receptors.
How do SGA's work? - ANS Moderate blockade of D2 and strong blockade of 5HT receptors.
, What is the best treatment for an acute dystonic reactions and parkinsonism symptoms? -
ANS Anticholinergics - cogentin
What is the best treatment for akathisia? - ANS Beta blockers or benzodiazepines or
anticholinergics
How do you treat Tardive Dyskinesia? - ANS You can't really. If severe, sometimes switching
medication helps.
The risk of early EPS with FGA's is highest with high-potency meds rather than low potency
meds. When is the highest risk for TD? - ANS Equal risk with both.
A patient has a higher risk of these adverse effects with low potency FGA's. List them. - ANS
Sedation
Orthostatic hypotension
Anticholinergic effects .
What is neuroleptic syndrome? - ANS Rare but serious reaction that carries a 4% risk of
mortality. Primary symptoms:
"lead pipe" rigidity
sudden high fever
Sweating
Autonomic instability manifested as dysrhythmias and fluctuations in BP
LOC may rise or fall
May appear confused or mute
Seizures or coma may develop
Death can result from respiratory failure, CV collapse, dysrhythmias, and other causes.
**More likely with high potency FGA's!
How do you treat neuroleptic syndrome? - ANS Supportive measures
Drug therapy
Immediate DC'ing of antipsychotics
Cooling blankets
Antipyretics
Hydration
Benzo's to relieve anxiety and reduce BP and tachycardia
2 drugs: Dantrolene - reduces muscle rigidity and hyperthermia
Bromocriptine - may relieve CNS toxicity.
Acute symptoms of schizophrenia include delusions and hallucinations. What are a few of the
residual symptoms? - ANS 1. Suspiciousness
2. Poor anxiety management
3. Diminished judgment, insight, motivation, and capacity for self-care.
Psychopharmacology study guide newest
review
What is the principal indication for antipsychotic medication? - ANS Schizophrenia, but many
are used for Bipolar Disorder as well.
What is schizophrenia? - ANS A chronic illness characterized by disordered thinking and
reduced comprehension of reality.
What 3 types of symptoms does schizophrenia include? - ANS 1. Positive symptoms -
hallucinations, delusions, and agitation. 2. Negative symptoms - blunted affect, poverty of
speech, and social withdrawal. 3. Cognitive dysfunction - disordered thinking, reduced ability to
focus attention, learning and memory difficulties.
What are the 2 groups of antipsychotic drugs called? - ANS 1. First Generation
Antipsychotics (FGA) 2. Second Generation Antipsychotics (SGA).
Which group of antipsychotics are more effective? FGA's or SGA's? - ANS They are equally
effective at treating schizophrenia.
What side effects do you see most often with FGA's? - ANS EPS - Dystonic Reactions,
Parkinsonism, Akathisia and Tardive Dyskinesia.
What is the biggest side effect risk you see with SGA's? - ANS Metabolic Syndromes -
Diabetes, Dyslipidemia, Weight Gain
Can you treat the elderly with dementia-related psychosis with antipsychotic medications? -
ANS No. Both groups increase the risk of mortality in these patients.
How quickly do you see improvement in symptoms with schizophrenia when adding an
antipsychotic drug? - ANS Initially, with adequate dosing, symptoms can begin to resolve
within 1-2 days. However, significant improvement takes 1-2 weeks and a full response may
take several months.
How do FGA's work? - ANS Strong blockade of D2 receptors.
How do SGA's work? - ANS Moderate blockade of D2 and strong blockade of 5HT receptors.
, What is the best treatment for an acute dystonic reactions and parkinsonism symptoms? -
ANS Anticholinergics - cogentin
What is the best treatment for akathisia? - ANS Beta blockers or benzodiazepines or
anticholinergics
How do you treat Tardive Dyskinesia? - ANS You can't really. If severe, sometimes switching
medication helps.
The risk of early EPS with FGA's is highest with high-potency meds rather than low potency
meds. When is the highest risk for TD? - ANS Equal risk with both.
A patient has a higher risk of these adverse effects with low potency FGA's. List them. - ANS
Sedation
Orthostatic hypotension
Anticholinergic effects .
What is neuroleptic syndrome? - ANS Rare but serious reaction that carries a 4% risk of
mortality. Primary symptoms:
"lead pipe" rigidity
sudden high fever
Sweating
Autonomic instability manifested as dysrhythmias and fluctuations in BP
LOC may rise or fall
May appear confused or mute
Seizures or coma may develop
Death can result from respiratory failure, CV collapse, dysrhythmias, and other causes.
**More likely with high potency FGA's!
How do you treat neuroleptic syndrome? - ANS Supportive measures
Drug therapy
Immediate DC'ing of antipsychotics
Cooling blankets
Antipyretics
Hydration
Benzo's to relieve anxiety and reduce BP and tachycardia
2 drugs: Dantrolene - reduces muscle rigidity and hyperthermia
Bromocriptine - may relieve CNS toxicity.
Acute symptoms of schizophrenia include delusions and hallucinations. What are a few of the
residual symptoms? - ANS 1. Suspiciousness
2. Poor anxiety management
3. Diminished judgment, insight, motivation, and capacity for self-care.
