NURS 660 LATEST
PSYCHOPHARM EXAM 1
Why do some antipsychotics increase prolactin? - ANSWERS-
Conventional antipsychotics are D2 antagonists and oppose dopamine's
inhibitory role on prolactin secretion from the pituitary lactotrophs. This
increases prolactin.
Serotonin and dopamine have reciprocal roles in regulation of prolactin
secretion from the pituitary prolactin lactotrophs.
What are extrapyamidal side effects - ANSWERS-Abnormal involuntary
movement disorders caused by a drug-induced imbalance between two
major neurotransmitter, dopamine and acetylcholine, in portions of the
brain. Too little dopamine in the nigrostriatal pathway and too much
acetylcholine.
Extrapyramidal Side Effects - ANSWERS-Acute dystonia
Akathisia
Pseudo-Parkinsonism
Tardive Dyskinesia
Acute dystonia - ANSWERS-Sustained muscle contraction in the face,
neck, trunk, or extremities, can affect the larynx. Oculogyric crisis can
be a dystonic reaction. Painful.
END OF
PAGE
1
, NURS 660 LATEST
PSYCHOPHARM EXAM 1
Onset- quickly, within hours.
Reversible with treatment of an anticholinergic, benadryl, benzotropine,
or congentin.
Akathisia - ANSWERS-Uncontrollable motor restlessness. Pace, fidget,
rock back and forth. Often misdiagnosed as anxiety, difficult to diagnose
Onset: typically occurs within days to weeks but within a month.
Reversible with beta blockers, benzos, can switch pt's medication.
First generation antipsychotics with high potency are highly likely to
produce akathisia.
pseudo-parkinsonism - ANSWERS-Rigidity, pill-rolling tremors,
bradykinesia (top 3), masked face, and shuffling gait. Does not progress
to Parkinson's, usually reversible.
Onset- Months to years (weeks but within a month-Langford)
Treat with amantadine and benzos
Tardive dyskinesia (TD) - ANSWERS-Late-onset (6 months to years)
Irreversible neurologic side effect, only 50% reversible
END OF
PAGE
2
, NURS 660 LATEST
PSYCHOPHARM EXAM 1
characterized by abnormal, involuntary movements such as lip
smacking, tongue protrusion, chewing, excessive blinking, grimacing,
irregular finger movements, and choreiform movements of the limbs and
feet
Older adults are at higher risk
Treatment- valbenazine, deutetrabenazine, benzos
Do not treat with anticholinergics.
Can test severity with AIMS test
Upregulation of dopamine 2 receptors - ANSWERS-Long term blockade
of D2 receptors in the nigrostritrial dopamine pathway can cause
upregulation of those receptors. May lead to TD as well as quick, jerky,
limb movements.
Upregulation may be the consequence of the neuron's futile attempt to
overcome drug induced blockade of its dopamine receptors
Downregulation of dopamine 2 receptors - ANSWERS-Process wherein
the postsynaptic neuron can make itself less sensitive to stimulation.
If a neuron is being activated too often, it can reduce the number of
receptors available on it's membrane, making itself less sensitive to
acitvation.
END OF
PAGE
3
PSYCHOPHARM EXAM 1
Why do some antipsychotics increase prolactin? - ANSWERS-
Conventional antipsychotics are D2 antagonists and oppose dopamine's
inhibitory role on prolactin secretion from the pituitary lactotrophs. This
increases prolactin.
Serotonin and dopamine have reciprocal roles in regulation of prolactin
secretion from the pituitary prolactin lactotrophs.
What are extrapyamidal side effects - ANSWERS-Abnormal involuntary
movement disorders caused by a drug-induced imbalance between two
major neurotransmitter, dopamine and acetylcholine, in portions of the
brain. Too little dopamine in the nigrostriatal pathway and too much
acetylcholine.
Extrapyramidal Side Effects - ANSWERS-Acute dystonia
Akathisia
Pseudo-Parkinsonism
Tardive Dyskinesia
Acute dystonia - ANSWERS-Sustained muscle contraction in the face,
neck, trunk, or extremities, can affect the larynx. Oculogyric crisis can
be a dystonic reaction. Painful.
END OF
PAGE
1
, NURS 660 LATEST
PSYCHOPHARM EXAM 1
Onset- quickly, within hours.
Reversible with treatment of an anticholinergic, benadryl, benzotropine,
or congentin.
Akathisia - ANSWERS-Uncontrollable motor restlessness. Pace, fidget,
rock back and forth. Often misdiagnosed as anxiety, difficult to diagnose
Onset: typically occurs within days to weeks but within a month.
Reversible with beta blockers, benzos, can switch pt's medication.
First generation antipsychotics with high potency are highly likely to
produce akathisia.
pseudo-parkinsonism - ANSWERS-Rigidity, pill-rolling tremors,
bradykinesia (top 3), masked face, and shuffling gait. Does not progress
to Parkinson's, usually reversible.
Onset- Months to years (weeks but within a month-Langford)
Treat with amantadine and benzos
Tardive dyskinesia (TD) - ANSWERS-Late-onset (6 months to years)
Irreversible neurologic side effect, only 50% reversible
END OF
PAGE
2
, NURS 660 LATEST
PSYCHOPHARM EXAM 1
characterized by abnormal, involuntary movements such as lip
smacking, tongue protrusion, chewing, excessive blinking, grimacing,
irregular finger movements, and choreiform movements of the limbs and
feet
Older adults are at higher risk
Treatment- valbenazine, deutetrabenazine, benzos
Do not treat with anticholinergics.
Can test severity with AIMS test
Upregulation of dopamine 2 receptors - ANSWERS-Long term blockade
of D2 receptors in the nigrostritrial dopamine pathway can cause
upregulation of those receptors. May lead to TD as well as quick, jerky,
limb movements.
Upregulation may be the consequence of the neuron's futile attempt to
overcome drug induced blockade of its dopamine receptors
Downregulation of dopamine 2 receptors - ANSWERS-Process wherein
the postsynaptic neuron can make itself less sensitive to stimulation.
If a neuron is being activated too often, it can reduce the number of
receptors available on it's membrane, making itself less sensitive to
acitvation.
END OF
PAGE
3
