CS I Psych Pharm- STUDY GUIDE ANSWERS- Schizophrenia,
Bipolar
1. What are the 4 dopaminergic pathways of the brain involved in schizophre- nia?: nigrostriatal
mesolimbic
mesocortical
tuberoinfundibular
2. What is the role of the *nigrostriatal pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to motor movement
control
in Sz: relates to *treatment side effects* in Sz
treatment:
D2 blocking leads to *less DA, resulting in unwanted extrapyramidal side effects*;
5HT2a blockers lead to *more DA and fewer extrapyramidal side effects*
3. What is the role of the *mesolimbic pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to pleasure and
reward
in Sz: relates to *disease positive symptoms* from too much DA here. (Positives = halluc, delusions,
disorg speech, behavior, psychomotor agitation)
in Sz treatment:
1/
, CS I Psych Pharm- STUDY GUIDE ANSWERS- Schizophrenia,
Bipolar
D2 blockers lead to *decrease in positive Sz symptoms*; 5HT2a blockers *don't do much*
4. What is the role of the *mesocortical pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to motivation and
emotional response
in Sz: relates to *disease negative symptoms & cognitive symptoms* from too little DA here
(negatives = flat affect, alogia (less speech or low-content speech), no goal-directed behavior,
anhedonia)
in Sz treatment:
D2 blockers make the negative &cog Sx worse
5HT2a blockers lead to increase in DA and *decrease in negative & cog Sx*
2/
, CS I Psych Pharm- STUDY GUIDE ANSWERS- Schizophrenia,
Bipolar
5. What is the role of the *tuberoinfundibular pathway* in schizophrenia? How is it related to
the pathyophys of the disease and AEs of meds?: normal role:
DA release regulates PRL release
in Sz: relates to *treatment side effects*
in Sz treatment: D2 blockers here lead to increased PRL, an unwanted side effect. 5HT2a blockers here
lead to increase in DA and *decrease in PRL* (normal levels)
6. 1st Generation (Typical) Antipsychotics: What is their mechanism of ac- tion?: They relieve
the positive Sx of schizophrenia
by blocking D2 receptors in the mesolimbic path, and lead to side effects by blocking D2 receptors in
the nigrostriatal and tubero-inf. paths.
also block:
alpha-1-Rs, orthostatic HTN ADRs mAch-
Rs, anticholinergic ADRs
H1-Rs, wt gain and drowsiness ADRs
7. 1st Generation (Typical) Antipsychotics: What symptoms of schizophrenia do they alleviate?:
The relieve the positive symptoms like:
1. hallucinations
2. delusions
3. disorganized speech
3/
Bipolar
1. What are the 4 dopaminergic pathways of the brain involved in schizophre- nia?: nigrostriatal
mesolimbic
mesocortical
tuberoinfundibular
2. What is the role of the *nigrostriatal pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to motor movement
control
in Sz: relates to *treatment side effects* in Sz
treatment:
D2 blocking leads to *less DA, resulting in unwanted extrapyramidal side effects*;
5HT2a blockers lead to *more DA and fewer extrapyramidal side effects*
3. What is the role of the *mesolimbic pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to pleasure and
reward
in Sz: relates to *disease positive symptoms* from too much DA here. (Positives = halluc, delusions,
disorg speech, behavior, psychomotor agitation)
in Sz treatment:
1/
, CS I Psych Pharm- STUDY GUIDE ANSWERS- Schizophrenia,
Bipolar
D2 blockers lead to *decrease in positive Sz symptoms*; 5HT2a blockers *don't do much*
4. What is the role of the *mesocortical pathway* in schizophrenia? How is it related to the
pathyophys of the disease and AEs of meds?: normal role: DA release leads to motivation and
emotional response
in Sz: relates to *disease negative symptoms & cognitive symptoms* from too little DA here
(negatives = flat affect, alogia (less speech or low-content speech), no goal-directed behavior,
anhedonia)
in Sz treatment:
D2 blockers make the negative &cog Sx worse
5HT2a blockers lead to increase in DA and *decrease in negative & cog Sx*
2/
, CS I Psych Pharm- STUDY GUIDE ANSWERS- Schizophrenia,
Bipolar
5. What is the role of the *tuberoinfundibular pathway* in schizophrenia? How is it related to
the pathyophys of the disease and AEs of meds?: normal role:
DA release regulates PRL release
in Sz: relates to *treatment side effects*
in Sz treatment: D2 blockers here lead to increased PRL, an unwanted side effect. 5HT2a blockers here
lead to increase in DA and *decrease in PRL* (normal levels)
6. 1st Generation (Typical) Antipsychotics: What is their mechanism of ac- tion?: They relieve
the positive Sx of schizophrenia
by blocking D2 receptors in the mesolimbic path, and lead to side effects by blocking D2 receptors in
the nigrostriatal and tubero-inf. paths.
also block:
alpha-1-Rs, orthostatic HTN ADRs mAch-
Rs, anticholinergic ADRs
H1-Rs, wt gain and drowsiness ADRs
7. 1st Generation (Typical) Antipsychotics: What symptoms of schizophrenia do they alleviate?:
The relieve the positive symptoms like:
1. hallucinations
2. delusions
3. disorganized speech
3/
