Chapter 3 – (don’t forget to review her slides since we didn’t have class)
1. Abnormal involuntary movement scale (AIMS) (p. 68) – a scale to monitor the involuntary movements
after administration of the conventional antipsychotic agents.
2. Antagonists (p. 68) – Drugs that block or depress the normal response of a specific receptor by only
partly fitting the receptor site. Conventional Antipsychotics are strong antagonists.
3. Antianxiety (anxiolytic) drugs (p. 61)
A. Benzodiazepines –
o First line drug for seizures (anticonvulsants)
o Ability to reduce the neuronal overexcitement of alcohol withdrawal.
o Used alone, rarely causes resp. depression, coma, and death
o Combined with CNS depressants (alcohol, opiates, TCAs) inhibitory actions of benzos can
lead to CNS Depression
o Cautioned about engaging in activities that could be dangerous if reflexes and attention
are impaired
o In order adults, may contribute to falls and broken bones.
o Ataxia is a common side effect
o can cause sedation at higher therapeutic doses.
Diazepam (Valium)
Clonazepam (Klonopin)
Alprazolam (Xanax) - reduce anxiety w/o the soporific (sleep producing
effect)
Lorazepam (Ativan) – reduce anxiety w/o the soporific (sleep producing
effect)
Flurazepam (Dalmane) – tx for insomnia w/ an hypnotic effect.
Temazepam (Restoril) – tx for insomnia w/ an hypnotic effect.
Triazolam (Halcion) – tx for insomnia w/ an hypnotic effect.
Estazolam (ProSom) – tx for insomnia w/ an hypnotic effect.
Quazepam (Doral) – tx for insomnia w/ an hypnotic effect.
4. Anticholinesterase drugs (p. 71) -
Also known as Cholinesterase Inhibitors
Treatment for Alzheimer’s Disease – slows the rate of memory loss and in some patients may
even improve memory.
Tacrine (Cognex) – acetylcholinesterase inhibitor - not used extensively because of its risk for
hepatic toxicity
Donepezil (Aricept) - acetylcholinesterase inhibitor
Galantamaine (Razadyne) - acetylcholinesterase inhibitor
Revastigmine (Exelon) – acetylcholinesterase inhibitor
Memantine (Namenda) – non-competitive NMDA receptor antagonist
5. Atypical antipsychotics as a class (p. 69) –
Page 1 of 12
, Second Generation of antipsychotic drugs
Produce fewer extrapyramidal side effects
Target both the negative and positive symptoms of schizophrenia
Bind to dopamine receptors in the limbic system
Dopamine and serotonin antagonist
Decrease motor side effects
Increase the risk for metabolic syndrome
Clozapine & olanzapine have highest risk for metabolic syndrome while aripiprazole and
ziprasidon have the lowest
Increase weight, blood glucose and triglycerides
A. Clozaril (clozapine) (p. 70) –
o Free of the motor side effects
o Potential to suppress bone marrow and induce agranulocytosis
o Regular measurement of white blood cell count is required – the count is
measured weekly for the first 6 months, every other week for the next 6
months, and monthly thereafter.
o Potential for inducing convulsions
o Potential for myocarditis and should be monitored
o Common side effects are drowsiness, sedation, hypersalivation, weight gain,
reflex tachycardia, constipation, and dizziness.
6. Basal ganglia (p. 54 & p. 55) – Located in the pockets of integrating gray matter deep within the
cerebrum. Involved in the regulation of movement, emotions, and basic drives.
7. Brain imaging techniques, Table 3-2, (p. 55) A variety of noninvasive imaging techniques used to
visualize brain structure, functions, and metabolic activity.
A. Structural – CT and MRI – identify gross anatomical changes in the brain.
B. Functional – PET and SPECT – reveal physiological activity in the brain.
PET scans are useful in identifying phys. And biochemical changes as they occur.
Schizophrenic patients – PET scans show decreased use of glucose in the frontal lobes
Patients with OCD – PET scan shows increased brain metabolism
Patients with depression – PET scans show decreased brain activity in the prefrontal cortex.
8. Circadian rhythms (p. 48) – the cycle of sleep and wakefulness is only one aspect of circadian rhythms.
Fluctuation of various physiological and behavioral parameters over a 24-hour cycle. Other variations
include body temp, secretion of hormones such as corticotropin and cortisol, and secretions of neurotransmitters
such as norepinephrine and serotonin which affect mood.
9. Conventional antipsychotics (p. 68) – Figure 3-19 Pg. 69 – Shows symptoms of each block
First generation antipsychotic drugs – (the book did not list any drug names)
Page 2 of 12
1. Abnormal involuntary movement scale (AIMS) (p. 68) – a scale to monitor the involuntary movements
after administration of the conventional antipsychotic agents.
2. Antagonists (p. 68) – Drugs that block or depress the normal response of a specific receptor by only
partly fitting the receptor site. Conventional Antipsychotics are strong antagonists.
3. Antianxiety (anxiolytic) drugs (p. 61)
A. Benzodiazepines –
o First line drug for seizures (anticonvulsants)
o Ability to reduce the neuronal overexcitement of alcohol withdrawal.
o Used alone, rarely causes resp. depression, coma, and death
o Combined with CNS depressants (alcohol, opiates, TCAs) inhibitory actions of benzos can
lead to CNS Depression
o Cautioned about engaging in activities that could be dangerous if reflexes and attention
are impaired
o In order adults, may contribute to falls and broken bones.
o Ataxia is a common side effect
o can cause sedation at higher therapeutic doses.
Diazepam (Valium)
Clonazepam (Klonopin)
Alprazolam (Xanax) - reduce anxiety w/o the soporific (sleep producing
effect)
Lorazepam (Ativan) – reduce anxiety w/o the soporific (sleep producing
effect)
Flurazepam (Dalmane) – tx for insomnia w/ an hypnotic effect.
Temazepam (Restoril) – tx for insomnia w/ an hypnotic effect.
Triazolam (Halcion) – tx for insomnia w/ an hypnotic effect.
Estazolam (ProSom) – tx for insomnia w/ an hypnotic effect.
Quazepam (Doral) – tx for insomnia w/ an hypnotic effect.
4. Anticholinesterase drugs (p. 71) -
Also known as Cholinesterase Inhibitors
Treatment for Alzheimer’s Disease – slows the rate of memory loss and in some patients may
even improve memory.
Tacrine (Cognex) – acetylcholinesterase inhibitor - not used extensively because of its risk for
hepatic toxicity
Donepezil (Aricept) - acetylcholinesterase inhibitor
Galantamaine (Razadyne) - acetylcholinesterase inhibitor
Revastigmine (Exelon) – acetylcholinesterase inhibitor
Memantine (Namenda) – non-competitive NMDA receptor antagonist
5. Atypical antipsychotics as a class (p. 69) –
Page 1 of 12
, Second Generation of antipsychotic drugs
Produce fewer extrapyramidal side effects
Target both the negative and positive symptoms of schizophrenia
Bind to dopamine receptors in the limbic system
Dopamine and serotonin antagonist
Decrease motor side effects
Increase the risk for metabolic syndrome
Clozapine & olanzapine have highest risk for metabolic syndrome while aripiprazole and
ziprasidon have the lowest
Increase weight, blood glucose and triglycerides
A. Clozaril (clozapine) (p. 70) –
o Free of the motor side effects
o Potential to suppress bone marrow and induce agranulocytosis
o Regular measurement of white blood cell count is required – the count is
measured weekly for the first 6 months, every other week for the next 6
months, and monthly thereafter.
o Potential for inducing convulsions
o Potential for myocarditis and should be monitored
o Common side effects are drowsiness, sedation, hypersalivation, weight gain,
reflex tachycardia, constipation, and dizziness.
6. Basal ganglia (p. 54 & p. 55) – Located in the pockets of integrating gray matter deep within the
cerebrum. Involved in the regulation of movement, emotions, and basic drives.
7. Brain imaging techniques, Table 3-2, (p. 55) A variety of noninvasive imaging techniques used to
visualize brain structure, functions, and metabolic activity.
A. Structural – CT and MRI – identify gross anatomical changes in the brain.
B. Functional – PET and SPECT – reveal physiological activity in the brain.
PET scans are useful in identifying phys. And biochemical changes as they occur.
Schizophrenic patients – PET scans show decreased use of glucose in the frontal lobes
Patients with OCD – PET scan shows increased brain metabolism
Patients with depression – PET scans show decreased brain activity in the prefrontal cortex.
8. Circadian rhythms (p. 48) – the cycle of sleep and wakefulness is only one aspect of circadian rhythms.
Fluctuation of various physiological and behavioral parameters over a 24-hour cycle. Other variations
include body temp, secretion of hormones such as corticotropin and cortisol, and secretions of neurotransmitters
such as norepinephrine and serotonin which affect mood.
9. Conventional antipsychotics (p. 68) – Figure 3-19 Pg. 69 – Shows symptoms of each block
First generation antipsychotic drugs – (the book did not list any drug names)
Page 2 of 12
