NGR 6538
NGR 6538 EXAM 2 QUESTIONS AND
ANSWERS
dopamine pathways - Nigrostriatal
Mesolimbic
Mesocortical
Tuberoinfundibular
dopamine theory - excess of dopamine implicated in schizophrenia
mesolimbic pathway in schizophrenia - positive symptoms, too much dopamine
mesocortical pathway in schizophrenia - negative and cognitive symptoms, too little
dopamine
Nigrostriatal pathway - Hyperactivity of dopamine in this pathway leads to movement
disorders
Antipsychotics decrease dopamine
tuberofundibular pathway - Dopamine inhibits prolactin via this pathway. Antipsychotics
decrease dopamine, increasing prolactin, causing gynecomastia
Antipsychotics with the lowest metabolic risk - Aripiprazole and Lurasidone
Antipsychotics with the highest metabolic risk - Quetiapine and olanzapine
NGR 6538
, NGR 6538
Antipsychotic that increases QT prolongation - Geodon
Side effects of clozapine - Agranulocytosis (neutropenia) and seizures
Clozapine monitoring - CBC weekly for 6 months
then CBC every 2 weeks for 6 months
then CBC monthly
Clozapine adjunct - Prophylactic antiepileptics recommended
2nd generation antipsychotics recommended for bipolar depression - Lurasidone,
olanzapine/fluoxetine, quetiapine
Olanzapine LAI adverse reaction - Delirium
Part of the brain that dopamine affects - midbrain
VMAT-2 inhibitors mechanism - Blocking dopamine transport reduces movement
disorders
In aggressive patients, do not mix: - IM olanzapine with benzodiazepines (causes
respiratory suppression)
Antipsychotic monitoring - Baseline and annual: CMP, CBC, lipid panel, weight BMI
3 months after starting: Lipid panel, weight BMI
NGR 6538
NGR 6538 EXAM 2 QUESTIONS AND
ANSWERS
dopamine pathways - Nigrostriatal
Mesolimbic
Mesocortical
Tuberoinfundibular
dopamine theory - excess of dopamine implicated in schizophrenia
mesolimbic pathway in schizophrenia - positive symptoms, too much dopamine
mesocortical pathway in schizophrenia - negative and cognitive symptoms, too little
dopamine
Nigrostriatal pathway - Hyperactivity of dopamine in this pathway leads to movement
disorders
Antipsychotics decrease dopamine
tuberofundibular pathway - Dopamine inhibits prolactin via this pathway. Antipsychotics
decrease dopamine, increasing prolactin, causing gynecomastia
Antipsychotics with the lowest metabolic risk - Aripiprazole and Lurasidone
Antipsychotics with the highest metabolic risk - Quetiapine and olanzapine
NGR 6538
, NGR 6538
Antipsychotic that increases QT prolongation - Geodon
Side effects of clozapine - Agranulocytosis (neutropenia) and seizures
Clozapine monitoring - CBC weekly for 6 months
then CBC every 2 weeks for 6 months
then CBC monthly
Clozapine adjunct - Prophylactic antiepileptics recommended
2nd generation antipsychotics recommended for bipolar depression - Lurasidone,
olanzapine/fluoxetine, quetiapine
Olanzapine LAI adverse reaction - Delirium
Part of the brain that dopamine affects - midbrain
VMAT-2 inhibitors mechanism - Blocking dopamine transport reduces movement
disorders
In aggressive patients, do not mix: - IM olanzapine with benzodiazepines (causes
respiratory suppression)
Antipsychotic monitoring - Baseline and annual: CMP, CBC, lipid panel, weight BMI
3 months after starting: Lipid panel, weight BMI
NGR 6538
