This page describes a Qedoc learning module or quiz entitled "Antipsychotics". You can download the module from this page to put on your computer. You can also launch the module straight off the web using the launch quiz link on the right-hand side of this page. Another way to access this quiz is to install the Qedoc Quiz Player and bring up its directory of downloadable quizzes. Whichever way you choose to use it, it's free.
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Definition of psychosis, classification of psychoses; biochemical basis, especially the involvement of dopamine and its receptors. The development of drug therapy to treat psychotic illness (barbiturates, reserpine, phenothiazines, thioxanthines, butyrophenones, diphenylbutylpiperidines). Typical phenothiazine effects (chlorpromazine) and the similarity of other types. Evidence for antagonism at dopamine receptors D1 and D2. Adverse effects of antipsychotic drugs including extrapyramidal motor effects and tardive dyskinesias. Choice of antipsychotic agent, possible biochemical basis for differences between drugs.
The module contains the following activities:
- All Questions
- Dopamine Recognition
- Side Effects
The following is a short sample of the questions in this module and may help to better assess the level, topic and suitability of the material for your purposes. Images are omitted and the questions may not make complete sense without the context of the interactive answer activities which follow them in the module. To best preview this module, click the launch link at the top right of this page.
- Potent D2-receptor agonists (e.g. apomorphine and bromocriptine), like amphetamine, exacerbate the symptoms of schizophrenic patients. Furthermore, dopamine antagonists and drugs that block neuronal dopamine storage (e.g. reserpine) are effective in controlling the positive symptoms of schizophrenia, and in preventing amphetamine-induced behavioural changes.
- Antipsychotic malignant syndrome is a rare but serious complication similar to the malignant hyperthermia syndrome seen with certain anaesthetics. Muscle rigidity is accompanied by a rapid rise in body temperature and mental confusion. It is usually reversible, but death from renal or cardiovascular failure occurs in 10-20% of cases.
- NMDA receptor antagonists such as phencyclidine,ketamine and dizocilpine produce psychotic symptoms (e.g. hallucinations, thought disorder) in humans, and reduced glutamate concentrations and glutamate receptor densities have been reported in post-mortem schizophrenic brains-one of the few fairly consistent findings.
- The first-generation compounds show some preference for D2 over D1-receptors, whereas some of the newer agents (e.g. sulpiride, amisulpride, remoxipride) are highly selective for D2-receptors. Clozapine is relatively non-selective between D1- and D2-, but has high affinity for D4.
- A variant of the dopamine hypothesis suggests that schizophrenia reflects an imbalance between excessive activation of D2-receptors in subcortical regions (causing positive symptoms) and deficient activation of cortical D1-receptors (causing negative symptoms).
- The mechanism of antipsychotics is by dopamine receptor antagonism in the mesolimbic limbic system. Block of the nigrostriatal pathway leads to extrapyramidal side effects. Block of the tuberohypophysial pathway leads to the side effect of galactorrhoea.
- Sedation, which tends to decrease with continued use, occurs with many antipsychotic drugs. Antihistamine (H1) activity is a property of phenothiazines and contributes to their sedative and antiemetic properties, but not to their antipsychotic action.
- Effects on the mesolimbic/mesocortical dopamine pathways are believed to correlate with antipsychotic effects, whereas effects on the nigrostriatal pathways are responsible for the unwanted motor effects produced by antipsychotic drugs
- Brain activity during hallucination show the visual and auditory field are activated. Patients thus are not imagining their sights and voices to the patients they are real.
- Dopamine, released in the median eminence by neurons of the tuberohypophyseal pathway acts physiologically to inhibit prolactin secretion via D2-receptors.
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- Not so easy: click the download link at the bottom of the "quick facts" box and the module's ZIP file will download to your desktop. To actually use this, however, you must move it to the /player/modplay subdirectory of whichever directory the Qedoc software is installed in (usually /programme files/qedoc).
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