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12 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Pathophysiology of schizophrenia? |
Glutamate Hypothesis: 1. NMDA hypofunctions :. glutamate & NDMA activity hypofunction → This is because glutamatergic NDMA synapse during neurodevelopment (compromised/ abnormal). e.g PCp/Ketamine are NDMA antagonist → which when used trigger positive symptoms of schizopmerina (hallucination)& cognitive & negative symptoms. MOA: Disinhibition in the frontal cortex leads to too much glutamate. → Pyramidal cells release glutamate. → Inter neurons Inhibit the pyramidal neurons → Excitation of Internerons cause Inhibition → NDMA causes excitation of interneurons. →therefore, if NDMA hypofunctions s excitation of interneurons doesn't occur & Inhibition of pyramidal neurons doesn't occur therefore leading to pyramidal cells releasing more glutamate.
2. Mesolimbic /Dopamine hypothesis Of positive Symptoms. MoA : overactivity of mesolimbic pathway.
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Increased risk of death from heart disease & respiratory disease |
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Symptom of schizophrenia, which is worse? |
Positive (Delusion, hallucinations (mostly auditory),Disorganised speach/behavior, Agitation) Negative (emotional withdrawal, poor rapport, passivity, Apathetic social withdrawal, Attention impairment) Cognitive impairment (problems 'representing & maintearing goals, focusing/Sustaing attention, evaluating functions, monitoring performances serial learning, Prioritising) |
Positive, negative Cognitive impairment? |
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Conditions to rule out & differential diagnosis? |
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D2 antagonism in major dominergic pathways S. E? |
Nigrastriatal Mesolimbic Mesocortical Tuberoinfundibular |
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EPSE management (discerns pharmacological options) |
Anticholinergics? |
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Benefits & risks of depot injections? |
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Psychosocial considerations for schizophrenia? |
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Cultural considerations for Schizophrenia? |
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Clozapine |
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goal of therapy Indication MOA |
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Clozapine ADRs & Red flags? |
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Monitoring & counselling for weight gain & cardiovascular risk with atypical anti-psychotics. |
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Law question: if Resistant to standard therapy & requires clozapine legal consideration for prescription & supply of clozapine? |
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