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Exam 2: MH701 / MH 701 (
Update 2025 / 2026) Psychopharmacologic / Neuroscience Foundations of Mental Health Care Questions with Answers - Frontier
Question:
What are all the contraindications for use of 1st generation antipsychotics
Answer:
-Neuroleptic Malignant Syndrome -Seizures (can lower seizure threshold) -Especially Hypotension and antihypertensives -Cardiac arrhythmias -Pregnancy (never in the first trimester) & Lactation -Agranulocytosis - Decr granulocytes (incr risk of infection) -Leukopenia - Decr WBC count, specifically neutrophils
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Question:
What are the positive therapeutic indications for 1st generation of antipsychotics
Answer:
hallucinations and delusions, Borderline, Tourettes and Huntington's,
SEVERE AGITATION/VIOLENCE: (Repeat administration in children is
controversial)
Question:
NO FGA has been FDA approved for
Answer:
dementia-related agitation due to Incr risk of sudden death & CVA.
Question:
How many adverse reactions 1st generation of antipsychotics
Answer:
GAM = "God-Awful Many"
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Question:
Blocks Noradrenergic, Cholinergic and Histaminergic receptors effects
Answer:
-Noradrenergic - Prolonged atrial + ventricular conduction and refractory; decrease cardiac contractility. Low potency is worse than high potency.Prolonged QTc and Torsades/sudden death
Anti-Alpha 1 effects: Postural hypotension
-Cholinergic: Dry mouth, constipation, urinary retention, agitation,
disorientation, hallucinations, seizures, high fever, dilated pupils, stupor, coma - Physostigmine to treat, w/ caution
-Histaminergic: sedation (H1 blocking effect) - Chlorpromazine/Thorazine is
most sedating
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Question:
Ways Neuroleptics Affects 4 pathways: ---Mesocortical, Mesolimbic,
Nigrostriatal, and Tuberoinfundibular pathways
Answer:
Mesocortical - worsen negative symptoms of cognitive impairment, blunted emotions, social ...
Mesolimbic - Antipsychotic effects block hallucinations, delusions, and agitation (positive sx) - what we want!
Nigrostriatal - EPS: Parkinson-like S.E. and Tardive Dyskinesia
-Acute dystonia - (hours to days after initiation) - acute muscle contractions -Akathisia - (days to weeks ...) restless, jittery, like a caffeine rush -Parkinsonism - (weeks to months ... ) tremor, cog-wheel rigidity, hypokinesia -Tardive Dyskinesia - (months to years ...) hyperkinesis, perioral movements -TD is IRREVERSIBLE - risk increases 3% every year patient is on the drug
Tuberoinfundibular- Dopamine acts as Prolactin-inhibiting factor; D2 block increases prolactin levels = gynecomastia, sexual S.E., osteoporosis, amenorrhea, galactorrhea
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