General Information

Question 1

Psychoactive (psychotropic) Drugs

Answer 1

1. chemicals that interact with the CNS to produce a change in mood, consciousness, perception, and or behavior.
2. act to increase/decrease the production or reuptake of neurotransmitters,
3. by increasing or preventing the release of neurotransmitters
4. facilitating, mimicking or blocking the effects of neurotransmitters at receptor sites.

Question 2

Drug Effects

Answer 2

1. Agonists: produce effects similar to those produced by a neurotransmitter.
   
   1. Direct Agonists: exert effects by mimicking the effect of a neurotransmitter at a receptor site
   2. Indirect Agonists: attach to a binding site on a receptor cell and facilitate the action of the neurotransmitter
2. Inverse Agonists: produce an effect opposite to the effect produced by a neurotransmitter or an agonist.
3. Partial Agonists: produce effects that are similar to but less than the effects produces neurotrans/agonist.
4. Antagonists: produce no activity in the cell on their own but, instead, reduce or block the effects of a neurotransmitter or agonist.
   
   1. Direct Antagonists and Indirect Antagonists

Question 3

Drugs and Older Adults

Answer 3

Medication related problems are common cause of hospital admission for people over 65.

1. Changes in sensitivity, multiple meds, noncompliance to complex regimes all causes.
2. change in sensitivity: age-related changes in drug absorption, distribution, metabolism, and excretion.
3. start low and go slow is rule of thumb.

Question 4

Drugs and Race/Ethnicity

Answer 4

there are some cross-ethnic differences in responses to psychotropic meds.

Pharmacokinetic: ethnic dissimilarities in drug response are linked to differences in metabolism.

1. Asians and some Blacks, have slower/poorer metabolizers of specific isoenzymes, so they are more sensitive to the therapeutic and side effects of certain drugs such as neuroleptics, benzodiazepines, lithium, and some antidepressants.
2. go slow and low.

Question 5

Prescribers of Psychotropic Drugs

Answer 5

1. Psychotropic (CNS) drugs are most frequently provided, prescribed or continued at ambulatory care visits in primary care offices followed by medical speciality offices (i.e. psychiatrists/neurologists).
2. exception is for antipsychotics and antimanics more by speciality medical offices.

Question 6

Drug by Category

Answer 6

1. Conventional Antipsychotics
   
   1. chlorpromazine (thorazine)
   2. Fluphenazine
   3. Thiothixene
   4. Haloperidol (haldol)
2. Atypical Antipsychotics
   
   1. Clozapine (clozaril)
   2. resperidone (risperdal)
   3. olanzapine (zyprexa)
   4. quetiapine (seroquel)
3. Tricyclics (TCA)
   
   1. amitriptyline (elavil)
   2. doxepin
   3. imipramine (trofranil)
   4. clomipramine (anafranil)
   5. nortriptyline
4. SSRIs
   
   1. Fluoxetine (prozac)
   2. Fluvoxamine
   3. paroxetine (paxil)
   4. sertraline (zoloft)
5. MAOIs
   
   1. Isocarboxazid
   2. phenelzine
   3. tranylcypromine
6. Anxiolytics (benzodiazepines)
   
   1. diazepam (valium)
   2. alprazolam (xanax)
   3. oxazepam
   4. triazolam
   5. chlordiazepoxide
   6. lorazepam (ativan)