PsychoPharm Flashcards
(49 cards)
What is volume transmission;
- No synaptic connection needed to pass message bc the NT released from presynaptic neuron diffuses out toward other synpases in its diffusion radius.
- Can also be used in autoregulation.
Monoamines:
-includes which neurotransmitters?
catecholamines (END), histamine, tryptamines (serotonin, melatonin).
What are the 3 main reuptake transporters?
-other one that we have a drug for?
SERT, NET, DAT
-GABA xporter = GAT1
Which substances do NOT have reuptake inhibitors?
-name 2
histamine, neuropeptides
How do inverse agonists decrease baseline enzyme activity?
turn off constitutive activity of enzyme.
Olanzapine:
- two most common side effects, in order:
- how common?
- Weight Gain - problematic
2. Sedation - common
Olanzapine
-usual dose:
10-20 mg/day
Olanzapine:
- Is OD lethal?
- OD side effects:
- rarely lethal in monotherapy
- sedation and slurred speech
Citalopram
-brand name?
celexa
Citalopram
-unique s/e is sedation, why?
mild anti-histamine properties, may contribute to sedation or fatigue in some patients.
who is more vulnerable to possible activating effects of SSRIs?
Undiagnosed bipolar or psychotic disorders
Citalopram
-usual dosage range?
20-40mg/day
Escitalopram
-brand name?
Lexapro
Mirtazapine
-mechanism of action:
Boost neurotransmitters serotonin and norepinephrine/noradrenaline • Blocks alpha 2 adrenergic presynaptic receptor, thereby increasing norepinephrine neurotransmission • Blocks alpha 2 adrenergic presynaptic receptor on serotonin neurons (heteroreceptors), thereby increasing serotonin neurotransmission
Mirtazapine
-how does it cause sedation?
anti-histamine
Mirtazapine
- dosage?
- best dosage for sedation?
15-45mg qHS
-break the 15 in half and give 7.5 mg for best sedative effects.
“neurolepsis”
-classically what does it mean?
an extreme form of slowness or absence of motor movements as well as behavioral indifference in experimental animals.
-in humans: psychomotor slowing, emotional quieting, and affective indifference.
Shared pharmacological property of conventional antipsychotics:
D2 antagonism (in mesolimbic pathway = quells positive symptoms of psychosis).
How much D2 blocking do you need in mesolimbic pathway for anti-psychotic effect?
80% receptor blockage.
EPS: what % of D2 receptor blockade do you need in dorsal striatum to get EPS?
80%
What % of D2 receptor blockade do you need in pituitary to get hyper-PRL?
80%
Conventional antipsychotics
-amount the drug blocks D2 receptors in different dopamine pathways?
same number blocked in all brain areas
- this is why there are so many side effects.
- “high cost of doing business.”
Consequence of blocking D2 receptors in nucleus accumbens? (mesolimbic pathway)
This is reward center - so blocking D2 receptors here can quell positive symptoms but also cause anhedonia, apathetic, amotivational - particularly with socialization. A state very similar to negative Sxs of schizophrenia.
- thus using conventional antipsychotics can treat positive Sxs but worsen negative Sxs of schizophrenia.
- potential reason for drug abuse in schizois - need high the drug to get anything out of that reward system thats being blocked.
high or low density of D2 receptors in cortex?
low D2 density in cortex
