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Flashcards in Psychopharm Deck (115):
1

Agonist

Produces effects similar to those produced by a neurotransmitter.

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Direct Agonist

Exert their effects by mimicking the effects of a neurotransmitter at a receptor site.

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Indirect Agonist

Attach to a binding site on a receptor cell (a site other than the one used by the neurotransmitter) and facilitate the action of the neurotransmitter.

4

Inverse Agonist

Produces an effect opposite of the effect produced by a neurotransmitter or an agonist.

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Partial Agonist

Produces effects that are similar to (but less than) the effects produced by a neurotransmitter or an agonist.

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Antagonists

Produce no activity in the cell on their own, but instead, reduce or block the effects of a neurotransmitter or agonist.

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Direct Antagonists

exert their effects by attaching to a neurotransmitter's receptor site.

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Indirect Antagonists

Attach to a binding site on a receptor cell (a site other than one used by the neurotransmitter) and interfere with the action of the neurotransmitter.

9

Antipsychotic Drugs

Tranquilizers or Neuroleptics --> traditional and atypical

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Traditional (Conventional) Antipsychotic Drugs

phenothiazine (chlorpromazine, fluphenazine)
thioxanthene (thiothixene)
butyrophenone (haloperidol)

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Traditional (Conventional) Antipsychotic Drugs - USE

effective for alleviating psychotic symptoms; most often prescribed as a treatment for Schizophrenia (most effective with positive symptoms: hallucinations, delusions, and agitation). Also treat acute mania, delusions and hallucinations associated with Major Depressive Disorder, and organic psychosis. Less effective for Schizophrenia's negative symptoms.

12

Traditional (Conventional) Antipsychotic Drugs -
MODE OF ACTION

Exert effects by blocking dopamine receptors in the brain (especially D2 receptors).

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Dopamine Hypothesis

Proposes that Schizophrenia is related to overactivity at dopamine receptors either as the result of oversensitivity of the receptors or excessive dopamine levels - Studies have demonstrated that amphetamines and other drugs that elevate dopamine levels produce psychosis in non-schizophrenics that is similar to acute paranoid Schizophrenia and the administration of low doses of those drugs to individuals with Schizophrenia exacerbates their symptoms.

14

Traditional (Conventional) Antipsychotic Drugs - SIDE EFFECTS

Anticholinergic effects - dry mouth, blurred vision urinary retention, constipation, tachycardia, and delayed ejaculation. Effects appear early, and tolerance ordinarily develops within a few weeks or months.
Extrapyramidal side effects - (caused by effects of drugs on dopamine receptors, especially in the Caudate Nucleus) Parkinsonism, akathisia (extreme motor restlessness), acute dystonia (muscle spasms in the mouth, face, and neck), Tardive Dyskinesia.
Neuroleptic Malignant Syndrome (NMS) - rare and potential fatal; rapid onset of motor, mental, and autonomic symptoms including muscle rigidity tachycardia, hyperthermia and altered consciousness.

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Anticholinergic effects

Dry mouth, blurred vision, dry eyes, urinary retention, nausea, constipation, tachycardia, and delayed ejaculation/sexual dysfunction.

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Neuroleptic Malignant Syndrome (NMS)

Rare and potential fatal; rapid onset of motor, mental, and autonomic symptoms including muscle rigidity tachycardia, hyperthermia and altered consciousness.

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Extrapyramidal side effects

Caused by effects of drugs on dopamine receptors, especially in the Caudate Nucleus; include Parkinsonism, akathisia (extreme motor restlessness), acute dystonia (muscle spasms in the mouth, face, and neck), and Tardive Dyskinesia. HALOPERIDOL - most potent antipsychotic and associated with most severe extrapyramidal side effects.

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Tardive Dyskinesia

The most serious extrapyramidal side effect; late-occurring and more common in females and older patients. Symptoms are similar to Huntington's Disease; involuntary rhythmic movements of the jaw, lips, tongue, and extremities. Traditionally viewed as irreversible, but new studies say may not be the case for all patients - symptoms improve when drug is gradually withdrawn (can be an initial worsening) benzodiazepine or other GABA agonists can alleviate symptoms.

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Atypical (Novel) Antipsychotic Drugs

dibenzodiazepine (clozapine)
benzisoxazole (resperidone)
thienobenzodiazepine (olanzapine)
dibenzothiazepine (quetiapine)

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Atypical (Novel) Antipsychotic Drugs - USE

Treat Schizophrenia and other disorders with psychotic symptoms. Alleviate both positive and negative symptoms of of Schizophrenia. They are often effective where traditional antipsychotics have failed. May have a slower onset of therapeutic effects than traditional antipsychotics. Additionally, clozapine specifically has been found useful in treating Bipolar Disorder that has not responded to a mood stabilizer, depression and suicidality, alcohol and drug addiction, hostility, and the motor symptoms of Parkinson's disease, Huntington's disease, and other movement disorders.

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Clozapine

An atypical antipsychotic drug that has been found useful in treating Bipolar Disorder that has not responded to a mood stabilizer, depression and suicidality, alcohol and drug addiction, hostility, and the motor symptoms of Parkinson's disease, Huntington's disease, and other movement disorders.

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Atypical (Novel) Antipsychotic Drugs - MODE OF ACTION

Act of D4 and other dopamine receptors as well as receptors for other neurotransmitters including serotonin and glutamate.

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Atypical (Novel) Antipsychotic Drugs - SIDE EFFECTS

Anticholinergic effects, lowered seizure threshold, and sedation. Extrapyramidal side effects are much less common (except for akathisia); they are much less likely to cause tardive dyskinesia. They can produce agranulocytosis (a marked decrease in a certain type of white blood cell), and other blood dycrasias, and consequently their use requires * careful blood monitoring * They may also cause Neuroleptic Malignant Syndrome (NMS).

24

Antidepressant Drugs

tricyclics, SSRIs, MAOIs, and more recent norepinephrine dopamine reuptake inhibitors, and serotonin norepinephrine reuptake inhibitors.

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Tricyclics

(TCAs) include: amitriptyline, nortriptyline, doxepin, imipramine, and clomipramine.

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Tricyclics - USE

Most effective for depressions that involve decreased appetite and weight loss, early morning awakening and other sleep disturbances, psychomotor retardation, anhedonia. Useful for alleviating the vegetative, somatic symptoms of depression. Take 2 - 4 weeks to take a therapeutic effect (for patients with severe depressions and at high risk for suicide, ETC is sometimes preferred. TCAs can also be used for Panic Disorder, Agoraphobia, Bulimia, Obsessive Compulsive Disorder (especially clomipramine), enuresis in children and adolescents (especially imipramine), and neuropathic pain (especially amitriptyline and nortriptyline)

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Clomipramine

a TCA used for Obsessive Compulsive Disorder

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Imipramine

a TCA used for enuresis in children and adolescents

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Amitriptyline

a TCA used for neuropathic pain

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Nortriptyline

a TCA used for neuropathic pain

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Tricyclics - MODE OF ACTION

TCAs block the reuptake of norepinephrine, serotonin, and/or dopamine at nerve synapses - catecholamine hypothesis

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Catecholamine Hypothesis

Proposes that depression is caused by a deficiency of the norepinephrine neurotransmitter.

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Tricyclics - SIDE EFFECTS

TCA's most serious problem is that they are cardiotoxic, producing such cardiovascular symptoms at tachycardia, palpitations, hypertension, severe hypertension (drop in blood pressure), and cardiac arrhythmia. Other side effects: cardiovascular symptoms, anticholinergic effects, confusion, drowsiness, fatigue, weight gain, fine tremor, paresthesia, and blood dyscrasia. Symptoms of tricyclic overdose include ataxia, impaired concentration, agitation, severe hypertension, fever, cardiac arrhythmia, delirium, seizures, and coma. Overdose can be lethal and should be prescribed in small quantities for individuals at high risk for suicide.

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Cardiotoxic

Producing such cardiovascular symptoms at tachycardia, palpitations, hypertension, severe hypertension (drop in blood pressure), and cardiac arrhythmia.

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Selective Serotonin Reuptake Inhibitors (SSRIs)

fluoxetine, fluvoxamine, paroxetine, and sertraline

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Fluoxetine

(Prozac) most widely prescribed antidepressant - some controversy due to links to violence and suicide

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SSRIs - USE

Used to treat depression, and particularly effective for melancholic depression. Several are also prescribed for obsessive-compulsive symptoms, bulimia, panic disorder, and PTSD

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SSRIs - MODE OF ACTION

Block the reuptake of serotonin.

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SSRIs - SIDE EFFECTS

Gastrointestinal disturbances (e.g. nausea, appetite loss, constipation or diarrhea); insomnia, anxiety; headache; dizziness; anorexia; tremor; frequent urination; sexual dysfunction.

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SSRIs - Advantages

Less cardiotoxic, safer in overdose, less likely to produce cognitive impairment. Rapid onset of therapeutic effects (typically within 2 - 4 weeks... full therapeutic effects within 6 - 8 weeks)

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Serotonin Syndrome

When SSRIs are administered in conjunction with MAOI or other serotonergic agents, can result in neurological effects (headache, nystagmus, tremor, dizziness, unsteady gait), changes in mental state (irritability, confusion, delirium), cardiac arrhythmia, and can progress to coma and death.

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Monoamine Oxidase Inhibitors (MAOIs)

Isocarboxazid, phenelzine, and tranylcypromine.

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MAOI - USE

Most effective for treating non-endogenous and atypical depressions that involve anxiety, reversed vegetative symptoms (e.g. hypersomnia, hyperplasia), and interpersonal sensitivity.

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MAOI - MODE OF ACTION

Inhibit the enzyme monoamine oxidase, which is involved in deactivating dopamine, norepinephrine, and serotonin.

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MAOI - SIDE EFFECTS

The most serious side effect is hypertensive crisis. Other side effects include: anticholinergic effects, insomnia, agitation, confusion, skin rash, weight gain, edema, headache, dizziness, tremor, and blood dyscrasia.

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Hypertensive Crisis

Occurs when an MAOI is taken in conjunction with barbiturates, amphetamines, antihistamines, or certain other drugs or with foods containing the amino said tyramine (e.g. aged cheeses and meats, beer, red wine, chicken liver, avocados, bananas, fave beans, soy sauce). Symptoms include severe headache, stiff neck, rapid heart rate, nausea, vomiting, sweating, and sensitivity to light. Emergency treatment should be sought if symptoms are experienced.

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Norepinephrine Dopamine Reuptake Inhibitor (NDRI)

Bupropion (Wellbutrin, Zyban)

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NDRI - USE

Used to treat Major Depressive Disorder and the depressive phase of Bipolar Disorder. Under the name Zyban, used to facilitate smoking cessation. Effective for individuals who have not responded to antidepressants.

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NDRI - Side Effects

May aggravate pre-existing psychosis and seizures, but has fewer anticholinergic side effects and is less cardiotoxic than TCAs, and it does not cause sexual dysfunction.

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Serotonin Norepinepherine Reuptake Inhibitors (SNRI)

Venlafaxine (Effexor) and duloxetine (Cymbalta)

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SNRI - USE

Prescribed for Major Depressive Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, and OCD. Also effective for certain pain disorders including fibromyalgia, mixed headaches, back pain, and peripheral neuropathic pain. Duloxetine (Cymbalta) is prescribed for MDD and GAD.

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SNRI - SIDE EFFECTS

Can increase blood pressure and needs frequent monitoring. Overall less dangerous in overdose than TCAs, and may have faster therapeutic effects.

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Mood Stabelizing Drugs

Lithium and carbamazepine

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Lithium - USE

Drug treatment of choice for Bipolar Disorder, especially “classic” bipolar involving manic episodes with elevated (as opposed to irritable or dysphoric) mood without rapid cycling of moods). It not only reduces or eliminates manic symptoms but also suppresses mood swings.

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Lithium - MODE OF ACTION

Appear to be related to the reuptake of serotonin and norepinephrine.

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Lithium - SIDE EFFECTS

Gastrointestinal side effects (nausea, vomiting, diarrhea, a metallic taste, and weight gain) are common but usually subside within a few weeks. Other side effects: fine hand tremor and shakiness, fatigue, restlessness, polyuria, and polydipsia.
Toxicity is major danger and results when dose is too high; signs are diarrhea, ataxia, drowsiness, slurred speech, confusion, and coarse tremor. Can result in seizures, coma, and death. Serum levels must be regularly monitored.
Sodium levels affect the retention of lithium so when taking must avoid fluctuations in salt intake and avoid careen, alcohol, and other diuretics. Contraindicated for people with cardiovascular, kidney, liver, thyroid, or gastrointestinal problems.

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Carbamazepine

(Tegretol) Initially used as an anticonvulsant drug, but is also effective in mania.

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Anticonvulsant Drugs

Used as mood stabilizers: Carbamazepine (Tegretol), valproic (Depakote) and clonazepam (Klonopin).

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Carbamazepine - USE

Effective treatment for Bipolar Disorder, especially for individuals who have not responded to lithium. Some evidence that more effective than Lithium for individuals who experience rapid cycling and those with dysphoric mania.

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Carbamazepine - MODE OF ACTION

Believed to affect serotonin levels

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Carbamazepine - SIDE EFFECTS

Dizziness, ataxia, visual disturbances, anorexia, nausea, and rash, but tolerance for these develops fairly quickly. . Contraindicated for people with abnormalities in cardiac conduction because of potential effects on cardiovascular functioning. Also a slight risk for agranulocytosis and aplastic anemia, and careful blood monitoring is required.

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Sedative-Hypnotics

Include barbiturates, anxiolytics, and alcohol. Generalized CND depressants that are dose-dependent. At low doses they reduce arousal and and motor activity; at moderate doses they induce sedation and sleep; and at high doses they can produce anesthesia, coma, and death. Initial increase in activity and feelings of elation are due to their suppression of inhibitory mechanisms in the brain. Sedating and hypnotic effects result from suppression of excitatory mechanisms.

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Chronic Use of Sedative-Hypnotics

Produces tolerance, physical, and psychological dependence. Abrupt cessation can cause withdrawal symptoms characterized by tremors, anxiety, nausea, vomiting, paranoia, and (in extreme cases) hallucinations, delirium, and life-threatening convulsive seizures. Effects are synergistic and produce a cross-tolerance.

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Synergistic

Effects of sedative-hypnotics combined (an anxiolytic with a barbiturate or alcohol) can have lethal consequences due to super-addictive nature of their actions on the brain structure that control respiration.

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Cross-Tolerance

when tolerance develops to one sedative-hypnotic, it is likely to be the case for other sedative-hypnotics as well.

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Barbiturates

Amobarbital, pentobarbital, secobarbital, and phenobarbital

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Barbiturates - USE

Used in the past as sedatives and anesthetic agents

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Barbiturates - MODE OF ACTION

interrupt impulses to the reticular activating system.

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Barbiturates - SIDE EFFECTS

Slurred speech, nystagmus, dizziness, irritability, and impaired motor and cognitive performance. Overdose can produce ataxia, confusion, agitation, respiratory depression, and death. Causes decrease in REM sleep, and abrupt cessation can produce an REM rebound and nightmares. If used to help with insomnia effects might last a few weeks, then sleep may actually fall to bellow pre-drug levels. Withdrawal is generally severe and can be life-threatening. * Most abused class of drugs and are frequently involved in suicides and accidental deaths *

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Barbiturates - Tolerance

Chronic use can lead to tolerance and psychological and physical dependence. Tolerance is NOT equal for all affected symptoms (e.g. users will develop tolerance to sleep-inducing actions of that drug, but respiratory centers will not adapt, and therefor increasing the dose to increase soporific effects can be deadly).

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Benzodiazepines

Anxiolytics (minor tranquilizers or anti-anxiety drugs) are the most widely used psychiatric medication, and of the anxiolytics, benzodiazepines are most commonly prescribed. Include diazepam, alprazolam, oxazepam, triazolam, chlordiazepoxide, and lorazepam.

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Benzodiazepines - USE

Primarily used to relieve anxiety but also used to treat sleep disorders, seizures, cerebral palsy, and other disorders involving muscle spasms, and alcohol withdrawal.

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Benzodiazepines - MODE OF ACTION

Stimulate the inhibitory action of the neurotransmitter GABA.

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Benzodiazepines - SIDE EFFECTS

Drowsiness, dizziness lethargy, lured speech, ataxia, and impaired psychomotor ability are the most common side effects; other effects include irritability hostility, paradoxical excitation or agitation, increased appetite and weight gain, skin rash, blood dyscrasia, impaired sexual functioning, disorientation and confusion, sleep disturbances, (e.g. reduced REM sleep), anterograde amnesia, and depression.

75

Azapirone (buspirone)

The first anxiolytic that reduces anxiety without sedation. It appears to be non-addictive, non-habit-forming, and not subject to abuse. Unlike the benzos and similar anxiolytics, which have immediate therapeutic effects, buspirone must be taken for several weeks before it is effective.

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Beta-Blockers

Propanolol (Inderal) *can be potential lethal to individuals with certain respiratory problems. Should also not be stopped abruptly.

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Beta-Blockers - USE

Treat high blood pressure, angina and other cardiovascular disorders; tremors; migraine headache; and glaucoma. Also useful for reducing palpitations, tremors, excessive sweating, and other physical symptoms associated with anxiety.

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Beta-Blockers - SIDE EFFECTS

Bradycardia, shortness of breath, arterial insufficiency (usually the Raynaud's type), nausea, diarrhea, depression dizziness, sexual dysfunction, trouble sleeping, and numbness or tingling in fingers and toes.

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Narcotic-Analgesics

(opioids) - have sedative and analgesic properties

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Natural Opioids

opium, morphine, and codeine

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Semi-Synthetic derivatives of morphine

heroin, Percodan, Dilaudid

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Pure Synthetics

Demerol, Darvon, methadone

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Narcotic-Analgesics - USE

Medically can be used as analgesics, treatments for diarrhea, and cough suppressant.
Provides a short-lived "rush" or sense of euphoria usually followed by feelings of tranquility, drowsiness, apathy, decreased physical activity, and impaired attention and memory.

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Narcotic-Analgesics - METHOD OF ACTION

It is hypothesized that the body produces its own opioid-like substances in the spinal chord, and various regions of the brain including the amygdala, thalamus, and hypothalamus. Hypothesis supported by discovery of endorphins and enkephalins, which appear to be involved in reducing pain perception, especially emotional responsively to pain.

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Narcotic-Analgesics - SIDE EFFECTS (Physical Signs)

Physical signs of use include constricted pupils, decreased visual acuity, increased perspiration, constipation, nausea, vomiting, and respiratory depression Overdose (toxicity) can produce slow and shallow breathing, muscle rigidity, catalepsy, clammy skin, decreased blood pressure and pulse rate, convulsions, coma, and death.

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Narcotic-Analgesics (tolerance, physical, and psych dependence)

Psych dependence is developed first due to euphoria produced by the drug. Once psych dependence has diminished, physical dependence develops as user takes drug to avoid withdrawal, which looks like a bad case of the flu: stomach cramps, nausea, vomiting, weakness, fever, muscle and joint pain, sweating and insomnia.

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Methadone

(Synthetic Narcotic-Analgesic) Heroine detoxification. Provides user with a means of satisfying physical dependence without psychological-reinforcing positive feelings. Nearly as addictive as heroine, but withdrawalis milder.

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Psychostimulants

Amphetamines and methylphenidate

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Psychostimulants - USE

Amphetamines (e.g. dexamphetamine sulphate) is used to treat narcolepsy and ADHD. Methylphenidate (Ritlin, Concerta, and Metadate) is used to treat ADHD in children and adults.

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Psychostimulants - METHOD OF ACTION

Potentiate the release of norepinephrine and dopamine and block their reuptake.

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Psychostimulants - SIDE EFFECTS

Restlessness, insomnia, poor appetite, tremor, palpitations, and cardiac arrhythmia. Repeated use can result in tolerance, dependence and sensitization. Prolonged use of amphetamine can lead to a psychotic state that resembles paranoid Schizophrenia

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Sensitization

The opposite of tolerance; involves greater behavioral response to the drug that occurs when it is used intermittently.

93

Methylphenidate - SIDE EFFECTS

Decreased appetite, insomnia, dysphoria (anxiety, irritability, depression, euphoria, sadness), abdominal pain, and tachycardia. Growth suppression may be a side effect at higher doses. Methylphenidate is contraindicated for individuals with anxiety and tension, anorexia, severe hypertension or angina pectoris, a history of functional psychosis, a recent history of drug or alcohol abuse, pre-existing motor tics, or a family history of Tourette's

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Anti-Alcohol Drugs

Disulfiram (Antabuse) and naltrexone (ReVia, Vivitrol)

95

Anti-Alcohol Drugs - USE

prevent alcohol use in individuals with Alcohol Use Disorder

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Anti-Alcohol Drugs - MODE OF ACTION (disulfiram)

inhibits alcohol metabolism, causing an accumulation of acetaldehyde and unpleasant reactions (severe nausea, vomiting, sweating headache, tachycardia, and hypertension) that deter user from drinking.

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Anti-Alcohol Drugs - MODE OF ACTION (naltrexone)

An opioid receptor antagonist, It blocks the craving for and reinforcing effects of alcohol.

98

Anti-Alcohol Drugs - SIDE EFFECTS (disulfiram)

Drowsiness, depression, disorientation, headache, restlessness, impotence, and blood dycrasias.

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Anti-Alcohol Drugs - SIDE EFFECTS (naltrexone)

Abdominal cramping, nausea, vomiting, insomnia, nervousness, headache, and joint and muscle pain.

100

Drug that is effective for alleviating psychotic symptoms; most often prescribed as a treatment for Schizophrenia (most effective with positive symptoms: hallucinations, delusions, and agitation). Also treat acute mania, delusions and hallucinations associated with Major Depressive Disorder, and organic psychosis. Less effective for Schizophrenia's negative symptoms.
- Beta-Blockers
- Traditional (Conventional) Antipsychotic Drugs
- Atypical (Novel) Antipsychotic Drugs
- Norepinephrine Dopamine Reuptake Inhibitor (NDRI)

Traditional (Conventional) Antipsychotic Drugs

101

The below side Effects are associated with which drug class? Anticholinergic effects, Extrapyramidal side effects , Parkinsonism, akathisia, acute dystonia, Tardive Dyskinesia, Neuroleptic Malignant Syndrome (NMS)
- Atypical (Novel) Antipsychotic Drugs
- Barbiturates
- Anticonvulsant Drugs
- Traditional (Conventional) Antipsychotic Drugs

Traditional (Conventional) Antipsychotic Drugs

102

Drug used to treat Schizophrenia and other disorders with psychotic symptoms. Alleviate both positive and negative symptoms of Schizophrenia.
- Lithium
- Benzodiazepines
- Atypical (Novel) Antipsychotic Drugs
- Traditional (Conventional) Antipsychotic Drugs

Atypical (Novel) Antipsychotic Drugs

103

This atypical antipsychotic drug has been found useful in treating Bipolar Disorder that has not responded to a mood stabilizer, depression and suicidality, alcohol and drug addiction, hostility, and the motor symptoms of Parkinson's disease, Huntington's disease, and other movement disorders.
- clozapine
- tranylcypromine
- quetiapine
- haloperidol

Clozapine

104

The below side effects are associated with which drug class? Anticholinergic effects, Extrapyramidal side effects, Parkinsonism, akathisia, acute dystonia, Tardive Dyskinesia, Neuroleptic Malignant Syndrome (NMS).
- Traditional (Conventional) Antipsychotic Drugs
- Atypical (Novel) Antipsychotic Drugs
- Beta-Blockers
- Benzodiazepines

Atypical (Novel) Antipsychotic Drugs

105

Most effective for depressions that involve decreased appetite and weight loss, early morning awakening and other sleep disturbances, psychomotor retardation, anhedonia. Useful for alleviating the vegetative, somatic symptoms of depression. Can also be used for Panic Disorder, Agoraphobia, Bulimia, Obsessive Compulsive Disorder (especially clomipramine), enuresis in children and adolescents (especially imipramine), and neuropathic pain (especially amitriptyline and nortriptyline)
- clozapine
- fluoxetine
- tricyclics
- bupropion

Tricyclics

106

The below side effects are associated with which drug class? The most serious problem is that they are cardiotoxic. Other side effects include cardiovascular symptoms, anticholinergic effects, confusion, drowsiness, fatigue, weight gain, fine tremor, paresthesia, and blood dyscrasia. Symptoms of overdose include ataxia, impaired concentration, agitation, severe hypertension, fever, cardiac arrhythmia, delirium, seizures, and coma. Overdose can be lethal and drugs should be prescribed in small quantities for individuals at high risk for suicide.
- Benzodiazepines
- Selective Serotonin Reuptake Inhibitors
- Tricyclics
- Carbamazepine

Tricyclics

107

Used for Obsessive Compulsive Disorder
- Carbamazepine
- Clomipramine
- Nortriptyline
- Fluoxetine

Clomipramine

108

Used for enuresis in children and adolescents
- Buspirone
- Amitriptyline
- Imipramine
- Clomipramine

Imipramine

109

A TCA used for neuropathic pain
- codeine
- Clomipramine
- Amitriptyline
- Lithium

Amitriptyline

110

A TCA used for neuropathic pain
- Imipramine
- clomipramine
- clozapine
- Nortriptyline

Nortriptyline

111

Used to treat depression, and particularly effective for melancholic depression. Several are also prescribed for obsessive-compulsive symptoms, bulimia, panic disorder, and PTSD
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Monoamine Oxidase Inhibitors (MAOIs)
- Norepinephrine Dopamine Reuptake Inhibitor (NDRI)
- Serotonin Norepinepherine Reuptake Inhibitors (SNRI)

Selective Serotonin Reuptake Inhibitors (SSRIs)

112

Most widely prescribed antidepressant - some controversy due to links to violence and suicide
- Bupropion
- Lithium
- Clozapine
- Fluoxetine

Fluoxetine

113

The below side effects are associated with which drug class? Gastrointestinal disturbances (e.g. nausea, appetite loss, constipation or diarrhea); insomnia, anxiety; headache; dizziness; anorexia; tremor; frequent urination; sexual dysfunction.
- Monoamine Oxidase Inhibitors (MAOIs)
- Norepinephrine Dopamine Reuptake Inhibitor (NDRI)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin Norepinepherine Reuptake Inhibitors (SNRI)

Selective Serotonin Reuptake Inhibitors (SSRIs)

114

Most effective for treating non-endogenous and atypical depressions that involve anxiety, reversed vegetative symptoms (e.g. hypersomnia, hyperplasia), and interpersonal sensitivity.
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Monoamine Oxidase Inhibitors (MAOIs)
- Norepinephrine Dopamine Reuptake Inhibitor (NDRI)
- Serotonin Norepinepherine Reuptake Inhibitors (SNRI)

- Monoamine Oxidase Inhibitors (MAOIs)

115

The most serious side effect of this drug class is hypertensive crisis. Other side effects include: anticholinergic effects, insomnia, agitation, confusion, skin rash, weight gain, edema, headache, dizziness, tremor, and blood dyscrasia.
- Norepinephrine Dopamine Reuptake Inhibitor (NDRI)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Monoamine Oxidase Inhibitors (MAOIs)
- Serotonin Norepinepherine Reuptake Inhibitors (SNRI)

Monoamine Oxidase Inhibitors (MAOIs)