Psychopharmacology Flashcards Preview

AATBS EPPP 2017 !! > Psychopharmacology > Flashcards

Flashcards in Psychopharmacology Deck (55)
Loading flashcards...
1

effects of psychoactive drugs

agonists --> produces effect similar to neurotrans
---direct agonist: mimics the effect of neurotrans
--indirect agonist: attach to receptor site to facilitate action of the neurotrans
inverse agonists --> produces opposite effect of neurotrans
partial agonists --> produces similar but lesser effect
antagonists --> reduce or block effects of neurotrans
--direct antagonist: attach to receptor site to block
--indirect antagonist: attach to site and interfere with action of neurotrans

2

Traditional/conventional vs atypical/novel antipsychotics

traditional = effective for + Sx, less effective for -
used for: schizophrenia, acute mania, delusions/hallucinations from MDD, organic psychoses
atypical= effective for both + and - Sx
used for: schizophrenia, Clozapine used for bipolar not responding to mood stabilizer, depression and suicidality, addiction, hostility, motor Sx of Huntington's and Parkinson's

3

side effects of traditional antipsychotics

1) extrapyramidal effects: due to effects on dopamine receptors in caudate nucleus
e.g., tardive dyskinesia (late-occuring, more in females and older patients)
TD can be relieved by discontinuing drug, adding a benzo or other GABA agonist.
Haloperidol = most severe side effects
2) anticholinergic effects: "dry" Sx, tachycardia
3) neuroleptic malignant syndrome (NMS): rapid onset of motor, mental and autonomic Sx

4

conventional/typical antipsychotics

holperidol (Haldol)
thiothixene (Narvane)
fluphenazine (Prolixin)
chlorpromazine (Thorazine)

5

atypical antipsychotics

clozapine (Clozaril)
resperidone (Risperdal)
olanzapine (Zyprexa)
quetiapine (Seroquel)

6

traditional antipsychotics exert effects by ______

blocking dopamine receptors (at D2 receptors)

7

atypical/novel antipsychotics exert effects by _____

blocking D4 dopamine receptors AND receptors for serotonin and glutamate

8

side effects of atypical antipsychotics

anticholinergic effects
lowered seizure threshold
sedation
less common extrapyramidal side effects (except for akathisia)
agranulocytosis
neuroleptic malignant syndrome (NMS)

9

Tricyclic antidepressants

amitriptyline (Elavil, Endep)
nortriptyline (Pamelor)
doxepin (Sinequan, Adapin)
imipramine (Trofanil)
clomipramine (Anafranil)

10

TCAs most effective for ______

depression with vegetative, somatic Sx
Panic Disorder
Agoraphobia
Bulimia
OCD (esp chlomipramine)
enuresis (imipramine)
neuropathic pain (amitriptyline, nortriptyline)

11

mode of action of TCAs

block reuptake of norepi, serotonin, and/or dopamine

12

catecholamine hypothesis

depression caused by deficiency of norepinephrine

13

side effects of TCAs

***CARDIOTOXIC***
anticholinergic effects
confusion
drowsiness
fatigue
weight gain
fine tremor
paresthesia
blood dyscrasia

14

SSRIs

fluoxetine (Prozac)
fluvoxamine (Faverin, Luvox)
paroxetine (Paxil)
setraline (Zoloft)

15

SSRIs most effective for _____

melancholic depressions
OCD
Bulimia
Panic Disorder
PTSD

16

Side effects of SSRIs

GI disturbance
insomnia
anxiety
headache
sissiness
anorexia
tremor
frequent urination
sexual dysfunction

17

advantages of SSRIs over TCIs

less cardiotoxic
safer in overdose
cognitive impairment less likely

18

serotonin syndrome

neurological effects (headache, nystagmus, tremor, dizziness, unsteady gait)
cardiac arrhythmia
coma/death

19

MAOIs

isocarboxazid (Marplan)
phenelzine (Nardil)
tranylcypromine (Parnate)

20

MAOIs best for treating _____

atypical depressions involving anxiety, reversed vegetative Sx, interpersonal sensitivity

21

MAOIs side effects

hypertensive crisis -- when taken with tyramine foods
anticholinergic effects
insomnia
agitation
confusion
skin rash
weight gain
edema
headache
dizziness
tremor
blood dycrasia

22

tyramine-rich foods

aged cheeses and meats, beer, red wine, chicken liver, avocados, bananas, lava beans, soy sauce

23

Sx of hypertensive crisis

severe headache
stiff neck
rapid heart rate
nausea/vomiting
sweating
sensitivity to light

24

NDRIs (norepi dopamine reuptake inhibitor)

buproprion (Wellbutrin)
used for MDD, depressive phase of BP
used under name Zyban for smoking cessation
can aggregate preexisting psychosis and seizures

25

SNRIs (serotonin norepi reuptake inhibitor)

venlafaxine (Effexor)
duloxetine (Cymbalta)
used of MDD, GAD, social anxiety, OCD
some pain syndromes (fibromyalgia, mixed headaches, back pain, peripheral nueropathic pain)

26

Modd stabilizers

lithium
carbamazepine

27

lithium best for ____

"classic" BP with manic episodes with elevated mood and without rapid cycling
reduces or eliminates manic symptoms and suppresses mood swings

28

lithium toxicity

diarrhea
ataxia
drowsiness
slurred speech
confusion
coarse tremor
can result in seizures, coma and death
must regulate serum lithium levels in blood

29

if taking lithium, must avoid ____

fluctuations in salt intake
caffeine
alcohol
other diuretics
contraindicated for: cardiovascular, thyroid, kidney, liver and GI problems

30

Carbamazepine (Tegretol)

was anticonvulsant drug
also effective for mania
"rapid cycling" BP + dysphoric mania
also valproic acid (Depakote) and clonazepam (Klonopin)