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AATBS EPPP 2017 !! > Psychopharmacology > Flashcards

Flashcards in Psychopharmacology Deck (55):
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)

31

side effects of carbamazepine

dizziness
ataxia
visual disturbances
anorexia
nausea
rash
bad for cardio conduction patients
slight risk for agranulocytosis and aplastic anemia

32

sedative-hypnotics include _____

barbiturates
anxiolytics
alcohol

33

withdrawal Sx of sedative-hypnotics

tremors
anxiety
nausea/vomiting
paranoia
extreme cases: hallucinations, delirium, convulsive seizures

34

barbiturates exert effect by ____

interrupting impulses to the RAS

35

benzodiazepines

diazepam (Valium)
alprazolam (Xanax)
oxapam (Serax)
triazolam (Halcion)
chlordiazepoxide (Librium)
lorazepam (Ativan)

36

benzodiazepines work by ____

stimulating inhibitory action of GABA

37

side effects of benzodiazepines

drowsiness
dizziness
lethargy
slurred speech
ataxia
impaired psychomotor ability
----------
irritability, hostility, paradoxical agitation, increased disorientation, sleep disturbance (reduced REM), ante grade amnesia, depression

38

azapirone (buspirone)

first anxiolytic without sedation
need to take for several weeks before effective

39

Beta-Blockers used for ____

high blood pressure
angina/cardiovascular disorders
tremors
migraines
glaucoma
reducing palpitations, tremor and excessive sweating from anxiety

40

beta-blockers work by _____

blocking beta-andrenergic receptors (which respond to epinephrine and norepinephrine)
Propranolol (Inderal)

41

side effects of propranolol

bradycardia
shortness of breath
arterial insufficiency (like Raynaud's)
nausea
diarrhea
depression
dizziness
sexual dysfunction
trouble sleeping
numbness/tingling in fingers/toes

42

propranolol is potentially lethal for people with ____

respiratory issues
obstructive pulmonary disease

43

narcotics-analgesics (opiods)

natural opiods (opium, morphine, codeine)
semi-synthetics of morphine (heroin, Percodan, Dilaudid)
pure synthetics (Demerol, Darvon, methadone)

44

narcotics-analgesics (opiods) work by ____

opiod receptors in the spinal cord and amygdala, thalamus and hypothalamus

45

enkephalins are ____

beta-endorphins

46

signs of narcotic use are:

constricted pupils
decreased visual acuity increased perspiration
constipation
nausea/vomiting
respiratory depression

47

narcotics overdose:

slow/shallow breathing
muscle rigidity
catalepsy
clammy skin
decreased blood pressure and pulse rate
convulsions
coma/death

48

narcotics/opiod withdrawal symptoms

flu-like Sx
stomach cramps
nausea/vomiting
weakness
fever
muscle and joint pain
sweating
insomnia

49

psychostimulants

amphetamines (dexamphetamine sulphate) - for narcolepsy and ADHD
methylphenidate (Ritalin, Concerta, Metadate) for ADHD

50

psychostimulants work by ___

potentiating the release of norephinephrine and dopamine and block their reuptake

51

side effects of amphetamines

restlessness
insomnia
poor appetite
tremor
palpitations
cardia arrhythmia

52

side effects of methyphenidate

decreased appetite
insomnia
dysphoria
abdominal pain
tachycardia

53

anti-alcohol drugs

disulfiram (Antabuse) -- inhibits alcohol metabolism, causing accumulation of acetaldehyde and unpleasant reactions (nausea, vomiting, seating, headache, tachycardia, hypotension)

naltrexone (ReVia, Vivitrol) -- opiod receptor antagonist - blocks craving for alcohol

54

side effects of disulfam (Antabuse)

drowsiness
depression
disorientation
headache
restlessness
impotence
blood dyscrasia

55

side effects of naltrexone

abdominal cramping
nausea/vomiting
insomnia
nervousness
headache
joint and muscle pain