Psychopharmacology for Psychiatry Flashcards by Fara A

What are the 4 main psychiatric treatments?

chemical (drugs + immunotherapies)
electrical stimulation (ECT)
structural rearrangement (psychosurgery/deep brain stimulation)
talking therapies (CBT)

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What is the advantage of classifying psychiatric drugs based on their chemical structure?

each drug has a unique structure, easy to allocate data.

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What is the disadvantage of classifying psychiatric drugs based on their chemical structure?

no use in clinical decision making

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What is the advantage of classifying psychiatric drugs based on the disease that they treat?

easy for doctors to choose drugs as they make diagnosises

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What is the disadvantages of classifying psychiatric drugs based on the disease that they treat?

many psychiatric drugs are used in several disorders
most disorders have multiple symptoms and may not all be treated with one drug

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What is classifying psychiatric drugs based on their pharmacology?

neuroscience based nomenclature (NbN)

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What are the 4 different drug targets?

receptors
neurotransmitter reuptake sites
ion channels
enzymes

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What are some examples of drugs that block enzyme activity?

monoamine oxidase inhibitors (depression)
acetylcholinesterase inhibitors (dementia)
lithium (bipolar)

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What does lithium block?

glycogen synthase kinase - for mood stability

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What are some examples of receptors which drugs (antagonists) block?

dopamine receptors
serotonin receptors
histamine receptors

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What are dopamine receptor blockers used to treat?

schizophrenia

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What are serotonin receptor subtype antagonists used to treat?

depression

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What are histamine receptor antagonists used to treat?

sleep

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What are some examples of drug agonists?

benzodiazepines
guanfacine

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What do benzodiazepines do?

enhance GABA
help with sleep

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What does guanfacine do?

enhance noradrenaline
helps with ADHD

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What do reuptake site blockers do?

block reuptake sites
increase neurotransmitter concentration in the synapse
enhance post-synaptic receptor activity

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What are some examples of reuptake blockers?

citalopram
desipramine
methylphenidate

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What does citalopram do?

enhances serotonin
serotonin reuptake inhibitor (SRI)
treats depression and anxiety

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What does desipramine do?

noradrenaline reuptake inhibitor (NRI)
enhances noradrenaline
treats depression

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What does methylphenidate do?

dopamine reuptake inhibitor (DRI)
enhances dopamine
treats ADHD

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Which drugs swap reuptake site direction to enhance release?

amfetamine (for ADHD)

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What do drugs that target Ion Channels do?

block channels to reduce neuronal excitability

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What are some examples of drugs that block sodium channels?

sodium valproate
carbamazepine

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What do sodium valproate and carbamazepine treat?

epilepsy and mood stabilisation

What are some examples of calcium channel blockers?

- gabapentin - pregabalin

What do gabapentin and pregabalin treat?

epilepsy anxiety

How would you describe fast acting neurotransmitters?

on-off switch

What is an example of an excitatory fast acting neurotransmitters?

Glutamate 80% of all neurons pyramidal cells

What is an example of an inhibitory fast acting neurotransmitters?

GABA 15% of interneurons

What do fast-acting neurons tend to be involved in?

- memory - movement - vision

How would you describe slow acting neurons?

modulators

How common are slow-acting neurons?

5% of all neurons

What are some examples of slow acting neurotransmitters?

- dopamine - serotonin - noradrenaline - acetylcholine - endorphins

What do fast-acting neurotransmitters tend to be involved in?

- emotions - drive - valence of memory

What is epilepsy caused by?

excess glutamate

What drug can be used to treat excess glutamate in epilepsy?

perampanel - glutamate blocker

What is alcoholism caused by?

excess glutamate

What drugs can be used to treat excess glutamate in alcoholism?

- acamprosate - ketamine (glutamate blockers)

What is thought to cause anxiety?

GABA deficiency

What drug can be used to treat a GABA deficiency?

benzodiazapine - GABA enhancer

What is thought to be caused by a 5-HT deficiency?

depression and anxiety

What can be used to treat a 5-HT deficiency?

SRIs MAOIs (serotonin enhancers)

What is thought to be caused by excess dopamine?

psychosis

What can be used to treat excess dopamine?

dopamine receptor blockers

What can be caused by excess noradrenaline?

nightmares

What can be used to treat excessive noradrenaline?

prazosin - noradrenaline blocker

What is caused by a acetylcholine deficiency?

impaired memory/dementia

What is the treatment for a deficiency in acetylcholine?

acetylcholine esterase enzyme blockers

What do most drugs for depression act on?

the 5-HT systems

What is the difference between partial and full agonists?

partial agonists have a lower maximum efficacy than full agonists

What are the advantages of using a partial agonist over a full agonist?

- improved safety (especially in overdose) - combats hyperactivity while still maintaining the necessary amount of the neurotransmitter - in states of high neurotransmitter or excess agonist medicine can act as an antagonist

What are inverse agonists?

drugs that have the the opposite effects to agonists but don't block receptors like an antagonist

What is allosteric modulation?

When drugs work on different sites on the target proteins compared to the endogenous neurotransmitter

What is an orthosteric site?

the site that the desired substrate binds to

What is an allosteric site?

a different binding site of the substance, but on the same protein complex

What happens when GABA binds to the GABA receptor?

- enhances Cl ion conductance - inhibits neurons - calms the brain

What happens when benzodiazepines, barbituates, alcohol and neurosteroids bind to the allosteric point on the GABA receptor?

- enhances the action of GABA - sedation - sleep, reduced anxiety, anti-epilepsy

What is the selectivity of haloperidol?

- highly selective for the dopamine receptor - adverse effects are due to dopamine receptor block

What is the selectivity of clozapine?

- non-selective - lots of adverse effects due to off-target effects (eg; sedation, weight gain, metabolic syndrome)

What is the selectivity of amitriptyline?

low, also binds to histamine and acetylcholine receptors causing adverse effects

What is the selectivity of citalopram?

- selective SRI - adverse effects are solely due to increased serotonin

What do agonist drugs do?

Stimulate/ enhance receptors

What does the partial agonist buprenorphine treat?

Heroin addiction

What does the partial agonist aripiprazole treat?

- dopamine receptor partial agonist - treats psychosis along - better treatment than haloperidol

What is varenicline used to treat?

Nicotine addiction

Psychopharmacology for Psychiatry Flashcards

(66 cards)