Psychopharmacology & Toxins

Question 1

How do monoamine oxidase inhibitors (MAOIs) work?

Answer 1

Inhibit the enzyme MAO (which deactivates DA, NE, & serotonin)

Question 1

Drug potentiation

Answer 1

Synergistic action of 2+ drugs when this is more powerful than their additive effects

Question 2

Cognitive deficits associated with long-term MDMA use

Answer 2

Persist up to 1 year postabstinence Learning & memory, exec fx & planning, attention & vigilance, verbal fluency, visual scanning

Question 2

Mercury exposure is associated with

Answer 2

Encephalopathy of cerebellum, BG, primary visual corteix, spinal cord Motor slowing, clumsiness, tremor, paresthesia, visual & hearing defects, agitation Long-term exposure associated with depression, slowing, impaired STM

Question 2

Dialysis dementia

Answer 2

Caused by high brain aluminum levels Marked by stuttering & dysfluent speech, myoclonus & difficulty swallowing, concentration & memory problems

Question 3

Neuroimaging findings among cocaine users

Answer 3

Cerebral atrophy correlated w/ length of use, demyelination, hyperintensities, vasospasm, stroke-like defects, multiple patchy areas of hypoperfusion, EEG - marked reduced alpha power in frontal & temporal regions

Question 4

Typical antipsychotics work by

Answer 4

Blocking dopamine

Question 4

How do beta-blockers work?

Answer 4

Block beta-adrenergic receptors, which respond to epinephrine & NE

Question 5

How do tricyclics work?

Answer 5

Block reuptake of NE & serotonin (DA?)

Question 6

Name some common tricyclics

Answer 6

ANDI: amitriptyline, nortirptyline, doxepin, imipramine

Question 7

How do benzodiazepines work?

Answer 7

Inhibit GABA

Question 7

Side effects of benzodiazepines

Answer 7

Can cause sedation/drowsiness, confusion, disorientation in elderly, disturbed sleep, potential for withdrawal If stopped, see rebound hyperexcitability leading to seizures, depersonalization, panic, & stroke

Question 8

Neuroimaging findings in recently detoxified alcoholics

Answer 8

Cerebral atrophy & white & gray matter volume loss

Question 9

Neuropsych deficits associated with glue sniffing

Answer 9

Dose-related deficits in attention, memory, visuospatial fx, complex cognition, naming, reading/writing

Question 10

How do barbiturates work?

Answer 10

Interrupt impulses to RAS

Question 11

MAOIs are used for

Answer 11

Used for atypical depression, hostility, anxiety, hypochondriasis

Question 12

Alcohol-induced persisting dementia

Answer 12

Dysfx of general intellectual abilities, memory, visuospatial abilities, abstraction, problem solving Orientation to time & place, language abilities remain well-preserved May be on average 10 yrs younger than those w/ other dementias, 2x the avg length of institutionalization

Question 14

Symptoms of cocaine withdrawal

Answer 14

Crash, disrupted sleep, appetite, psychomotor fx, vivid disturbing dreams due to REM rebound

Question 15

How do amphetamines work in the CNS?

Answer 15

Provoke discharge of DA & then blocks reuptake Increases activity of NE that produces sympathomimetic effects

Question 16

Tricyclics are used for

Answer 16

Used for somatic & vegetative symptoms of depression, panic attacks, agoraphobia, & obsessive states

Question 18

Long term cognitive deficits among amphetamine users

Answer 18

Attentional & motor skills, verbal memory & attention

Question 19

How do atypical antipsychotics work?

Answer 19

Work on D2 & other DA receptors, serotonin, & glutamate

Question 20

Neuroleptic malignant syndrome

Answer 20

High fever, severe muscle rigidity, altered consciousness, ANS dysregulation

Question 22

Hepatic encephalopathy

Answer 22

Perform worse on STM, eye tracking, hand-eye coordination Many deficits improve following liver transplantation, memory does not Subclinical can cause sig. memory impairment & motor slowing w/ intact intellectual fx & abstraction

Question 23

Primary CNS target of manganese

Answer 23

Dopaminergic neurons in striatum

Question 25

NP findings among sober moderate-heavy cocaine users

Answer 25

Memory flexibility & control, attention & concentration, visuomotor ability, verbal & visual learning/memory

Question 26

Multiple exposures to PCP may produce what chronic impairments?

Answer 26

Memory & confusion

Question 27

How do SSRIs work, and what are they used for?

Answer 27

Block reuptake of serotonin; used for depression, OCD, eating disorders

Question 28

CNS damage from carbon monoxide is centered in

Answer 28

GP, cortex, hippocampus, cerebellum, fornix, CC

Question 29

Characteristic triad of opioid overdose

Answer 29

Coma, miosis, respiratory depression

Question 31

Long-term cognitive deficits associated with alcohol use

Answer 31

Complex memory deficits due to use of inefficient organization strategies during encoding; problem-solving, perceptuomotor abilities, visual learning & memory, contextual memory

Question 32

What are beta-blockers used for?

Answer 32

used for physical manifestations of anxiety, high BP, angina, tremors, migraines, glaucoma

Question 33

How does MDMA work in the CNS?

Answer 33

Provokes sudden emptying of presynaptic serotonin stores With continued use, destroys serotoninergic neurons & creates cognitive impairments

Question 34

Symptoms of mercury exposure

Answer 34

Cerebral encephalopathy, oral hemorrhage, auditory/visual hallucinations, fine motor tremor, insomnia, agitation

Question 35

What are some contraindications for psychostimulants?

Answer 35

anxiety & tension, anorexia, HTN, hx of psychosis, recent hx of drug or ETOH abuse, pre-existing motor tics

Question 36

How do psychostimulants work?

Answer 36

Works on catecholamines (DA, NE, epinephrine)

Question 37

Neuroimaging findings among heavy MDMA users

Answer 37

Global decreases in 5-HT transporter densities in parieto-occipital, occipital, & sensory cortex

Question 38

NP findings in current cocaine users

Answer 38

Deficits in verbal & visual recall, WM, attention

Question 39

How does cocaine work in the CNS?

Answer 39

Provokes a discharge of DA from presynaptic storage vesicles & then blocks its reuptake (particularly in mesolimbic system) Blocks reuptake of NE =\> pronounced sympathomimetic effects (arrhythmias, HTN, vasospasm, pupillary dilation) Blocks reuptake of serotonin =\> euphoria

Question 40

Central serotonin syndrome

Answer 40

Severe HA, nystagmus, tremor, dizziness, unsteady gait, irritability, confusion, delirium, cardiac arrhythmia