Psychopharmacology Flashcards
What are agonists?
Produce effects similar to those by an endogenous neurotransmitters.
What are direct agonists?
They exert effects by mimicking the effect of a neurotransmitter ay the receptor cite.
What are indirect agonists?
They attached to a binding site on a receptor cell and aid the action of the neurotransmitter.
What are inverse agonists?
They produce an effect that is opposite to that produced by a neurotransmitter or agonists.
What are antagonists?
They reduce or block the effects of a neurotransmitter or agonists.
What are direct antagonists?
They exert effect by attaching to a neurotransmitter’s receptor site.
What are indirect antagonists?
They attach to binding site on a receptor cell and interfere with the action of the neurotransmitter.
What is the general rule for prescribing drugs to older people?
Start low and go slow.
Conventional (typical) antipsychotics does what?
They mainly block dopamine receptors, especially D2 receptors.
Conventional (typical) antipsychotics includes?
chlorpromazine (Thorazine)
fluphenazine (Prolixin)
haloperidol (Haldol)
thiothixene (Narvane)
Conventional (typical) antipsychotics are used to treat what?
They help to alleviate symptoms of schizophrenia and other disorders with psychotic features.
Are conventional (typical) antipsychotics better at treating positive or negative symptoms?
They are more effective for positive symptoms.
What are the primary side effects of conventional (typical) antipsychotics?
Anticholinergic symptoms (dry mouth, blurred vision, urinary retention, constipation, tachycardia, delayed ejaculation)
Extrapyramidal (like Parkinsonism, akathisia-extreme motor restlessness, acute dystonia-muscle spasms, tardive dyskinesia-most serious, involuntary rhythmic movements)
Neuroleptic malignant syndrome (muscle rigidity, tachycardia, high fever, severe diarrhea, hyperthermia, and altered state of consciousnesses.
Atypical antipsychotics includes?
clozapine (Clozaril)
olanzapine (Zyprexa)
quetiapine (Seroquel)
risperidone (Risperdal)
Conventional (typical) antipsychotics are known as what?
They are known as major tranquilizers and neuroleptics.
How can tardive dyskinesia be alleviated?
Using benzodiazepines or other GABA agonists.
What should you do if a person develops neuroleptic malignant syndrome?
Stop the drug immediately.
What antipsychotic is most associated with extrapyramidal effects?
haloperidol (Haldol)
Atypical antipsychotics are used to treat what?
To treat schizophrenia and other disorders with psychotic symptoms
clozapine (Clozaril) can also be used to treat?
Bipolar when mood stabilizers didn’t work, depression, suicidality, drug addiction, motor symptoms of movement in disorders like Huntington’s and Parkinson’s.
What are the benefits of using atypical antipsychotics?
They alleviate both positive and negative symptoms of schizophrenia, especially when conventional (typical) antipsychotics failed. They also are less likely to produce extrapyramidal side effects including tardive dyskinesia.
What are the disadvantages of using atypical antipsychotics?
Slower onset of therapeutic effects than conventional ones.
Atypical antipsychotics does what?
They mainly block dopamine receptors, especially D4 receptors. They also act on other neurotransmitters like serotonin, norepinephrine, and glutamate.
What are the primary side effects of atypical antipsychotics?
Anticholinergic symptoms (dry eyes, blurred vision, urinary retention, constipation), lowered seizure threshold and sedation.
Extrapyramidal: less common, except akathisia-extreme motor restlessness.
Neuroleptic malignant syndrome (muscle rigidity, tachycardia, high fever, severe diarrhea, hyperthermia, and altered state of consciousnesses)
Agranulocytosis (decrease in certain types of white blood cells) - requires careful blood monitoring.
Tricyclics (TCAs) include?
amitriptyline (Elavil or Endep) clomipramine (Anafranil) doxepin (Sinequan or Adapin) imipramine (Trofranil) nortriptyline (Pamelor)
Antidepressants include what drug categories?
TCAs, SSRIs, and the MAOIs
Norepinephrine, dopamine and serotonin reuptake inhibitors are recently also considered?
Antidepressants
What are the TCAs used to treat?
Most effective in treating depression. Alleviates the vegetative and somatic symptoms. Can also be used to treat panic disorder, agoraphobia, bulimia, OCD, neuropathic pain, and enuresis in children and adolescents.
How does the TCAs work?
They are antagonists. They block the reuptake of norepinephrine, serotonin, and dopamine at nerve synapses.
What disadvantage does the TCAs have?
They take about 2-4 weeks to exert their therapeutic effects. Also, overdose can be fatal.
What are the side effects for the TCAs?
Anticholinergic symptoms (dry eyes, blurred vision, urinary retention, constipation), lowered seizure threshold and sedation.
Drowsiness, tremors, memory problems, confusion, fatigue, weight gain and sexual dysfunction.
Cardiotoxic-leads to cardiovascular symptoms (lower dosage if it occurs)
What are overdose symptoms for the TCAs?
Overdose symptoms include ataxia, impaired concentration, agitation, severe hypertension, fever, cardiac arrhythmia, delirium, seizures, and coma.
SSRIs are what type of drugs?
Antidepressants
SSRIs include what drugs?
fluoxetine (Prozac)
fluvoxamine (Faverin or Luvox)
paroxetine (Paxil)
sertraline (Zoloft)
How does the SSRIs work?
They are antagonists. They block the reuptake of serotonin at nerve synapses.
What are the SSRIs used to treat?
Treat depression, especially melancholic depression. Also, OCD symptoms, bulimia, panic disorder, and PTSD.
What are the side effects for the SSRIs?
Gastrointestinal disturbances (nausea, appetite loss, constipation, diarrhea), insomnia, anxiety, headaches, dizziness, anorexia, tremor, frequent urination, and sexual dysfunction.
Are SSRIs side effects permanent?
No. They are usually temporary and may require a change in dose or drug.
What are the benefits of using SSRIs?
Less cardiotoxic, safer in overdose, less likely to produce cognitive impairment, rapid onset of therapeutic effects (2-4 weeks), less side effects than the TCAs.
What is serotonin syndrome?
Neurological issues like headaches, nystagmus, tremors, dizziness, unsteady gait.
Mental state changes like confusion, irritability, delirium.
Cardiac arrhythmia (can progress to coma and death)
What drugs may cause serotonin syndrome?
SSRIs with a MAOI or other serotonergic agent (ones that affect the serotonin levels).
What type of drugs are monoamine oxidase inhibitors (MAOIs)
They inhibit the enzyme monoamine oxidase, which is involved in deactivating dopamine, serotonin and norepinephrine.
MAOIs include what drugs?
isocarboxazid (Marplan)
phenelzine (Nardil)
tranylcypromine (Parnate)
What are the MAOIs used to treat?
Non-endogenous and atypical depression that involve anxiety, reversed vegetative symptoms and interpersonal sensitivity.
What are the side effects for the MAOIs?
Anticholinergic symptoms (dry eyes, blurred vision, urinary retention, constipation), sexual dysfunction, insomnia, agitation, confusion, skin rash, weight gain, edema, headaches, dizziness, tremors, blood dyspraxia, and hypertensive crisis (most dangerous side effect).
When would hypertensive crisis likely to happen?
When a MAOIs are taken with barbiturates, amphetamines, antihistamines or with food containing the amino acid Tyramine (aged cheese, meats, beer, red wine, chicken liver, avocado, bananas, fava beans, soy sauce)
What are the symptoms for a hypertensive crisis?
Severe headaches, stiff neck, rapid heart rate, nausea, vomiting, sweating and sensitivity to light.
What should you do in a hypertensive crisis?
Get emergency treatment
What are the newer antidepressants?
Norepinephrine dopamine reuptake inhibitor (NDRI) and serotonin norepinephrine reuptake inhibitor (SNRI)
NDRI includes what drug?
bupropion (Wellbutrin)
SNRI includes what drug?
venlafaxine (Effexor)