Psychopharmacology Flashcards

1
Q

What are agonists?

A

Produce effects similar to those by an endogenous neurotransmitters.

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2
Q

What are direct agonists?

A

They exert effects by mimicking the effect of a neurotransmitter ay the receptor cite.

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3
Q

What are indirect agonists?

A

They attached to a binding site on a receptor cell and aid the action of the neurotransmitter.

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4
Q

What are inverse agonists?

A

They produce an effect that is opposite to that produced by a neurotransmitter or agonists.

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5
Q

What are antagonists?

A

They reduce or block the effects of a neurotransmitter or agonists.

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6
Q

What are direct antagonists?

A

They exert effect by attaching to a neurotransmitter’s receptor site.

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7
Q

What are indirect antagonists?

A

They attach to binding site on a receptor cell and interfere with the action of the neurotransmitter.

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8
Q

What is the general rule for prescribing drugs to older people?

A

Start low and go slow.

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9
Q

Conventional (typical) antipsychotics does what?

A

They mainly block dopamine receptors, especially D2 receptors.

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10
Q

Conventional (typical) antipsychotics includes?

A

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

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11
Q

Conventional (typical) antipsychotics are used to treat what?

A

They help to alleviate symptoms of schizophrenia and other disorders with psychotic features.

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12
Q

Are conventional (typical) antipsychotics better at treating positive or negative symptoms?

A

They are more effective for positive symptoms.

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13
Q

What are the primary side effects of conventional (typical) antipsychotics?

A

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.

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14
Q

Atypical antipsychotics includes?

A

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

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15
Q

Conventional (typical) antipsychotics are known as what?

A

They are known as major tranquilizers and neuroleptics.

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16
Q

How can tardive dyskinesia be alleviated?

A

Using benzodiazepines or other GABA agonists.

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17
Q

What should you do if a person develops neuroleptic malignant syndrome?

A

Stop the drug immediately.

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18
Q

What antipsychotic is most associated with extrapyramidal effects?

A

haloperidol (Haldol)

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19
Q

Atypical antipsychotics are used to treat what?

A

To treat schizophrenia and other disorders with psychotic symptoms

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20
Q

clozapine (Clozaril) can also be used to treat?

A

Bipolar when mood stabilizers didn’t work, depression, suicidality, drug addiction, motor symptoms of movement in disorders like Huntington’s and Parkinson’s.

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21
Q

What are the benefits of using atypical antipsychotics?

A

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.

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22
Q

What are the disadvantages of using atypical antipsychotics?

A

Slower onset of therapeutic effects than conventional ones.

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23
Q

Atypical antipsychotics does what?

A

They mainly block dopamine receptors, especially D4 receptors. They also act on other neurotransmitters like serotonin, norepinephrine, and glutamate.

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24
Q

What are the primary side effects of atypical antipsychotics?

A

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.

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25
Q

Tricyclics (TCAs) include?

A
amitriptyline (Elavil or Endep)
clomipramine (Anafranil)
doxepin (Sinequan or Adapin)
imipramine (Trofranil)
nortriptyline (Pamelor)
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26
Q

Antidepressants include what drug categories?

A

TCAs, SSRIs, and the MAOIs

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27
Q

Norepinephrine, dopamine and serotonin reuptake inhibitors are recently also considered?

A

Antidepressants

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28
Q

What are the TCAs used to treat?

A

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.

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29
Q

How does the TCAs work?

A

They are antagonists. They block the reuptake of norepinephrine, serotonin, and dopamine at nerve synapses.

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30
Q

What disadvantage does the TCAs have?

A

They take about 2-4 weeks to exert their therapeutic effects. Also, overdose can be fatal.

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31
Q

What are the side effects for the TCAs?

A

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)

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32
Q

What are overdose symptoms for the TCAs?

A

Overdose symptoms include ataxia, impaired concentration, agitation, severe hypertension, fever, cardiac arrhythmia, delirium, seizures, and coma.

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33
Q

SSRIs are what type of drugs?

A

Antidepressants

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34
Q

SSRIs include what drugs?

A

fluoxetine (Prozac)
fluvoxamine (Faverin or Luvox)
paroxetine (Paxil)
sertraline (Zoloft)

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35
Q

How does the SSRIs work?

A

They are antagonists. They block the reuptake of serotonin at nerve synapses.

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36
Q

What are the SSRIs used to treat?

A

Treat depression, especially melancholic depression. Also, OCD symptoms, bulimia, panic disorder, and PTSD.

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37
Q

What are the side effects for the SSRIs?

A

Gastrointestinal disturbances (nausea, appetite loss, constipation, diarrhea), insomnia, anxiety, headaches, dizziness, anorexia, tremor, frequent urination, and sexual dysfunction.

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38
Q

Are SSRIs side effects permanent?

A

No. They are usually temporary and may require a change in dose or drug.

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39
Q

What are the benefits of using SSRIs?

A

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.

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40
Q

What is serotonin syndrome?

A

Neurological issues like headaches, nystagmus, tremors, dizziness, unsteady gait.

Mental state changes like confusion, irritability, delirium.

Cardiac arrhythmia (can progress to coma and death)

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41
Q

What drugs may cause serotonin syndrome?

A

SSRIs with a MAOI or other serotonergic agent (ones that affect the serotonin levels).

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42
Q

What type of drugs are monoamine oxidase inhibitors (MAOIs)

A

They inhibit the enzyme monoamine oxidase, which is involved in deactivating dopamine, serotonin and norepinephrine.

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43
Q

MAOIs include what drugs?

A

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

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44
Q

What are the MAOIs used to treat?

A

Non-endogenous and atypical depression that involve anxiety, reversed vegetative symptoms and interpersonal sensitivity.

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45
Q

What are the side effects for the MAOIs?

A

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).

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46
Q

When would hypertensive crisis likely to happen?

A

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)

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47
Q

What are the symptoms for a hypertensive crisis?

A

Severe headaches, stiff neck, rapid heart rate, nausea, vomiting, sweating and sensitivity to light.

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48
Q

What should you do in a hypertensive crisis?

A

Get emergency treatment

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49
Q

What are the newer antidepressants?

A

Norepinephrine dopamine reuptake inhibitor (NDRI) and serotonin norepinephrine reuptake inhibitor (SNRI)

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50
Q

NDRI includes what drug?

A

bupropion (Wellbutrin)

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51
Q

SNRI includes what drug?

A

venlafaxine (Effexor)

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52
Q

NDRI is used to treat what?

A

Major depressive disorder and depressive phase of bipolar disorder.

53
Q

SNRI is used to treat what?

A

Major depressive disorder, generalized anxiety disorder, social anxiety, and certain pain syndromes like fibromyalgia, mixed headaches, back pain, and peripheral neuropathic pain.

54
Q

What are the side effects for NDRIs?

A

Increase severity of pre-existing psychosis and seizures, anticholenergic effects and cardiotoxic, but less severe than TCAs.

55
Q

What are the benefits for NDRI?

A

Don’t cause sexual dysfunction and often effective for people who haven’t responded well to other antidepressants.

56
Q

What is Zyban used for?

A

Used to help smoking cessation.

57
Q

What are the side effects for SNRI?

A

Increase blood pressure

58
Q

What are the benefits of the SNRI?

A

Overdose less severe than TCAs and has faster onset of therapeutic effects.

59
Q

What drug is similar to venlafaxine (Effexor)?

A

duloxetine (Cymbalta) - treats major depressive disorder and generalized anxiety disorder

60
Q

What are the mood stabilizing drugs?

A

Lithium
carbamazepine (Tegretol)
clonazepam (Klonopin)
valproicacid (Depakote)

61
Q

What is lithium used to treat?

A

Classic bipolar disorder (manic episodes with elevated mood) and without rapid cycling of moods.

62
Q

What does lithium do?

A

It decreases and/or eliminates manic symptoms and suppressed mood swings.

63
Q

How does lithium work?

A

Not well understood. Believed to be related to the reuptake of serotonin and norepinephrine.

64
Q

What are the side effects for lithium?

A

Gastrointestinal symptoms, fine hand tremors, weakness and fatigue, excessive thirst and urination, toxicity.

65
Q

People taking lithium should stay away from what?

A

Diuretics like caffeine and alcohol. Also, things containing sodium because sodium levels affects the retention of the lithium.

66
Q

What are the mood stabilizers drugs used to treat?

A

Bipolar

67
Q

The other mood stabilizers (not lithium) are better at treating what?

A

Better for those with atypical bipolar aka frequent mood swings (rapid cyclers) and those with dysphoric mania.

68
Q

How does the other mood stabilizers work?

A

Not understood. Believed to affect serotonin levels.

69
Q

What are the side effects of the other mood stabilizers?

A

Dizziness, ataxia, tremors, visual disturbance, anorexia, nausea, rash, and possible cardiovascular functioning effects.

Regular blood monitoring should be done because use in risk for agranulocytosis and aplastic anemia.

70
Q

What drugs are sedatives/hypnotics?

A

Barbiturates, anxiolytics, and alcohol

71
Q

What are sedatives/hypnotics?

A

They are generalized CNS depressants.

72
Q

What does a low dose of a sedative do?

A

Decrease arousal and motor activity.

73
Q

What does a moderate dose of a sedative do?

A

Induce sedation and sleep.

74
Q

What does a high dose of a sedative do?

A

Anesthesia, coma, and death

75
Q

What is the progression of sedatives/hypnotics effects?

A

Increase in activity, feeling of elation, eventually sedating and hypnotic effect.

76
Q

What can chronic use of sedatives/hypnotics lead to?

A

Tolerance, psychological and physical dependence.

77
Q

What will happen if you suddenly stop using sedatives/hypnotics?

A

Withdrawal syndrome-tremors, anxiety, nausea, vomiting, paranoia.

Extreme cases=hallucinations, delirium, convulsive seizures.

78
Q

Does sedatives/hypnotics have synergistic effects?

A

Yes. When two or more are used at the same time there effects are additive.

79
Q

What drugs are barbiturates?

A

amobarbital
pentobarbital
phenobarbital
secobarbital

80
Q

Are barbiturates prescribed a lot?

A

No because of their lethal effects

81
Q

Why are barbiturates used?

A

As a sedative and anesthetic agents

82
Q

How does barbiturates work?

A

Interrupts impulses to the reticular activating system

83
Q

What are the side effects for barbiturates?

A

Slurred speech, nystagmus, dizziness,irritability, impaired motor and cognitive performance

84
Q

What are the overdose symptoms for barbiturates?

A

Ataxia, confusion, agitation, depression, respiratory issues, and death

85
Q

What is the relationship between barbiturates and REM sleep?

A

Use can lead to a decrease in REM sleep.

Abrupt cessation can lead to REM rebound and nightmares

86
Q

What category of drugs is benzodiazepines?

A

Anxiolytics-minor tranquilizers and anti anxiety drugs, most widely used

87
Q

What drugs are benzodiazepines?

A

alprazolam (Xanax)
diazepam (Valium)
lorazepam (Ativan)

88
Q

What are benzodiazepines used to treat?

A

Anxiety, sleep disturbances, seizures, cerebral palsy, other disorders with muscle spasms, and alcohol withdrawal.

89
Q

How does benzodiazepines work?

A

Stimulate the inhibitory action of GABA.

90
Q

What are the side effects for benzodiazepines?

A

Drowsiness, dizziness, confusion, reduced REM sleep lethargy, slurred speech, ataxia, impaired psychomotor ability, irritability, hostility, paradoxical excitation or agitation, anterograde amnesia, and depression

91
Q

What can chronic use of benzodiazepines lead to?

A

Tolerance, psychological and physical dependence

92
Q

What happens if you suddenly stop using benzodiazepines?

A

Severe withdrawal symptoms-hyperexcitability which may lead to seizures, depersonalization, panic, and stroke

93
Q

What is another anxiolytics drug?

A

azapirone (Buspirone)

94
Q

What does azapirone (Buspirone) do?

A

Decreases anxiety without sedation

95
Q

What are the benefits for using azapirone (Buspirone)?

A

It is non addictive, non habit forming.

96
Q

What is the downside of using azapirone (Buspirone)?

A

It takes several weeks before it is therapeutically effective

97
Q

Name a beta blocker?

A

propranolol (Inderal)

98
Q

What are beta blockers used to treat?

A

High blood pressure, angina, other cardiovascular disorders, tremors, migraines, headaches, glaucoma, and physical symptoms related with anxiety.

99
Q

How does beta blockers work?

A

They block the beta adrenergic receptors which respond to epinephrine and norepinephrine.

100
Q

What are the side effects for beta blockers?

A

Bradycardia, nausea, diarrhea, numbness or tingling in toes or fingers

101
Q

What happens if you overdose on beta blockers?

A

Toxicity- breathing difficulties, irregular heartbeat, blurred vision, confusion, convulsions or coma

102
Q

What happens if you suddenly stop using beta blockers?

A

Heart palpitations, headaches, tremulousness and cardiac arrhythmia

103
Q

What drugs are in the narcotic analgesics?

A

Opioids

104
Q

Opioids have what type of properties?

A

Both sedative and analgesic

105
Q

Name some natural narcotic analgesics

A

Opium, morphine, and codeine

106
Q

Name some semi-synthetic morphine derivatives narcotic analgesics

A

Heroin percodan, dilaudid

107
Q

Name some pure synthetic narcotic analgesics?

A

Demerol, darvon, methadone

108
Q

What is opioids used for?

A

Analgesics, diarrhea, cough suppressant

109
Q

How does the opioids progress?

A

Immediate effect is short lived rush followed by feeling tranquility, drowsiness, apathy, decrease physical activity, and impaired attention and memory

110
Q

How does opioids work?

A

Decrease pain perception

111
Q

What are the side effects for opioids?

A

Constricted pupils, decrease visual acuity, increase perspiration, constipation,nausea, vomiting, respiratory depression.

112
Q

What are the overdose symptoms for opioids?

A

Toxicity- slow and shallow breathing, muscle rigidity, catalepsy, clammy skin, decrease blood pressure and pulse rate, convulsions, coma, and death.

113
Q

What are the withdrawal symptoms for opioids?

A

Bad flu like symptoms-stomach cramps, nausea, vomiting, weakness, fever, muscle and joint pain, sweating and insomnia

114
Q

What is methadone used for?

A

Mainly in heroine detox programs because it satisfies person’s physical need but not the psychological reinforcing positive feelings. It is nearly as addictive as heroine, but withdrawal symptoms are milder and duration is longer.

115
Q

What drugs are psychostimulants?

A

Amphetamines and methylphenidate

116
Q

What are some drugs that are amphetamines?

A

dexamphetamine sulphate

117
Q

What is amphetamines used to treat?

A

Narcolepsy and ADHD

118
Q

What are some methylphenidate drugs?

A

Ritalin
Concerta
Metadata

119
Q

What is methylphenidate used to treat?

A

ADHD. More effective for alleviating symptoms than improving academic achievement and social functioning.

120
Q

How does Amphetamines and methylphenidate work?

A

They potentiate the release of norepinephrine and dopamine and block their reuptake.

121
Q

What are the side effects for Amphetamines?

A

Restlessness, insomnia, poor appetite, tremors, palpitations and cardiac arrhythmia, tolerance and dependence. Prolonged use=psychotic state that resembles paranoid schizophrenia.

122
Q

What are the side effects for methylphenidate?

A

Decrease appetite, insomnia, dysphoria (anxiety, irritability, depression, euphoria, sadness), abdominal pain and tachycardia. High does can lead to growth suppression- drug holidays can reduce this

123
Q

Who should not use methylphenidate?

A

Those with anxiety, tension, anorexia,severe hypertension, angina lector is, history of functional psychosis, recent history of substance use, preexisting motor tics or family history of Tourette’s disorder.

124
Q

What are the anti-alcohol drugs?

A

disulfiram (Antabuse)

naltrexone (ReVia)

125
Q

What are anti alcohol drugs used for?

A

To prevent alcohol use with those who have alcohol use disorder.

126
Q

How does disulfiram (Antabuse) work?

A

Inhibits alcohol metabolism which leads to accumulation of acetaldehyde and unpleasant reactions (severe nausea, vomiting, sweating, headaches, tachycardia,hypotension)

127
Q

How does naltrexone (ReVia) work?

A

It is a opioid receptor antagonist. Therefore, it blocks the crab for and reinforcing effects of alcohol.

128
Q

What are the side effects for disulfiram (Antabuse)?

A

Drowsiness, depression, disorientation, headaches, restlessness, impotence, and blood dyscrasias

129
Q

What are the side effects for

naltrexone (ReVia)?

A

Nausea, abdominal cramping, vomiting, insomnia, nervousness, headaches, and joint and muscle pain.