Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3. Mondays > 308 Drugs of psychiatric disorders > Flashcards

308 Drugs of psychiatric disorders Flashcards

1
Q

Name some SSRI’s

A

Fluoxetine
Paroxetine
Sertraline
Citalopram
Escitalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the indications for SSRI’s?

A

-Depression
-Anxiety disorders
-Panic disorders
-OCD
-PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which SSRI has the shortest half life?

A

Paroxetine (20 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which SSRI has the longest half life?

A

Fluoxetine (2-4 days)
But active metabolite has 14 day half life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do SSRI’s work?

A

They prevent the reuptake of serotonin so it stays in the synaptic cleft longer and has more of a chance of acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the main side effects of SSRI’s?

A

-Agitation and anxiety
-Dizziness, balance problems
-Nausea, diarrhoea
-Flu-like symptoms

Occur on abrupt cessation of the SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does Mirtazapine work?

A

It’s a noradrenergic and specific serotonergic antidepressant (NaSSA)

It works on alpha-2 receptors to cause continuous release of serotonin and noradrenaline without breaks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the side effects of Mirtazapine?

A

-Helps people to fall asleep
-Causes hunger and therefore weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name some tricyclic antidepressants

A

-Amitrptyline
-Imipramine
-Lofepramine
-Dothiepin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why are tricyclic antidepressants not commonly used?

A
  • Worse side effects
  • Dangerous with overdose

Dothiepin: most cardio toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do tricyclic antidepressants work?

A

They bind to reuptake inhibitors which increase the levels of neurotransmitters in the synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some side-effects of tricyclic antidepressants?

A

-‘They’re dry’: cause dry mouthy, constipation, urinary retention, cognitive effects (confusion)
-Psychotropic effects (agitation, nightmares)
-Sexual dysfunction
-Akathisia (restlessness)
-Muscle twitches
-Cardiac arrhythmias (QT interval)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does Venlaflaxine work?

A

It’s a serotonin and noradrenaline reuptake inhibitor (SNRI)

Often combines with Mirtazapine in treatment resistant depression (Referred to as California rocket fuel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some side effects of Venlafaxine?

A

-Headaches
-Nausea
-Hypertension
-Discontinuation syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What alternative uses of Duloxetine are there?

A

An SNRI that doesn’t come with the risk of hypertension

Used for diabetic neuropathy and urinary stress incontinence at different doses and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do MAOI’s work?

A

They prevent the action of monoamine oxidase which stops noradrenaline and serotonin being broken down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the food interactions of MAOI’s?

A

Most cheese
Red wine
Yeast production liver
Broad bean pods
Fermented sausages Eg. salami

These cause the tyramine reaction which is normally prevented by monoamine oxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does an accumulation of tyramine cause?

A

A hypertensive crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why are MAOI’s not commonly used?

A

-Lots of food interactions
-Increased risk of serotonin syndrome (so can’t be combined with SSRI’s. If medication is being switched, time is given for the medication to wash out of the system before the new medication is started)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name some SNRI’s

A

Venlafaxine
Duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name some tricyclic antidepressants

A

Amitriptyline
Dothiepin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do tricyclic antidepressants work?

A

They block the serotonin and noradrenaline reuptake pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name some MAOI’s

A

Phenelzine
Monclebamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name some tetracyclic antidepressants

A

Mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which neurotransmitter do antipsychotic medications work?
Dopamine
26
Which receptors does dopamine work on?
Metabotropic G-protein coupled receptors
27
What is the precursor to dopamine?
Tyrosine
28
What does dopamine do?
Executive functions Motor control Motivations Reward Lactations Nausea
29
Name some dopamine pathways in the brain
Mesocortical - from VTA to prefrontal cortex Mesolimbic - from VTA to nucleus accumbens Tuberoinfundibular - from hypothalamus to pituitary gland Nigrostriatal - from substantia nigra to caudate nucleus and putamen
30
What is the VTA?
The ventral tegmental striatum
31
What is the mesocortical pathway for?
Motivation Emotion Executive functions
32
What is the Mesolimbic pathway for?
Pleasure and reward
33
What is the Tuberoinfundibular pathway for?
Regulates prolactin secretion to the pituitary gland
34
What is the Nigrostriatal pathway for?
Voluntary movement through basal ganglia motor loops. It can influence cognition, reward, and addiction
35
Decreased function in which brain pathway causes negative symptoms of schizophrenia?
The mesocortical pathway
36
Increased function in which brain pathway causes positive symptoms of schizophrenia?
The mesolimbic pathway
37
Why are antipsychotics most effective at treating positive symptoms?
Because they block the effect of dopamine Positive symptoms are caused by too much dopamine
38
How do antipsychotics cause hyperprolactinaemia?
Dopamine has an inhibitory effect on prolactin release and antipsychotics block dopamine
39
What are extrapyramidal side effects?
Symptoms like: inability to sit still involuntary muscle contraction tremors stiff muscles involuntary facial movements Parkinsonism Dystonias Tardive dyskinesia Hyperprolactinaemia
40
How do antipsychotics cause extrapyramidal side effects?
Dopamine is needed in the nigrostriatal pathway. Decreased dopamine causes the symptoms
41
What are the symptoms of raised prolactin?
Lactation Amenorrhoea Sexual dysfunction Osteoporesis
42
What is the serotonin hypothesis of depression?
It's a theory as to the cause of depression Some hallucinogenic drugs like LSD have structural resemblance to serotonin, some newer antipsychotics act on serotonin receptors eg, clozapine
43
What is the glutamate hypothesis?
Theory that there is abnormal glutamate activity in schizophrenia Phenocyclidine (PCP) is a glutamate agonist that produces schizophrenia-like symptoms
44
What are neuroleptic drugs?
Another name for typical antipsychotics
45
What is the difference between typical and atypical antipsychotics?
Typical antipsychotic drugs act on the dopaminergic system, blocking the dopamine type 2 (D2) receptors Atypical antipsychotics have lower affinity and occupancy for the dopaminergic receptors, and a high degree of occupancy of the serotoninergic receptors 5-HT2A
46
What are the main symptoms of typical antipsychotics?
Parkinsonism Akathisia Dystonia Tardive dyskinesia
47
Give examples of typical antipsychotics
Butyrophenones: Haloperidol Phenothiazines: Chlorpromazine Trifluoperazine Fluphenazine Thioxanthines: Flupenthixol
48
Name some atypical antipsychotics
Risperidone Olanzapine Quetiapine Aripiprazole
49
Which are newer, atypical or typical antipsychotics?
Atypical antipsychotics
50
What is tardive dyskinesia?
A condition where your face, body or both make sudden, irregular movements which you cannot control Typical symptoms include facial grimacing, sticking out the tongue, sucking or fish-like movements of the mouth
51
What are some muscarinic (cholinergic) receptor side effects of antipsychotics?
Blurred vision Dry eyes Dry mouth Tachycardia Dyspepsia Constipations Dizziness Impaired memory and congition
52
What are muscarinic receptors?
They're activated by acetylcholine Associated mainly with parasympathetic functions
53
What are some alpha adrenergic receptor side effects of antipsychotics?
Orthostatic hypotension Vertigo Palpitations Sexual dysfunction
54
How do antipsychotics cause vertigo?
Because they can lower blood pressure
55
What is the difference between alpha and beta adrenergic receptors?
Alpha adrenoceptors mediate smooth muscle contraction and vasoconstriction Beta (β) receptors mediate vasodilation, smooth muscle relaxation, bronchodilation, and excitatory cardiac function
56
What is vertigo?
Dizziness
57
What is the most effective antipsychotic?
Clozapine It's used for treatment resistant cases because it has a lot of side effects
58
What are some side effects of clozapine?
Hypersalivation Hypotension Haematological problems Constipations Blurred vision Fast, pounding, or irregular heartbeat Drowsiness Trembling hands and legs
59
Which antipsychotics can be given for rapid tranquillisation?
Haloperidol Olanzapine Lorazepam Midazolam
60
Name some mood stabiliser medications
Lithium Sodium valproate Lamotrigine (Carbamazepine) Rarely used: gabapentin
61
What are the advantages of using lithium?
It reduces suicidality Reduced signals that contribute to mania
62
Which medication inhibits inositol?
Lithium
63
What is Inositol?
Also called myo-inositol, D-chiro-inositol, or hexaphosphate (IP6) It plays a critical function in the body's cellular growth. Though it used to be referred to as Vitamin B8, inositol is not actually a vitamin. It's a type of sugar that helps your body process insulin
64
How does Lithium act in the body?
At a neuronal level, lithium reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission
65
What are the side effects of Inositol deficiency?
Hair loss (alopecia) Skin problems such as eczema (extremely dry, itchy skin) Mental health symptoms such as troubles with sleep, mood, anxiety. Constipation. Hyperlipidemia (too many fats such as cholesterol or triglycerides in the blood). Muscle weakness
66
What are the short term side effects of lithium?
Polydipsia and polyuria Nausea Fine hair Loose stools
67
How does lithium cause alopecia?
Because it causes a hypoactive thyroid
68
What are the long term side effects of lithium?
Renal impairment Hypothyroidism Weight gain Acne
69
How does lithium cause acne?
When lithium is taken, many neutrophils move from the bloodstream to the skin, where they can cause inflammation and increase the likelihood of pimples
70
How does lithium cause hypothyroidism?
It inhibits iodine uptake
71
How does lithium cause polyuria and polydypsia?
The most common renal side effect of lithium is of concentrating urine despite normal or elevated concentrations of the antidiuretic hormone vasopressin The concentrating defect leads to decreased urine osmolality and increased urine volume (polyuria)
72
What is the therapeutic index of lithium?
0.4 - 1.0 mmol/L
73
What are the symptoms of lithium toxicity?
Coarse tremor Nausea Vomiting Ataxia Cerebellar signs Confusion
74
What is a coarse tremor?
It has more of a displacement than a fine tremor (More shaking)
75
What can cause lithium toxicity?
Dehydration Drug interactions Eg, NSAID's Deteriorating renal function
76
What effects does lithium have on protein kinase C and gene regulation?
Lithium decreases the phosphorylation of CREB It decreases protein kinase C translocation
77
What effects does valproate have in the body?
Inhibition of Ca2+ and Na+ channels Enhances inhibitory GABA reduces excitatory glutamate
78
How does Valproate produce a calming effect?
It enhances GAMA so blocks transmission across neurones and this has a calming effect
79
What are the uses of valproate?
Mood stabiliser migraine prophylaxis
80
What are the side effects of valproate?
VALPROATE Vomiting Alopecia Liver dysfunction Pancreatitis Retention of fat Oedema Appetite increase Tremor Enzyme inducer Teratogenic and causes developmental disorders (contraindicated in women of child baring age)
81
What are the side effects of Carbamazepine?
CABSANT CYP450 inducer Ataxia, diplopia Bone marrow suppressor (thrombocytopaenia, neutropoenia) Steven Johnson and other rashes Aplastic anaemia Na - Hyponatraemia (SIADH) Teratogenic
82
What is a Steven Johnson rash?
Starts off as flu-like symptoms It's made up of circular patches that are darker in the middle and lighter around the outside
83
What are anxiolytic drugs?
Medications that prevent anxiety
84
Name some commonly-used bendodiazapines
Diazepam Lorazepam Clonazepam Temazepam Clobazam
85
Name a short-acting benzodiazepine
Lorazepam
86
Name a long-acting benzodiazepine
Clonazepam
87
What are the uses of benzodiazepines in psychiatry?
Hypnotics Anxiolytics Minor tranquillisers Management of alcohol withdrawal Anticonvulsant (clobazam) and muscle relaxant
88
How do benzodiazepines produce their effect in the body?
They bind to BZP site of GABA-A receptors (the main inhibitory neurotransmitter in the CNS)
89
What are the disadvantages of using benzodiazepines?
They create tolerance - But there are people where long-term treatment is still indicated Abrupt withdrawal can precipitate acute delirium, rarely psychosis, convulsions Withdrawal causes nausea, hyperacusis, dizziness and imbalance, tinnitus, depersonalisation
90
What are hypnotic drugs?
Medications used to induce, extend, or improve the quality of sleep, and to reduce wakefulness during sleep
91
What is tinnitus?
Experience of ringing or other noises in the ear
92
What is depersonalisation?
Where you have the feeling of being outside yourself and observing your actions, feelings or thoughts from a distance
93
How is alcohol withdrawal managed?
Vitamin supplementation Medications: Acamprostate - reduces cravings Naltrexone - reduces cravings/enjoyment via opioid receptors Disulfiram (antabuse) - induces severe reaction if alcohol is consumed. It blocks the breakdown of alcohol Benzodiazepines
94
What is Chlodiazepoxide used for?
It's an anxiolytic Can be used instead of diazepam
95
Which medications are given instead of diazepam or Chlordiazepoxide in hepatic compromise?
Oxazepam or lorazepam
96
What is the difference between diazepam and chlordiazepoxide?
Chlordiazepoxide has a lower abuse potential Chlordiazepoxide is used short-term for severe anxiety, muscle spasm and alcohol withdrawal
97
What does pregabalin do in the body?
It binds to and modulates voltage-gated calcium channels in the CNS Originally developed for neuropathic pain but now has a role in anxiety, panic disorders, and partial seizures There are concerns with misuse because it gives a euphoria
98
What is Buspirone used for?
It's a partial agonist ay 5HT_1a receptors Licenced for generalised anxiety disorder but there are doubts over efficacy

3. Mondays (126 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions