block 6 lecture 7 psychotic drug Flashcards
what do psychotropic drugs target?
dopamine, noradrenaling, serotonin and mono-oxygenase inhibitos
what is the onset of schizophrenia?
young adult life
what are the positive symptoms of schizophrenia?
hallucinations/delusion/thought disorder
what are the negative symptoms of schizophrenia?
lack of motivation/reduced speech/reduced emotion/social with drawl
what is depression?
a collection of symptoms occuring together
what do you experience changes in in depression?
sleep/appetite/weight/concentration
what is bipolar disease?
episodes of manic and depression
what happens in the manic episodes of bipolar disorder?
elation/increased energy/reduced sleep/overactivity/disinhibition/rapid speech
what are the 4 dopamine pathways?
mesolimbic
mesocorticol
nigrostriatal
tubero-infundibular
what is the mesolimbic system for?
reinforcement and reward
what is the mesocortical system for?
planning
what is the nigrostriatal pathway for?
initiation and controll of movement
what is the tubero-infundibular system for?
dopamine inhibits the amount of prolactin hormone released by the pituitary gland (for making breast milk)
what is the route the infundibular system takes?
hypothalamus to the pituitary gland
where is noradrenaline released from?
neurones that orginate in the locus coeruleus in the brain stem
what does noradrenaline do?
influences: sleep/wakefullness/attention/feeding behaviour
how is dopamin inactivated?
reuptake into presynaptic neuron
what happens to the noradrenaline in the presynaptic neuron?
oxidised
what is serotonin also known as?
5HT
where is serotonin released form?
neurons that originate from the raphe nuclei in the brain stem
what does serotonin influence?
mood, emotional behaviors and sleep
what is serotonin inactivated by?
reuptake at the presynaptic membrane where its oxidised
what is GABA released by?
inhibitory neurones in the CNS
what do GABA receptors do when stimulated?
allow an influx of chloride ions across the post synaptic membrane causing hypopolarisation and inactiavtion
what do antipsychotic do?
antagonise D2 receptors in the mesolimbic and mesocortical system
what do antipsychotics treat?
schizophrenia
delusions
hallucinations
thought disorder
examples of antipsychotics?
Olanzapine, Risperidone, Haloperidol
what are the side effects of antipsychotics?
affects: the nigrostriatal pathway and the tubulo-infundibular pathway block histamine receptors blocks muscarinic receptors blocks alpha adrenoceptors blocks serotonin receptors
what are the nigrostriatal pathway side effects of antipsychotics?
parkinsonism/akathisia/dystonia/dyskinesia
what is tardive dyskinesia?
involuntary movements of the face
what is chlozapine good for?
when other drugs dont work
what happens when the histamine receptors are blocked?
sedation
what happens when the muscarinic receptors are blocked?
blocks parasympathetic nervous stimulation
what happens when the alpha adrenoceptors are blocked?
postural hypertension
what happens when the serotonin receptors are blocked?
weight gain
what are the metabolic and cardiac side effects of antipsychotics?
weight gain loss of control of blood sugar raised cholesterol arrhythmia rarely idiosynoric
why are the metabolic and cardiac side effects important to consider?
schizophrenia people are predisposed to cardiovascular disease
whata re the three groups of antidepressants?
tricyclic
serotonin reuptake inhibitors
monoamine oxidatuion inhibitors
what do tricyclic drugs do?
bl9ock noradrenaline and serotonin reuptake
what do tricyclic treat?
depression/anxiety/chronic pain
examples of tricyclic?
Amitriptyline, Lofepramine
what are the side effects of Amitriptyline and Lofepramine?
antagonises H1 receptors
antabonises muscarinic receptors
antagonises alpha adrenoceptors
what are SSRIs?
Selective serotonin reuptake inhibitors
Block only serotonin reuptake transporters, increasing serotonin availability at the synapse
what are SSRIs for?
depression
examples of SSRIs?
Fluoxetine, Citalopram
what are the side effects of SSRIs?
nausea and vomitting
sexual dysfunction
increase in scuicidal thoughts in young people
withdrawl reaction
what do MAOI do?
Mono-amine oxidase inhibitors
Block the action of this enzyme in the nerve terminals, increasing the availability of Noradrenaline, Serotonin, Dopamine
examples of MAOIs?
Phenelzine, Moclobemide
what are the side effects of MAOIs?
hypotensive crisis
what is lithium?
mood stabilizing drug
what would you take lithium for?
bipolar
what does lithium do?
Reduces excitory (Dopamine, Glutamate) increases inhibitory (GABA) neurotransmission Effects intracellular secondary messengers e.g. reduces formation of inositol tri-phosphate Protects neurones from damage (“neuroprotective”)
what are the side effects of lithium?
too high:
vomitting/shaking/drowsiness/ataxia = brain damage and death
what cant you take while on lithium?
diuretics and NSAIDs
what cant you take diuretics and NSAIDs while you are taking lithium?
stores lithium
what do Benzodiazepines so?
Bind to a site on the GABA receptor, potentiating the effects of GABA ie the GABA causes more Cl- flux and more inhibition
examples of Benzodiazepines?
Diazepam (Valium), Lorazepam (Ativan), Temazepam
side effects of Benzodiazepines?
Drowsiness Confusion Forgetfulness Impaired motor control Tolerance and Dependence Respiratory depression –especially with alcohol
