Chapter 10: Psychopharmacology Flashcards
What are examples of some extrapyramidal reactions and give their meanings.
Specifically choreiform, athetoid, rhythmic
choreiform: jerky movements
athetoid: slow continuous movements
rhythmic: stereotypical movements
What are the dopamine tracts?
- mesolimbic/ mesocortical
- nigrostriatal
- tuberoinfundibular
Main mechanism of antipsychotics.
DA blockage at the receptor
How does blocking DA affect the nigrostriatal pathway?
increases movement disorder
How does blocking DA affect the tuberoinfundibular pathway?
increases prolactin (galactorrhea, amenorrhea, gynecomastia)
How long does the side effect of dystonia come about after taking antipsychotics?
peaks hours to days
Treatment for dystonic reaction associated to taking antipsychotic medications.
anticholinergics: benztropine, trihexyphenidyl, diphenhydramine
When does rigidity start after taking antipsychotic meds?
3 weeks after
What is the treatment for rigidity after taking antipsychotics?
lower dose or anticholinergics
When can tremors develop after taking antipsychotics?
6 weeks
What is the treatment for tremors caused by use of antipsychotics?
lower dose or anticholinergics
When does the side effect of akathisia come about after use of anticholinergics?
10 weeks
What is the treatment for akathisia after using anti-psychotics?
B-blockers, benzodiazepines; lower dose or switch to atypical antipsychotics
What is the peak time tardive dyskinesia may develop after use of antipsychotics?
> 3 - 6 months
What are the treatment options for tardive dyskinesia caused by antipsychotics?
switch to atypical or clozapine
What are the treatment options for NMS?
neuroleptic malignant syndrome: may be lethal; dantrolene or bromocriptine
Describe the extrapyramidal symptom and anticholinergic effects levels associated with use of haloperidol. (Also describe if this is a high or low potency drug)
high potency drug so:
increased EPS
low anticholinergic effects
Describe the levels of potency, EPS, and anticholinergic effects associated with the drug chlorpromazine.
low potency
EPS levels = low
anticholinergic effects = high
MOA trazodone.
5 HT receptor antagonist, alpha 1 blocker
MOA mirtazapine.
Stimulates NE and 5 HT release; blocks 5HT2 and 5HT3 receptors
Uses for bupropion.
approved for depression and smoking cessation
What is the MOA of bupropion.
relatively weak inhibitor of the neuronal re-uptake of NE and DA; does not inhibit the re-uptake of serotonin
Which anti epileptic drug is associated with SJS?
lamotrigine
