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Pre-pharmacology > Chapter 18 (neuropsychiatric drugs) > Flashcards

Chapter 18 (neuropsychiatric drugs) Flashcards

1
Q

anxiolytics

A

drugs that sedate and decrease anxiety; are ‘downers’

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2
Q

anxiety and depression

A

same drugs treat both conditions and both diseases have same underlying pathology; really two sides of same coin

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3
Q

sedative-hypnotics

A

minor tranquilizers; all drugs that work to depress the CNS

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4
Q

alcohol

A

a sedative, ‘downer’, drug that works on the CNS

*causes many seizures during withdrawls

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5
Q

opium

A

sedative used for hundreds of years

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6
Q

physical and emotional pain

A

very difficult to separate; all pain occurs in our brain and these two go together. There are nociceptive pain signals, but they are not interpreted as pain until they are in our brains.

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7
Q

barbituric acid

A

synthesized by Adolf von Baeyer in 1864, which led to barbiturates later

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8
Q

Veronal

A

barbital; first barbiturate, found to produce euphoria

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9
Q

lethal injection

A

high dose of KCl to cause MI with a barbiturate before to make it painless

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10
Q

barbiturates

A

used as sedatives, antiepileptics (first ones to do so), sleeping aids, and to induce general anesthesia
But are very addictive, have extremely long 1/2 lives, give nausea, and make people groggy
*too many side e’s and addiction to use indiscriminately

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11
Q

Miltown

A

meprobamate; first drug specific as a pyschotropic (not just a ‘downer’ for general population use) for anxiety
Often too weak to be used for anything but anxiety
Launched as a less addictive medication for anxiety; one specific year it was 1/3 of all Rx in USA
*originally thought to be fabled non-addictive sedative-hypnotic

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12
Q

benzodiazepines

A

work at GABA-A rc. Have amazing sedative properties; used for people w/anxiety disorders, general anesthesia, seizures, and a small application as sleep aids
Great acute for seizures, but long term requires switching to another drug for maintenance
*tend to stop processing of new memories for general anesthesia
*all end with -epam or -olam

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13
Q

Valium

A

diazepam; benzodiazepine.
Given IV to control acute seizure exposure
Oral form lasts almost a day (8-10 hours)

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14
Q

Versed

A

midazolam; benzodiazepine. Best acute seizure drug b/c can be IV, IM, or down endotracheal tube
Only AED that is remarkably effective against many types of seizures

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15
Q

Xanax

A

alprazolam; benzodiazepine commonly over Rx’ed and abused

Lasts for a number of hours and does not make people feel hungover, hence it is so commonly used

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16
Q

Restoril

A

temazepam; benzodiazepine used mainly for sleep b/c it lasts all night and has pretty fast onset of action
*developed to be longer lasting sleep aid version of Halcion

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17
Q

Halcion

A

triazolam; benzodiazepine used mainly to put people to sleep, with fast 10 minute onset of action orally, but only lasts 2 hours

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18
Q

Rohypnol

A

flunitrazepam; benzodiazepine; one of top date rape drugs

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19
Q

Quaalude

A

methaqualone; sedative-hypnotic that was so abused in the 70s that it was banned in US and many other countries

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20
Q

antihistamines

A

used as anxiolytics that are non-addictive

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21
Q

Vistaril

A

hydroxyzine; 1st gen antihistamine with antiemetic and sedative properties
Also used to stop itching following an epidural

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22
Q

Atarax

A

hydroxyzine; 1st gen antihistamine with antiemetic and sedative properties
Also used to stop itching following an epidural

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23
Q

herbal anxiolytic remedies

A

have lack of efficacy compared to Rx drugs, but aren’t addictive and can help people who don’t have actual disease
St. John’s Wort, chamomile, Valerian root, kava kava, and melatonin

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24
Q

medical marijuana

A

used for anxiety, as well as cachexia, nausea, glaucoma, and pain
It is not an analgesic, but in relieving psychological pain through sedative properties it may be helping people relieve physical pain

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25
Q

epilepsy

A

common neurological disorder characterized by seizures (the spontaneous firing of a group of cells in the cerebral cortex)
Lifelong disorder that is not outgrown and typically has grand mal seizures

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26
Q

first treatment for epilepsy (historically)

A

manipulating the diet, which was largely unsuccessful

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27
Q

phenobarbital

A

barbiturate used as an anti-seizure drug, but has undesirable side e’s of barbiturates (drowsiness, behavioral changes, addiction)
*backup drug for treating seizures to Dilantin/Tegretol

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28
Q

Dilantin

A

phenytoin; sodium channel blocker (stabilizer); hydantoin drug used for oral maintenance prevention of partial/generalized seizures

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29
Q

Tegretol

A

carbamazepine; sodium channel blocker (stabilizer), but also has other effects on Ca currents and GABA receptors; anticonvulsant drug used for maintenance prevention of partial seizures

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30
Q

hydantoin drugs

A

stabilize excitable areas in brain where seizures start; fairly safe for oral maintenance therapy
*unfortunate side e of coarsening facial features and gingival hyperplasia with long term use over many years

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31
Q

GHB

A

gabbahydroxybutyrate; one of most popular date rape drug

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32
Q

status epilepticus

A

life threatening seizure condition defined by two seizures happening back to back without recovery or one seizure lasting 30 minutes or longer
Long seizures take up tons of O2 and leave toxic metabolites from anaerobic respiration (and brain in O2 depleted) which causes damage

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33
Q

status epilepticus treatment

A

IV Valium, Versed, barbiturate like Pentothal (thiopental), Dilantin, or sometimes even a general anesthetic is required in most severe cases

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34
Q

Pentothal

A

thiopental; barbiturate anticonvulsant used IV to stop acute seizures

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35
Q

anorexia nervosa

A

disorder of body image leading to starvation; treated with cognitive therapy

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36
Q

depression

A

disorder of NT imbalance; one of the affective disorders (those that affect our mood); big changes, good or bad, lead to anxiety and depression often
*some people have genetic, chronic depression that is constant imbalance of NTs

37
Q

four major classes of antidepressants

A

older: MAOIs (monoamine oxidase inhibitors) and TCAs and TeCAs (tricyclic and tetracyclic antidepressants)
newer: SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinepherine reuptake inhibitors)

38
Q

MAOIs

A

monoamine oxidase inhibitors; some of best antidepressants for severe depression
Have such bad side e’s and interactions with many foods that only psychiatrists Rx’d them for extremely depressed people
*also used for pain, anxiety, psychosis, etc.

39
Q

TCAs and TeCAs

A

tricyclic and tetracyclic antidepressants; Increase sensitivity of brain rc to NE and 5HT
not nearly as good of antidepressants to Rx b/c although they are effective, they have anticholinergic side e’s that suck (constipation, dry mouth, grogginess, tiredness, urinary issues, etc.)

40
Q

Elavil

A

amitriptyline; prototypical TCA used to help with sleep and to treat some weird pain syndromes, like shingles

41
Q

SSRIs and SNRIs

A

selective serotonin reuptake inhibitors and serotonin and norepinepherine reuptake inhibitors; best tolerated antidepressants; most used today

42
Q

Prozac

A

fluoxetine; SSRI antidepressant that was first of modern ADs and is prototype

43
Q

Cymbalta

A

duloxetine; SNRI antidepressant

Also used for neuropathic pain like fibromyalgia and works better for this than SSRIs

44
Q

co-morbid conditions with depression

A

often responsive to same SSRIs and anxiolytics as depression:
bipolar disease, generalized anxiety disorder, obsessive compulsive disorder, phobias, PTSD, and addictions

45
Q

BD

A

bipolar disorder, manic depression; wild emotional swings from depression to mania (disconnect with reality)
Treat with lithium and antidepressants

46
Q

Lithobid

A

long acting formulation of lithium; used to treat bipolar disease

47
Q

GAD

A

generalized anxiety disorder; affective disorder

Treat with benzodiazepines and antidepressants (especially Zoloft and Paxil SSRIs)

48
Q

Zoloft

A

sertraline; SSRI antidepressant

49
Q

Paxil

A

paroxetine; SSRI antidepressant

50
Q

OCD

A

obsessive compulsive disease
Treat with combination of antidepressants (SNRIs like Cymbalta) and anxiolytics (like Xanax)
*tertiary treatment includes antipsychotic medication (like latest gen atypical drug Risperdal)

51
Q

Risperdal

A

risperidone; latest gen atypical antipsychotic, most commonly used antipsychotic in US
Used for treating agitation associated with psychosis

52
Q

phobias

A

type of anxiety triggered by very specific situations that hinders people’s ability to function
Specific or simple phobias: fear of an object or situation
Social phobias: fear of embarrassment or humiliation in social settings
Agoraphobia: fear of being away from a safe place
Treat with anti-anxiety drugs like Xanax, B-blockers, and SSRI (and other antidepressants)

53
Q

PTSD

A

Treat with new antidepressants and B-blockers

54
Q

schizophrenia

A

psychotic illness; a psychosis resulting in loss of touch with reality

55
Q

antipsychotics

A

major tranquilizers, neuroleptics; treat psychotic ‘breaks’

Treat those who suffer from hallucinations, paranoia, and loss of touch with reality

56
Q

phenothiazine

A 
subclass of antipsyhchotics
*end with -azine
57
Q

Thorazine

A

chlorpromazine; first neuroleptic

58
Q

Compazine

A

prochlorperazine; phenothiazine used more often today to treat n/v

59
Q

typical antipsychotics

A

early antipsychotics; have ‘typical’ side e’s
Extrapyramidal symptoms occur: tics/automation behaviors like lip smacking, neck twitching, and arm movements
*these symptoms would sometimes be permanent even after drug discontinuation

60
Q

atypical antipsychotics

A

newer antipsychotics; do not have as high of rate of extrapyramidal (typical) side e’s, but have other major side e’s

61
Q

Seconal

A

secobarbital; barbiturate used as a sleep aid, but not used much anymore b/c of abuse potential and long 1/2 lives

62
Q

nonbenzodiazepines

A

group of drugs that are used basically just for sleep aids
Have activity at GABA-A (gammaaminobutyric acid type A) rc; drugs of choice for short term treatment of insomnia
S4 like benzodiazepines

63
Q

Ambien

A

zolpidem; nonbenzodiazepine, used for insomnia treatment short term

64
Q

Lunesta

A

eszopiclone; nonbenzodiazepine, used for insomnia treatment short term

65
Q

Rozerem

A 
ramelteon; first of new class of sleep agents that selectively bind and stimulate melatonin rc
*fitful dreams can be side e
66
Q

OTC sleep aids

A

antihistamines (1st gen drugs that cross BBB and have anticholinergic effect), Mg (also good for cramps), or alcohol

67
Q

NyQuil

A

liquid form has antihistamine doxylamine and alcohol

68
Q

Herbal remedies for sleep aid

A

Valerian root, chamomile, lemon balm, and melatonin

69
Q

melatonin

A

secreted by pineal gland in brain; is integral in maintaining our 24 hour sleep-wake cycle.
*potentially consuming it ‘naturally’ from animal brains could transmit prions

70
Q

ADHD

A

attention deficit hyperactivity disorder; treated with S2 amphetamines that exhibit a paradoxical effect (ADHD pts. become more calm and focused from this stimulant)

71
Q

Ritalin

A

methylphenidate; amphetamine-like drug used for ADHD treatment (b/c of paradoxical effect); high abuse potential
Long acting forms of drug are now used b/c of problems associated with taking multiple times a day and at school
*the original amphetamine used to treat ADHD

72
Q

ADHD diagnosis

A

should be done by a child psychiatrist that can really evaluate the child thoroughly, not just 10 minutes like a pediatrician might do. Treatment should be decided upon seriously since it can cause lack of motivation, headaches, and sleeping disorders

73
Q

insomnia treatment

A

1: nonbenzodiazepines, melatonin rc agonists

2. benzodiazepines

74
Q

anxiety treatment

A

1: antidepressants

2. benzodiazepines

75
Q

seizure treatment

A

1: Dilantin, Tegretol
2: benzodiazepines, barbiturates

76
Q

depression treatment

A

1: antidepressants

77
Q

manic depression treatment

A

1: lithium, antidepressants
2: antipsychotics

78
Q

psychosis treatment

A

1: antipsychotics

79
Q

phobia and OCD treatment

A

1: benzodiazepines, antidepressants
3: antipsychotics

80
Q

ADHD treatment

A

1: S2 stimulants
3: antipsychotics

81
Q

liquor

A

ethyl alcohol; by far most widely used anxiolytic, the ‘social lubricant’

82
Q

laudanum

A

tincture of opium

83
Q

long-term anxiety

A

best treated with newer antidepressants like Prozac (fluoxetine), Zoloft (sertraline), or Paxil (paroxetine)

84
Q

Inderal

A

propranolol; B-blocker used to treat conditions like PTSD

85
Q

Haldol

A

haloperidol; typical antipsychotic (used in the 70s-90s; later than the prototypical Thorazine, in the 50s)

86
Q

Adderall

A

mixed amphetamine salts; S2 stimulant with high abuse potential

87
Q

Hoffman-La Roche

A

major pharma company that made its wealth from developing benzodiazepines

88
Q

EPS

A

extrapyramidal symptoms, tardive dyskinesia; stiff, jerky involuntary movements that are associated with typical antipsychotics

89
Q

AEDs

A

anticonvulsants, also commonly known as antiepileptic drugs or as antiseizure drugs

Pre-pharmacology (27 decks)

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