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Phase II Other Drug Classes > Drugs used in Psychiatric Disorders > Flashcards

Drugs used in Psychiatric Disorders Flashcards

1
Q

Benzodiazepines are commonly used as _____ and as ______ to treat the symptoms and behaviours caused by ________________

A

Anxiolytics; sleeping pills; anxiety disorders

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2
Q

Name a short acting benzodiazepine

A

Midazolam

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3
Q

Name 2 intermediate acting benzodiazepines

A
  1. Lorazepam
  2. Alprazolam
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4
Q

Name 2 long acting benzodiazepines

A
  1. Diazepam
  2. Clonazepam
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5
Q

Describe the MOA of benzodiazepines

A

Bind to specific BZD sites in the CNS which potentiate GABA actions by increasing the frequency of chloride channel opening

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6
Q

Benzodiazepines are _____ dependent

A

GABA

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7
Q

Route of administration for benzodiazepines

A

Oral or IV

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8
Q

Which benzodiazepines can be given IV?

A

Midazolam, lorazepam, diazepam

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9
Q

Describe the adverse effects a/w benzodiazepine use

A
  1. CNS: Increased drowsiness, decreased motor skills, increased reaction time
  2. CNS: Anterograde amnesia (particularly with IV sedation)
  3. CVS: Decreased BP and respiration
  4. Paradoxical effects: excitement, garrulousness, irritability, hallucination, rage
  5. Neonatal toxicity: Floppy child syndrome
  6. Tolerance, dependence, withdrawal

*1, 2 and 3 are more common

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10
Q

State 4 causes of insomnia

A

Anxiety
Depression
Drug-induced
Drug withdrawal

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11
Q

Describe the characteristics of benzodiazepine-induced sleep

A

Reduced REM and deep (stage 4) sleep when compared to natural sleep

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12
Q

Elimination half-life of benzodiazepine hypnotics

A

Ranging from 2-24h

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13
Q

State 2 non-benzodiazepine hypnotics

A
  1. Zolpidem
  2. Zopiclone
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14
Q

MOA of non-benzodiazepine hypnotics

A

Acts on BZD sites SIMILAR to BZD

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15
Q

Hypnotic effect of non-benzodiazepine hypnotics to benzodiazepines

A

Comparable

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16
Q

Elimination half-life of non-benzodiazepine hypnotics

A

Short; 2-4h

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17
Q

2 adverse effects of non-benzodiazepine hypnotics

A
  1. Withdrawal anxiety
  2. Abuse potential
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18
Q

State 4 categories of non-pharmacological treatment of depression

A
  1. Psychological
  2. Social
  3. Behavioural
  4. Relaxation
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19
Q

Name the biochemical theory of depression

A

Monoamine deficiency

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20
Q

State the 4 classes of commonly used antidepressants

A
  1. Selective serotonin re-uptake inhibitors (SSRIs)
  2. Tri-cyclic antidepressants (TCAs)
  3. Serotonin norepinephrine re-uptake inhibitors (SNRIs)
  4. Noradrenergic and Specific serotonergic antidepressants (NaSSAs)
21
Q

Name 4 SSRIs

A
  1. Fluoxetine
  2. Escitalopram
  3. Sertraline
  4. Paroxetine
22
Q

Name 2 TCAs

A
  1. Amitriptyline
  2. Imipramine
23
Q

Name 1 SNRI

A

Venlafaxine

24
Q

Name 1 NaSSA

A

Mirtazapine

25
Q

MOA of SSRI

A

SSRI blocks reabsorption of serotonin by inhibiting the serotonin transporter (SERT) on the serotonergic pre-synaptic nerve ending

26
Q

MOA of TCA and SNRI

A

Inhibits SERT on serotonergic pre-synaptic nerves thus blocking reabsorption of serotonin AND
inhibits NET on noradrenergic pre-synaptic nerves thus blocking reabsorption of norepinephrine

27
Q

MOA of NaSSA

A

Blocks the NEalpha-2 Receptor on serotonergic and noradrenergic pre-synaptic nerves AND
Blocks the 5-HT2 and 5-HT3 receptors on post-synaptic nerves

28
Q

Overall effect of antidepressants on neurons

A

Overall increase in BDNF leading to trophic action that increases neuronal survival

29
Q

Describe the adverse effects a/w SSRI use

A
  1. Anxiety
  2. Weight loss / gain
  3. Headache, nausea (first few days)
  4. Sexual dysfunction
  5. Hyponatremia
  6. No fatality on overdose
30
Q

Describe 2 DDIs a/w SSRI use

A
  1. SSRIs are CYP450 inhibitors (fluoxetine greatest inhibitory effect)
  2. Do not take with MAOIs or St John’s wort (risk of serotonin syndrome)
31
Q

Taking SSRIs with MAOI or St John’s wort increases the risk of _______ syndrome which includes symptoms such as…

A

Serotonin syndrome.

  • Confusion
  • Agitation
  • Restlessness
  • GI symptoms
  • Sudden high body temp
  • Hypertension
  • Severe seizures
32
Q

Describe the adverse effects a/w TCAs

A
  1. CNS: Sedation, fatigue
  2. Cardiac rhythm: Tachycardia, arrhythmia
  3. Postural hypotension
  4. Anticholinergic effects: Glaucoma, blurred vision, urinary retention, constipation
  5. Fatality on overdose
33
Q

Describe the adverse effects a/w SNRIs

A
  1. CNS: Agitation, irritability, drowsiness
  2. CVS: BP may be affected at higher dose
  3. Hyponatremia
34
Q

5 factors that up-regulate adult neurogenesis

A
  1. Enriched environment
  2. Exercise
  3. Learning
  4. Estrogen
  5. Antidepressants, ECS
35
Q

5 factors that down-regulate adult neurogenesis

A
  1. Stress
  2. Glucocorticoids
  3. Age
  4. Opiates
  5. Excitatory amino acids
36
Q

Long term antidepressant treatment regulates _____ like _____

A

Neurotrophins; BDNF

37
Q

How does BDNF work?

A

Binds to specific receptors leading to activation of neurons;
Enhances the growth of serotonin and NE neurons
Overall protecting the neurons form neurotoxic damage

38
Q

Describe the hypotheses of psychosis

A
  1. Dopamine hypothesis Excessive dopamine transmission in the mesocortico-limbic system
  2. Abnormality in 5-HT, glutamate and other systems
39
Q

Positive symptoms of schizophrenia

A
  1. Delusion (abnormal belief)
  2. Hallucination
  3. Disorganised thinking, speech and behaviour
40
Q

Negative symptoms of schizophrenia

A
  1. Avolition
  2. Affect flattening
  3. Inability to plan
  4. Poor concentration
41
Q

Antipsychotic drugs are used to treat the _____ of psychoses

A

Symptoms

42
Q

Name the 2 classes of antipsychotic drugs

A
  1. Typical (1st gen)
  2. Atypical (2nd gen)
43
Q

Name 2 typical (1st gen) antipsychotics

A
  1. Haloperidol (high potency)
  2. Chlorpromazine (low potency)
44
Q

Name 5 atypical (2nd gen) antipsychotics

A
  1. Risperidone
  2. Olanzapine
  3. Quetiapine
  4. Clozapine
  5. Aripiprazole
45
Q

Describe the MOA of typical antipsychotics

A

Block D2 receptors more than 5-HT2 receptors.
Additional blocking effect on D1, cholinergic, histaminic, and alpha adrenergic receptors

46
Q

Describe the MOA of atypical antipsychotics

A

Block 5-HT2 receptors more than D2 receptors.
Additional blocking effect on D1, cholinergic, histaminic, and alpha adrenergic receptors

47
Q

Describe the adverse effects a/w typical antipsychotics like haloperidol

A
  1. Extrapyramidal reactions (blocks dopamine)
  2. Sedation
  3. Anticholinergic (blocks ACh)
  4. Rarely: Neuroleptic malignant syndrome
48
Q

Name 5 reactions of extrapyramidal reactions

A
  1. Acute dystonia
  2. Parkinsonism
  3. Akathisia
  4. Malignant syndrome
  5. Tardive dyskinesia
49
Q

Describe the adverse effects a/w atypical antipsychotics

A

*Less EPSE than typicals

Risperidone: EPS (dose dependent), weight gain
Clozapine: Agranulocytosis, weight gain, sedation
Olanzapine: Weight gain, sedation
Quetiapine: Weight gain

Phase II Other Drug Classes (6 decks)

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