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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
MOA of SSRI
SSRI blocks reabsorption of serotonin by inhibiting the serotonin transporter (SERT) on the serotonergic pre-synaptic nerve ending
26
MOA of TCA and SNRI
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
MOA of NaSSA
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
Overall effect of antidepressants on neurons
Overall increase in BDNF leading to trophic action that increases neuronal survival
29
Describe the adverse effects a/w SSRI use
1. Anxiety 2. Weight loss / gain 3. Headache, nausea (first few days) 4. Sexual dysfunction 5. Hyponatremia 6. No fatality on overdose
30
Describe 2 DDIs a/w SSRI use
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
Taking SSRIs with MAOI or St John's wort increases the risk of _______ syndrome which includes symptoms such as...
Serotonin syndrome. - Confusion - Agitation - Restlessness - GI symptoms - Sudden high body temp - Hypertension - Severe seizures
32
Describe the adverse effects a/w TCAs
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
Describe the adverse effects a/w SNRIs
1. CNS: Agitation, irritability, drowsiness 2. CVS: BP may be affected at higher dose 3. Hyponatremia
34
5 factors that up-regulate adult neurogenesis
1. Enriched environment 2. Exercise 3. Learning 4. Estrogen 5. Antidepressants, ECS
35
5 factors that down-regulate adult neurogenesis
1. Stress 2. Glucocorticoids 3. Age 4. Opiates 5. Excitatory amino acids
36
Long term antidepressant treatment regulates _____ like _____
Neurotrophins; BDNF
37
How does BDNF work?
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
Describe the hypotheses of psychosis
1. Dopamine hypothesis Excessive dopamine transmission in the mesocortico-limbic system 2. Abnormality in 5-HT, glutamate and other systems
39
Positive symptoms of schizophrenia
1. Delusion (abnormal belief) 2. Hallucination 3. Disorganised thinking, speech and behaviour
40
Negative symptoms of schizophrenia
1. Avolition 2. Affect flattening 3. Inability to plan 4. Poor concentration
41
Antipsychotic drugs are used to treat the _____ of psychoses
Symptoms
42
Name the 2 classes of antipsychotic drugs
1. Typical (1st gen) 2. Atypical (2nd gen)
43
Name 2 typical (1st gen) antipsychotics
1. Haloperidol (high potency) 2. Chlorpromazine (low potency)
44
Name 5 atypical (2nd gen) antipsychotics
1. Risperidone 2. Olanzapine 3. Quetiapine 4. Clozapine 5. Aripiprazole
45
Describe the MOA of typical antipsychotics
Block D2 receptors more than 5-HT2 receptors. Additional blocking effect on D1, cholinergic, histaminic, and alpha adrenergic receptors
46
Describe the MOA of atypical antipsychotics
Block 5-HT2 receptors more than D2 receptors. Additional blocking effect on D1, cholinergic, histaminic, and alpha adrenergic receptors
47
Describe the adverse effects a/w typical antipsychotics like haloperidol
1. Extrapyramidal reactions (blocks dopamine) 2. Sedation 3. Anticholinergic (blocks ACh) 4. Rarely: Neuroleptic malignant syndrome
48
Name 5 reactions of extrapyramidal reactions
1. Acute dystonia 2. Parkinsonism 3. Akathisia 4. Malignant syndrome 5. Tardive dyskinesia
49
Describe the adverse effects a/w atypical antipsychotics
*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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