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Neurology 1 > Pharmacology - An introduction to Psychopharmacology > Flashcards

Pharmacology - An introduction to Psychopharmacology Flashcards

1
Q

chloropromazine, haloperidol, sulpride, clopixol and fluphenazine are examples of what

a.first generation antipsychotics (typical)

b.second generation antipsychotics (atypical)

A

a.first generation antipsychotics (typical)

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2
Q

lurasidone,olanzapine, quetiapine, risperidone, aripiprazole, amisulpride and clozapine are examples of what

A

a.first generation antipsychotics (typical)

b.second generation antipsychotics (atypical)

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3
Q

what causes positive symptoms in schizophrenia (positive symptoms – any change in behaviour or thoughts, such as hallucinations or delusions)

a.overactivity of the mesolimbic pathway
b.underactivity of the mesolimbic pathway
c.mesocortical pathway dysfunction

A

a.overactivity of the mesolimbic pathway

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4
Q

what causes the negative symptoms of schizophrenia
negative symptoms – where people appear to withdraw from the world around then, take no interest in everyday social interactions, and often appear emotionless and flat

a.overactivity of the mesolimbic pathway
b.underactivity of the mesolimbic pathway
c.mesocortical pathway dysfunction

A

c.mesocortical pathway dysfunction

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5
Q

antipsychotics are antagonists of the receptors for which neurotransmitter

a. GABA
b.dopamine
c.glutamate
d.5HT

A

b.dopamine

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6
Q

antipsychotics are antagonists to which dopamine receptor

a.D1
b.D2
c.D3
d.D4
e.D12

A

b.D2

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7
Q

ANTIPSYCHOTICS ARE ……………….. to D2 dopamine receptors

a.agonists
d.antagonists

A

d.antagonists

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8
Q

which schizophrenia symptoms are improved by antipsychotics

a.positive symptoms
b.negative symptoms

A

a.positive symptoms

psychotic symptoms eg. hallucinations and delusions

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9
Q

prolactin elevation as a side effect of antipsychotics is due to dopamine antagonism in which area

a.nigrostriatal tract
b.corticospinal tract
c.HPA axis
d.tuberoinfundibular system

A

d.tuberoinfundibular system

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10
Q

extra pyrimidal side effects of antipsychotics are mediated by dopamine antagonism at which area

a.nigrostriatal tract
b.corticospinal tract
c.HPA axis
d.tuberoinfundibular system

A

a.nigrostriatal tract

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11
Q

acute dystonia, parkinsonism, akathisia and tardive dyskinesia are examples of extra pyrimidal side effects of antipsychotics these are due to dopamine antagonism in which area

a.nigrostriatal tract
b.corticospinal tract
c.HPA axis
d.tuberoinfundibular system

A

a.nigrostriatal tract

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12
Q

akathisia

A

inability to keep still

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13
Q

metabolic side effects are more common with which type of antipsychotics

a.first generation - typical
b.second generation - atypical

A

b.second generation - atypical

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14
Q

which of these drugs is most likely to have metabolic side effects

a. quetiapine
b.chloropromazine
c.haloperidol
d.sulpride
e.clopixol

A

a. quetiapine

increased risk with second gen especially quetiapine, olanzapine, clozapine

all the rest are first gen

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15
Q

which of these drugs is most likely to have metabolic side effects

a. olanzapine
b.chloropromazine
c.haloperidol
d.sulpride
e.clopixol

A

a. olanzapine

increased risk with second gen especially quetiapine, olanzapine, clozapine

all the rest are first gen

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16
Q

which of these drugs is most likely to have metabolic side effects

a.clozapine
b.chloropromazine
c.haloperidol
d.sulpride
e.clopixol

A

a.clozapine

increased risk with second gen especially quetiapine, olanzapine, clozapine

all the rest are first gen

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17
Q

3 metabolic side effects of antipsychotics …

A

weight gain
dyslipidaemia
type 2 diabetes

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18
Q

which metabolic side effect of antipsychotics is associated with 5HT2C, 5HT1A and H1 antagonism

a.weight gain
b.dyslipidaemia
c.type 2 diabetes

A

a.weight gain

dyslipidaemia - associated with weight gain and lifestyle factors

type 2 diabetes- associated with lifestyle, weight gain and direct effects

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19
Q

true or false people with schizophrenia have a normal life expectancy

A

a.false

reduced life expectancy

due to..
negative symptoms of illness
lifestyle factors
less likely to attend GP
less likely to be offered interventions

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20
Q

SSRIs, SNRIs, NASSAs , MAOIs and TCAs are alll examples of what

a.antipsychotics
b.anti depressants

A

b.anti depressants

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21
Q

SSRIs

A

selective serotonin reuptake inhibitors

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22
Q

SNRIs

A

serotonin and noradrenaline reuptake inhibitors

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23
Q

NASSAs

A

Noradrenergic and specific serotinergic antidepressants

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24
Q

MAOIs

A

monoamine oxidase inhibitors

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25
Q

TCAs

A

tricyclic antidepressants

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26
Q

SSRIs stop reuptake of serotonin into which neurons

a.pre synaptic
b.post synaptic

A

a.pre synaptic

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27
Q

problems with the monoamine hypothesis
(depression caused by a functional deficiency of monamines - serotonin and noradrenaline , derived from observation that antidepressants increased levels of serotonin and nor.)

A

antidepressants increases availability of monoamines immediately , however onset of action is delayed 2-3 weeks

evidence for serotonin in depression is conflicting

more detailed knowledge about neurotransmitter systems in the brain

novel antidepressants do not impact serotinergic systems eg ketamine

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28
Q

chronic stress/ genetic predisposition alters neuronal circuits n the brain
anti depressants increase ……………….. neurotransmission

a.dopaminergic
b.gaba
c.serotoninergic
d.muscarinic

A

c.serotinergic

29
Q

increase of serotinergic neurotransmission leading to…
increased brain derived neurogenic factor and stimulated neurogenesis to enhance synaptic plasticity

moderated connectivity in the limbic system to reduce negative cognitive bias

modulated neruotransmitter systems eg GABA and dopamine

describes the mechanism of action of which drug class

a.antipsychotics
b.antidepressants

A

b.antidepressants

30
Q

how does the increased serotinergic transmission by antidepressants enhance synaptic plasticity?

a.increase BDNF and neurogenesis

b.moderates connectivity in the limbic system

c.modulates other neurotransmitter systems eg GABA and dopamine

A

a.increase BDNF and neurogenesis

31
Q

how does the increased serotinergic neurotransmission reduce negative cognitive bias in schizophrenia?

a.increase BDNF and neurogenesis

b.moderates connectivity in the limbic system

c.modulates other neurotransmitter systems eg GABA and dopamine

A

b.moderates connectivity in the limbic system

32
Q

antidepressants are most effective in combination with…

A

psychological and social interventions

33
Q

benzodiazepines are examples of which drug class

a.antipsychotics
b.anti depressants
c.anxiolytics

A

c.anxiolytics

34
Q

which receptors do benzodiazepines work on

a.dopaminergic
b.muscarinic
c.GABA
d.serotinergic
e.glutamate

A

c.GABA

35
Q

which GABA receptor do benzodiazepines work on

a.GABA A
b, GABA B
c. GABA C

A

a.GABA A

36
Q

the GABA receptor is an ionotropic channel for which ion

a.sodium
b.chloride
c.magnesium
d.iron
e.potassium

A

b.chloride

37
Q

how many sub units make the GABA A receptor

a.3
b.4
c.5
d.6
e.7

A

c.5

2 alpha
2 beta
1 gamma

38
Q

there is a high concentration of which GABA receptors in the limbic system and amygdala

a. GABA A
b.GABA B
c.GABA C

A

a. GABA A

39
Q

there is a high concentration of GABA A receptors in which areas

a.limbic system and amygdala
b.limbic system and thalamus
c.caudate nucleus and thalamus
d.amygdala and thalamus

A

a.limbic system and amygdala

40
Q

what effect do benzodiazepines have on the affinity of GABA A receptor for GABA

a.increase
b.decrease

A

a.increase

GABA is an inhibitory neurotransmitter
so enhanced inhibitory effect on synaptic transmission

41
Q

how many different possible alpha sub units are there that could make up the 2 alpha parts of a GABA A receptor

a.4
b.5
c.6
d.7

A

c.6

usually 2x a1 found in a GABA A receptor (a1, a1)
but could be 2x a2 (a2,a2)
2x a3 (a3, a3)
2x a4 …… etc etc

up to (a6,a6)

42
Q

which alpha subunits do benzodiazepines have an affinity for

a. a1,2,3,4
b.a2,3,4,5
c.a3,4,5,6
d. a1,2,3,5
e.a1,2,3,6

A

d. a1,2,3,5

43
Q

which alpha subunit to anxiolytic benzodiazepines have an affinity for

a.a2 and a3
b. a1 and a5
c.a1 - a6

A

a.a2 and a3

44
Q

which alpha subunit to sedation, amnesia and ataxia benzodiazepines have an affinity for

a.a2 and a3
b. a1 and a5
c.a1 - a6

A

b. a1 and a5

45
Q

which alpha subunit do anticonvulsant benzodiazepines have an affinity for

a.a2 and a3
b. a1 and a5
c.a1 - a6

A

c.a1 - a6

46
Q

range of uses for benzodiazepines

A

anxiolytic
hypnotic
muscle relaxant
anti convulsant
amnesic

47
Q

what are the main side effects of benzodiazepines

a.metabolic side effects eg weught gain
b.headaches, confusion, amnesia , ataxia

A

b.headaches, confusion, amnesia , ataxia

also
dysarthria
paradoxical disinhibition reaction- characterized by acute excitement and an altered mental state
interaction with alcohol at GABA receptor
overdose - rarelt fatal but dangerous in combination with alcohol

48
Q

children, LD deficiency , CNS disorder and people with impulsivity are more at risk of which side effect of benzodiazepines

a.headache
b.confusion and amnesia
c.dysarthria
d.paradoxical disinhibition reaction
e.overdose esp with alcohol

A

d.paradoxical disinhibition reaction

49
Q

z drugs, barbituates , flumazenil and alcohol work at which receptor

a.GABA
b.glutamate
c.dopamine
d.serotonin

A

a.GABA

50
Q

what receptor do zolpidem and zopiclone ( z drugs) act on

a.GABA
b.glutamate
c.dopamine
d.serotonin

A

a.GABA

51
Q

which GABA receptor do z drugs work on

a.GABA A
b.GABA B
c. GABA C
d.GABA D

A

a.GABA A

bind to benzodiazepines site but have a different chemical structure

52
Q

the onset of action of z drugs is ..

a.short
b.long

A

a.short

53
Q

the z drugs are specific to which alpha subtype giving them hypnotic effects

a. a1
b.a2
c.a3
d.a4
e.a5
f.a6

A

a. a1

54
Q

only at …………. doses are z drugs muscle relaxant and anti convulsant

a.low
b.high

A

b.high

55
Q

side effects of z drugs are similar to…

a.antipsychotics
b.antidepressants
c.benzodiazepines

A

c.benzodiazepines

headaches, confusion, amnesia , ataxia

also
dysarthria
paradoxical disinhibition reaction- characterized by acute excitement and an altered mental state
interaction with alcohol at GABA receptor
overdose - rarelt fatal but dangerous in combination with alcohol

56
Q

amobarbital, phenobarbital, and thiopentone are examples of which drug class

a.antipsychotics
b.antidepressants
c. benzodiazepinnes
d.barbituates

A

d.barbituates

(anxiolytics)

57
Q

which drug class is now used only for severe insomnia, epilepsy and induction of anaesthesia

a.antipsychotics
b.antidepressants
c. benzodiazepinnes
d.barbituates

A

d.barbituates

highly addictive and dangerous in overdose

58
Q

which of these drugs binds to a different site than benzodiazepines on the GABA A. receptor

a.thiopentone
b.zolpidem
c.zopiclone

A

a.thiopentone

a barbituate so binds elsewhere on GABA receptor
so can be used with benzodiazepines

other 2 are z drugs so bind to benzodiazepine site on GABA A

59
Q

which drugs bind to GABA A increasing affinity for GABA to increase the FREQUENCY of opening of the chloride channel

a.benzodiazepines
b.barbituates

A

a.benzodiazepines

60
Q

which drugs bind to GABA A to increase the DURATION of opening of the chloride channel

a.benzodiazepines
b.barbituates

A

b.barbituates

can act in absence of GABA at high doses
increased risk of toxicity

61
Q

which of these drugs are a competitive antagonist in benzodiazepine binding site

a.barbituates
b.z drugs
c. flumazenil
d.thiopentone

A

c. flumazenil

displaces benzodiazepines so can treat overdose

62
Q

which of these can treat a benzodiazepine overdose

a.naloxone
b.andaxenet alpha
c.n acetyl cysteine
d.flumazenil

A

d.flumazenil

63
Q

flumazenil is a …………….. at the benzodiazepine binding site

a.competitive agonist
b.competitive antagonist
c.non competitive agonist
d.non competitive antagonist

A

b.competitive antagonist

64
Q

what effect does flumazenil have on barbituates

a.competitive agonist
b.competitive antagonist
c.non competitive agonist
d.non competitive antagonist
e.no effect

A

e.no effect

65
Q

in which cases should flumazenil not be used

a.when benzodiazepines are used to treat anxiety

b.when benzodiazepines are used for sedation

c.when benzodiazepines are used for ataxia

d.when benzodiazepines are used for epilepsy

A

d.when benzodiazepines are used for epilepsy

66
Q

where is flumazenil metabolised

a.kidney
b.liver
c.spleen

A

b.liver

67
Q

alcohol acts like benzodiazepines at the GABA A receptor and acts as a …………….. at glutamate receptors

a.serotonin
b.dopamine
c.glutamate
d.muscarinic

A

c.glutamate

less excitation

68
Q

alcohol withdrawal leads to

A

Neurology 1 (44 decks)

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