Pharmacology - Psychotic Disorders Flashcards
_________is a condition associated with tension, apprehension, fear or panic
anxiety
There are four major types of anxiety disorders
Generalized anxiety disorder
Panic disorder
Obsessive-compulsive disorder
Post traumatic stress disorder
Treatment of anxiety is done by medications that affect the following neurotransmitters:
-aminobutyric acid (GABA)
Serotonin (5-HT)
Norepinephrine (NE)
_________have a definite onset and end spontaneously.
panic attacks
most common drugs used to treat anxiety:
Benzodiazepines
Azapirones
Miscellaneous Anxiolytics
Antidepressants
_________work by reducing neuronal excitability
Benzodiazepines
What is a common self prescribed treatment for anxiety?
alcohol
________is the most common severe psychiatric disorder
clinical depression
What are the peak years for depression?
35-45
Who is more likely to suffer depression?
women
What are the different antidepressents?
SSRI, TCA, SNRI, MOAI
________block the reuptake of serotonin, with little effect on norepinephrine
SSRI
________is the most established in this class it is indicated for major depression and obsessive compulsive disorder.
Prozac
__________is indicated for depression, obsessive compulsive disorder and panic disorder
Paxil
________blocks reuptake of both serotonin and norepinephrine and is indicated for depression.
SNRI (EFFEXOR)
_________these contain three carbon rings (tricyclic) and four carbon rings (tetracyclic).
TCA
Usually a therapeutic dose of ten to twenty days is needed before improvements are apparent. The patient should stay on the drugs for 6 – 12 months to reduce risk of relapse.
TCA
_________may be used in children with bed wetting problems.
TCA
________inhibit the activity of the enzymes that break down catacholamines (epinephrine, dopamine norepinephrine) thus allowing these transmitters to build up in the synapse.
MAOI
_________are a second line treatment, because of their many interactions with food and other drugs.
MAOI
Trazodone should be avoided in young males. Can you find out why?
It can cause a long, hard, and dangerous erection
__________is characterized by cycling mood changes: severe highs (mania) and lows (depression).
Bipolar
Manic symptoms include:
Overactive Over talkative Lots of energy Patient may have disorganized thoughts Short attention span Easily distracted.
Depression symptoms:
Low mood Lack of energy Changes in eating and sleeping Sadness Feelings of worthlessness, guilt, hopelessness
__________are the most commonly prescribed drugs for bipolar
lithium
___________is a chronic psychotic disorder manifested by retreat from reality, delusions, hallucinations, ambivalence , withdrawal and bizarre or regressive behavior.
Schizophrenia
Dopamine and to a lesser degree serotonin are major players in __________
Schizophrenia
Drugs chosen to help the patient do not alter the natural course of schizophrenia rather they _________
reduce symptoms
________increases the risk of congenital malformations in babies born to women
lithium
________is a recurrent seizure disorder characterized by a sudden, excessive, disorderly discharge of cerebral neurons
epilepsy
_______is a symptom of brain dysfunction
epilepsy
What are the two major types of seizures?
Partial
General
_______affect only one hemisphere of the brain and can result from injury to the cerebral cortex
partial seizures
There are two distinct types of partial seizure:
complex and simple
What is the most common type of seizure?
partial
Stiffening or jerking in one extremity followed by a tingling sensation in the same area. Consciousness is not normally lost Sensory hallucinations May progress into a generalized seizure are symptoms of \_\_\_\_\_\_\_\_\_\_
simple partial seizures
Purposeless behavior (glassy stare, picking at clothing, aimless wandering, lip-smacking or unintelligible speech)
Patient may experience an aura immediately before seizure (smell, nausea, dreamy sensation unusual taste, visual disturbance
are symptoms of _________
complex partial seizures
__________involves both hemispheres of the brain simultaneously and has no local origin. It can occur in the absence of injury or abnormality.
general seizures
Generalized seizures can be broken down into four main categories:
Grand mal (tonic-clonic seizure)
Petit mal (absence seizure)
Myoclonic (bilateral massive epileptic myoclonus)
Atonic or Akinetic (drop attacks)
_________The body becomes rigid and the patient may fall , this last for a minute or two. The muscle jerks , shallow breathing and loss of bladder control occurs with excessive salivation. After the attack the patient is usually drowsy and confused for some hours.
grand mal
What are grand mal seizures treated with?
1st line therapy: Tegretol®, Dilantin® or valproic acid
2nd line therapy: phenobarbital
__________Begins with interruption of then patients activities, by blank stare, rotating eyes uncontrolled facial movements, chewing, rapid eye blinking twitching or jerking. No generalized convulsions occur. Often the person has a premonition of the attack through unusual sensations of light, sound or taste. After the attack the patient continues normally. More common in children.
Petit Mal Seizures
What are the treatments for Petit Mal Seizures?
valproic acid or clonazepam
_________These seizures occur with sudden, massive, brief muscle jerks, which may throw the patient down. Consciousness is not lost and this seizure type can occur during sleep.
Myoclonic Seizures
What are the treatment types for Myoclonic Seizures?
1st line therapy: valproic acid
2nd line therapy: lamotrigine or clonazepam
________These begin with sudden loss of both muscle tone and consciousness. The patient may collapse, the head may drop and the jaw may slacken.
Atonic Seizures
What is the treatment type for Atonic Seizures?
1st line therapy: Valproic acid
2nd line therapy: lamotrigine or clonazepam
_________is a medical emergency brought on by repeated generalized seizures that can deprive the brain of oxygen
Status Epilepticus
Therapy with anticonvulsants has two main goals:
control or reduce frequency of seizures
prevent emotional or behavioral changes
_________is the use of one drug only and increasing the dosage.
monotherapy
_________is the use of more than one drug and should be considered for patients who do not respond to monotherapy.
polytherapy
_________is used to managed generalized, grand mal and simple and complex partial seizures
Phenytoin (Dilantin®)
________is a known teratogen and are classified as a risk category D
Phenytoin
__________is a progressive disorder of the nervous system involving degeneration of dopaminergic neurons causing impaired muscle movement usually affecting persons over 60
Symptoms are caused by an imbalance between dopamine and acetylcholine
parkinson’s disease
_________is a hereditary progressive and degenerative disease of neurons that affects muscle movement, cognitive function and emotions
huntington’s disease
________is a neurodegenerative disease that causes memory loss and behavioral changes
alzheimer’s disease
Patients will Alzheimer’s will show a decline in the neurotransmitter__________
acetylcholine (ACh)
_________is also known as Lou Gehrig’s disease. It is a progressive degenerative disease of nerves that leads to muscle weakness, paralysis and eventual death.
ALS
What does ALS stand for?
Amyotrophic Lateral Sclerosis
________is a condition characterized by difficulty falling asleep, staying asleep or both.
Insomnia
_________ is a sleep disorder involving recurring inappropriate episodes of falling asleep suddenly and without warning. Attacks may last between a few seconds and 30 minutes.
Narcolepsy
________are currently the preferred choice for hypnotics primarily because of their somewhat long duration of effectiveness and lower risk of fatal overdose. (compared to barbiturates)
benzodiazepines
What are some non-prescription therapy’s for insomnia?
Diphenhydramine
Doxylamine
Melatonin
Valerian
Primary treatment of narcolepsy is administration of ________
stimulants
ADHD is assessed by three characteristics:
hyperactivity, impulsivity and distractibility.
_________ has less hyperactivity then ADHD
ADD (Attention Deficit Disorder)
The ________child is more lethargic and more easily distracted than a child without this disorder
ADD
_________ & __________are more common in boys than girls.
ADHD and ADD
_________is the drug of choice to treat ADHD and narcolepsy
Methylphenidate
_________ is a severe, throbbing, vascular headache. It is characterized by recurrent unilateral head pain combined with neurologic and GI disturbances.
migraine headache
Classic migraine has 5 components:
prodrome ( a symptom indicating the onset) Aura Headache headache relief and postdrome (knowing it is gone)
___________proposes that migraines are caused by vasodilation and the concomitant mechanical stimulation of sensory nerve endings.
vascular theory
The medications used in migraine therapy can be divided into two classes:
Abortive therapy
Prophylactic therapy
__________treats acute migraine headaches after they occur. The abortive drugs should be taken at the first sign of a headache.
abortive therapy
__________therapy attempts to prevent or reduce occurrence
Prophylactic
_________ are thin nerve fibers that carry pain signals
Nociceptors
________is a self-limiting sensation triggered by an injury, burn, infection or other stimuli. It is usually short term in duration
acute pain
_________ is pain that associated with nerve injury
Neuropathic pain
Narcotics have the following effects:
Analgesia – reduce pain from most sources
Sedation – relieve anxiety and cause drowsiness
Euphoria – state of intense happiness or well being
Dysphoria – feeling of emotional or mental discomfort, restlessness and depression
How is mild to moderate pain usually treated?
acetaminophen or an NSAID.
Different types of neuropathic pain include:
Diabetic neuropathy
Phantom limb
Shingles
Trigeminal Neuralgia
Classes of drugs used to treat neuropathic pain include:
Antidepressants
Antiseizure drugs
Local anesthetics
Topical medications
_________pain lasting over three months and severe enough to impair function
chronic
There are two types of narcotic analgesics:
Opiates & Opioids
_______are the alkaloids found in opium (a white liquid extract of (unripe seeds of the poppy plant).
Opiates
________are any medication which bind to opioid receptors in the central nervous system or gastrointestinal tract.
Opioids
What are derived from opiates?
opiods
Most severe side effects and adverse reactions to narcotics:
respiratory depression
fatal overdose
__________promote inflammation, pain, and fever, support the function of platelets that are necessary for the clotting of blood, and protect the lining of the stomach from the damaging effects of acid.
Prostaglandins
The typical recommended dose for ibuprofen is _________
400 mg taken every eight hours (max 800mg/q8h)
taking more than _______mg of acetaminophen or using it long term can increase the risk of liver damage
4000 mg/day
Skeletal muscle relaxants are used to reduce spasticity in:
multiple sclerosis cerebral palsy skeletal muscle injuries orthopedic surgery spinal cord injury.
Drugs used to treat spasticity are classified as:
Central acting:
Botulinum toxin
Dantrolene
Baclofen
Peripheral acting:
Diazepam
tizanidine
_____________is a muscle relaxant that is available over the counter to help with muscle strains
methocarbamol
What is in robaxin?
methocarbamol
What is in robaxisal?
methocarbamol + ASA
What is in robaxisal C1/2, C1/4, C1/2
methocarbamol + ASA + codeine
What is in robaxacet?
methocarbamol + acetaminophen
What is in robaxacet 8?
methocarbamol + acetaminophen + codeine
What is in robax platinum?
methocarbamol + ibuprofen
__________is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS , the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body.
Multiple sclerosis
_________a hereditary condition marked by progressive weakening and wasting of the muscles.
muscular dystrophy
