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General Pharm > Pharmacology - Test 2 - Antipsychotic > Flashcards

Pharmacology - Test 2 - Antipsychotic Flashcards

1
Q

Antipsychotic

A

Drugs

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2
Q

Psychosis

A

mental disorder of organic and/or emotional origin; derangement of personality/loss of contact with reality

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3
Q

Schizophrenia

A

psychotic disorder characterized by disturbed thought processes, delusions, or hallucinations, in the absence of a full affective syndrome or organic mental disorder.

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4
Q

Affective Disorder

A

a disturbance of mood accompanied by related symptoms, and generally involves depression and/or elation.

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5
Q

Manic disorder

A

predominant mood is elevated, expansive or irritable, and is associated with other symptoms, such as hyperactivity, flight of ideas, inflated self-esteem, accelerated speech, and distractibility.

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6
Q

Major Depressive disorder

A

emotional state of dejection, usually associated with loss of interest in pleasure, sleep disturbances, and feelings of worthlessness or guilt, which is not a reaction to a particular environmental event

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7
Q

Schizophrenia: 3 symptoms

A

Positive, Negative, Cognitive

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8
Q

Target receptors of antipsychotics

A

Dopamine, D2 family

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9
Q

Two dopamine subtype families

A

D1, D2

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10
Q

D1 subtype

A

increase cAMP, excitatory

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11
Q

D2 subtype

A

decrease cAMP, inhibitory

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12
Q

Side effects of antipsychotics, due to binding of other receptors

A

alpha 1: orthostatic HoTN; H1 histamine: sedation; mucarinic: sedation, dry mouth; 5HT2 serotonin: aid in antipsychotic effects

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13
Q

BLockade of D2 causes extrapyramidal motor effects

A
  • Parkinsonian symptoms (MOST COMMON), -Akathesia (discomfort in legs that results in walking about),
  • Tardive dyskinesia (stereotyped involuntary movements)
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14
Q

subclass causing extrapyramidal motor side effects

A

typical

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15
Q

subclass NOT causing extrapyramidal motor side effects

A

atypical

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16
Q

atypical drugs

A

do not increase prolactin; some can reduce negative and positive symptoms; bind to D2 more briefly

17
Q

aripiprazol (Abilify) mechanism

A

D2 PARTIAL AGONIST;

18
Q

Abilify mechanism

A

activation of the D2 receptor in states of low dopaminergic tone and inhibition at the receptor in states of high dopaminergic tone.

19
Q

Abilify tx of:

A

schizophrenia, bipolar

20
Q

tricyclic antidepressants mechanism

A

inhibit MAO transporters: inhibit NE, 5HT uptake; increase 5HT transmission

21
Q

TCA side effects

A 
-sedation
- anticholinergic
- orthostatic hypotension
- arrhythmias
- tachycardia
- tremor
- transition to hypomanic or manic excitement

therapeutic latency of 2-6 weeks

22
Q

TCA Prototype

A

imipramine

23
Q

Selective Serotonin Uptake Inhibitors (SSRI’s)

mechanism

A

block SERT, increasing synaptic 5HT levels

24
Q

SSRI prototype

A

fluoxetine (prozac)

25
Q

SSRI side effects

A

less antimuscarinic than TCA; less anticholinergic (tachycardia)

26
Q

MAOIs: 2 classes

A

hydrazine, non-hydrazine

27
Q

MAOI mechanism

A

irreversible inhibition of MAO, leading to increased levels of NE, 5HT, and DA; maximal inhibition of MAO seen within a few a days, but the antidepressant effect takes longer to develop

28
Q

Hydrazine prototype

A

Phenelzine

29
Q

non-hydrazine prototype

A

Tranylcypromine

30
Q

MAOI side effects

A

orthostatic hypotension; excessive CNS stimulation: tremors and insomnia

31
Q

MAOI drug interactions

A

L-DOPA: agitation and hypertension

- tyramine (cheese/ wine/ beer): hypertensive crisis

32
Q

Mood stabilizers/ Antimanics

A

haloperidol and aripiprazol, lithium

-treatment of acute mania

33
Q

Lithium

A

calming effect in acute mania; effect slow to develop; recommended use with haloperidol for treatment of severe manic reaction
-prophylaxis in bipolar affective disorder

34
Q

Lithium mechanism

A

inhibits GSK-3B (overexpression causes mania in mice), regulates circadian rhythm

35
Q

Lithium side effects

A

low margin of therapeutic index tremor, most common, sensitive to propranolol

  • mental confusion
  • ataxia
  • polydipsia and polyurea
  • nephrotoxicity
36
Q

Antimanic drugs

A

Carbamazepine / valproate (mechanism unknown)

General Pharm (10 decks)

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