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BAHS 505 > Psych Drugs > Flashcards

Psych Drugs Flashcards

1
Q

Generally speaking, blocking which receptors causes orthostatic hypertension?

A

A1-adrenergic receptors

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2
Q

Blocking A1-adrenergic receptors causes

A

orthostatic hypertension

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3
Q

Generally speaking, blocking which receptors causes sedation only?

A

H1 histamine receptors

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4
Q

Blocking H1 histamine receptors causes

A

sedation

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5
Q

Generally speaking, blocking which receptors causes sedation and dry mouth?

A

Muscarinic cholinergic receptors

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6
Q

Blocking muscarinic cholinergic receptors causes:

A

sedation + dry mouth

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7
Q

Generally speaking, blocking which receptors may contribute to anti-psychotic effect?

A

5HT serotonin receptors

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8
Q

Blocking 5HT serotonin receptors may cause:

A

anti-psychotic effect

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9
Q

What receptor may mediate the antipsychotic effect of these drugs?

A

5HT serotonin receptors

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10
Q

What receptor may mediate the dry mouth + sedation effects?

A

Muscarinic cholinergic receptors

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11
Q

Which receptor may mediate the sedation-only effect?

A

H1 histamine receptors

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12
Q

Which receptor may mediate the orthostatic hypertensive effect?

A

A2 adrenergic receptors

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13
Q

Tardive dyskinesias occur when what receptors are blocked in what part of the body?

A

D2 receptors; corpus striatum

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14
Q

Tardive dyskinesia can occur when D2 receptors are blocked in the:

A

corpus striatum

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15
Q

What may happen when D2 receptors are blocked in the corpus striatum?

A

Tardive dyskinesias

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16
Q

Chlorpromazine is a typical anti-psychotic drug in that it blocks:

A

dopamine receptors

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17
Q

What types of receptors does chlorpromazine have an effect? Highest to lowest.

A

Chlorpromazine affects 1 adrenergic receptors (orthostatic hypertension) + 5HT serotonin receptors (anti-psychotic) equally. Then it works on D2 receptors (beware tardive dyskinesias), then D1 receptors.

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18
Q

What are the chances of extrapyramidal effects while using Chlorpromazine (tardive dyskinesias)?

A

Works on D2 receptors, but not as much as it does on A1 + 5HT receptors, so moderate risk

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19
Q

Level of sedation while on Chlorpromazine?

A

high

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20
Q

What are the chances of hypotension while using Chlorpromazine?

A

moderate

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21
Q

Haloperidol is a typical anti-psychotic, meaning it acts on:

A

dopamine receptors

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22
Q

What types of receptors does haloperidol act on? Highest to lowest affinity?

A

D2 (tardive dyskinesias) > D1, but affinity for D1 and D4 is equal. Then affinity for A1 (orthostatic hypertension), then affinity for 5HT serotonin receptors (anti-psychotic)

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23
Q

Chances of extrapyramidal activity while taking haloperidol?

A

High

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24
Q

Level of sedation offered by haloperidol?

A

Low

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25
Q

Chances of hypotension while using haloperidol?

A

Moderate

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26
Q

Which drug causes hyperprolactinemia?

A

Haloperidol

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27
Q

Haloperidol can cause hyperprolactinemia because it:

A

has a high affinity for D2 receptors.

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28
Q

Haloperidol has a high affinity for what type of receptors? Therefore it can cause?

A

D2 receptors

hyperprolactinemia

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29
Q

Is Clozapine a typical or atypical anti-psychotic?

A

Atypical

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30
Q

Receptors that clozapine works on? In order of affinity?

A

D4 = A1 adrenergic receptors (orthostatic hypertension), the 5HT serotonin receptors (anti-psychotic), then D2 (tardive dyskinesias = D1

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31
Q

Clozapine occupies which receptors more briefly than other anti-psychotics?

A

D2 receptors

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32
Q

Extrapyramidal effect of clozapine?

A

Very low

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33
Q

Sedative effect of clozapine?

A

Moderate

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34
Q

Hypotensive effect of clozapine?

A

Low-moderate

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35
Q

If patients are resistant to anti-psychotics, what drug may be an effective treatment?

A

Clozapine

36
Q

What percentage of patient develop agranulocytes while on clozapine?

A

3%

37
Q

3% of patients develop what while using clozapine?

A

Agranulocytes

38
Q

Class of aripipraole?

A

DSS; dopamine system stabilizer

39
Q

Is aripipraole a typical or atypical anti-psychotic?

A

atypical

40
Q

Is aripipraole a dopamine receptor antagonist?

A

NO, it is a dopamine system stabilizer (DSS)

41
Q

Aripipraole is a partial agonist of what receptors?

A

D2 dopamine receptors + 5HT1A receptors

42
Q

Aripipraole is an antagonist of what receptors?

A

5HT1A receptors

43
Q

Aripipraole has both antagonistic and agonist effects at which receptor type?

A

5HT1A receptors

44
Q

Which drug is a treatment for schizophrenia and bipolar disorder?

A

Aripipraole

45
Q

In states of low dopaminergic tone, aripipraole has what effect on the D2 receptor?

A

Activates it

46
Q

In states of high dopaminergic tone, aripipraole has what effect on D2 receptor?

A

Inhibits it

47
Q

What drug is a tricyclic antidepressant?

A

Imipramine

48
Q

Class of imipramine?

A

Tricyclic antidepressant

49
Q

Which transport does imipramine inhibit?

A

Monoamine transporter

50
Q

By inhibiting monoamine transporter, what effect does imipramine have?

A

It increases hippocampal neurogenesis because it increases 5HT serotonin transmission + postsynaptic 5HT serotonin receptors.

51
Q

Does imipramine have a euphoric effect?

A

No; instead, it dulls depressive ideation.

52
Q

What part of the brain does imipramine mainly affect?

A

Hippocampus

53
Q

Side effects include sedation, anticholinergic, orthostatic Hypotension. arrhythmias, tachycardia, tremor

A

Imipramine

54
Q

Which drug has a two-week latent period and therefore needs to be taken consistently?

A

Imipramine

55
Q

Class of fluoxetine?

A

Selective serotonin reuptake inhibitor (SSRI) anti-depressant

56
Q

Common name of fluoxetine?

A

Prozac

57
Q

Fluoxetine blocks what transporter?

A

SERT, a serotonin transporter

58
Q

Fluoxetine increases levels of what receptors?

A

5HT serotonin receptors

59
Q

Fluoxetine increases 5HT serotonin receptor concentration at synapse, but what other effect do they have on 5HT receptors?

A

They are selective 5HT receptor inhibitors.

60
Q

Fluoxetine has what effect?

A

Dulls depressive ideation

61
Q

Which drug is more user friendly, imipramine or fluoxetine?

A

Fluoxetine has fewer problems with patient compliance

62
Q

Name two MAO inhibitors.

A

Phenylzine + Tranylcypromine

63
Q

Phenylzine is what class of drug?

A

Antidepressant, MAO inhibitor

64
Q

Mechanism of phenylzine?

A

Irreversible inhibition of MAO increases levels of 5HT serotonin receptors, NE, and dopamine in the brain

65
Q

Therapeutic latency of phenylzine?

A

2-3 weeks

66
Q

MAO inhibitors are psychomotor ______________.

A

Stimulants

67
Q

Do not use phenylzine with:

A

L-DOPA and tyramine

68
Q

Side effects of phenylzine?

A

orthostatic hypotension, tremors, insomnia

69
Q

Class of tranylcypromine?

A

Antidepressant; MAO inhibitor

70
Q

Tranylcypromine mechanism of action?

A

Irreversible blockade of MAO causes increased levels of 5HT serotonin receptors, NE and dopamine PLUS inhibition of dopamine uptake

71
Q

How does tranylcypromine differ from phenylzine?

A

Tranylcypromine has the same mechanism as phenylzine, but it also inhibits dopamine uptake.

72
Q

Which is a more powerful psychomotor stimulant–tranylcypromine or phenylzine?

A

Tranylcypromine

73
Q

Do not use tranylcypromine with:

A

L-DOPA or tyramine

74
Q

Side effects of tranylcypromine?

A

orthostatic hypotension, tremors, insomnia

75
Q

Lithium is an antipsychotic useful for treating:

A

acute mania

76
Q

Class of lithium drug?

A

Antipsychotic for acute mania.

77
Q

What two medications are useful in treating acute mania?

A

Lithium and Carbamezapine/Valproate

78
Q

Lithium prevents metabolism of _____________ ____________ by blocking what enzyme?

A

inositol phosphate; inositol phosphatase

79
Q

Lithium’s calming effect is slow to develop, so it is recommended to use it with:

A

Haloperidol

80
Q

Lithium is a prophylactic measure in treating what disease?

A

Bipolar disorder

81
Q

Therapeutic index of Lithium?

A

2-3

82
Q

Therapeutic blood levels of Lithium?

A

0.9 to 1.4 meq/L

83
Q

Lithium becomes toxic at blood levels of

A

2 meq/L

84
Q

Severe toxicity and possible death may result if Lithium concentration in the blood reaches

A

3 meq/L

85
Q

In addition to treating acute mania, Carbamezapine/Valproate treats what condition?

A

Epilepsy

86
Q

Carbamezapine/Valproate class?

A

Antipsychotic; acute mania and anti-epileptic

BAHS 505 (9 decks)

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