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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
Chances of hypotension while using haloperidol?
Moderate
26
Which drug causes hyperprolactinemia?
Haloperidol
27
Haloperidol can cause hyperprolactinemia because it:
has a high affinity for D2 receptors.
28
Haloperidol has a high affinity for what type of receptors? Therefore it can cause?
D2 receptors | hyperprolactinemia
29
Is Clozapine a typical or atypical anti-psychotic?
Atypical
30
Receptors that clozapine works on? In order of affinity?
D4 = A1 adrenergic receptors (orthostatic hypertension), the 5HT serotonin receptors (anti-psychotic), then D2 (tardive dyskinesias = D1
31
Clozapine occupies which receptors more briefly than other anti-psychotics?
D2 receptors
32
Extrapyramidal effect of clozapine?
Very low
33
Sedative effect of clozapine?
Moderate
34
Hypotensive effect of clozapine?
Low-moderate
35
If patients are resistant to anti-psychotics, what drug may be an effective treatment?
Clozapine
36
What percentage of patient develop agranulocytes while on clozapine?
3%
37
3% of patients develop what while using clozapine?
Agranulocytes
38
Class of aripipraole?
DSS; dopamine system stabilizer
39
Is aripipraole a typical or atypical anti-psychotic?
atypical
40
Is aripipraole a dopamine receptor antagonist?
NO, it is a dopamine system stabilizer (DSS)
41
Aripipraole is a partial agonist of what receptors?
D2 dopamine receptors + 5HT1A receptors
42
Aripipraole is an antagonist of what receptors?
5HT1A receptors
43
Aripipraole has both antagonistic and agonist effects at which receptor type?
5HT1A receptors
44
Which drug is a treatment for schizophrenia and bipolar disorder?
Aripipraole
45
In states of low dopaminergic tone, aripipraole has what effect on the D2 receptor?
Activates it
46
In states of high dopaminergic tone, aripipraole has what effect on D2 receptor?
Inhibits it
47
What drug is a tricyclic antidepressant?
Imipramine
48
Class of imipramine?
Tricyclic antidepressant
49
Which transport does imipramine inhibit?
Monoamine transporter
50
By inhibiting monoamine transporter, what effect does imipramine have?
It increases hippocampal neurogenesis because it increases 5HT serotonin transmission + postsynaptic 5HT serotonin receptors.
51
Does imipramine have a euphoric effect?
No; instead, it dulls depressive ideation.
52
What part of the brain does imipramine mainly affect?
Hippocampus
53
Side effects include sedation, anticholinergic, orthostatic Hypotension. arrhythmias, tachycardia, tremor
Imipramine
54
Which drug has a two-week latent period and therefore needs to be taken consistently?
Imipramine
55
Class of fluoxetine?
Selective serotonin reuptake inhibitor (SSRI) anti-depressant
56
Common name of fluoxetine?
Prozac
57
Fluoxetine blocks what transporter?
SERT, a serotonin transporter
58
Fluoxetine increases levels of what receptors?
5HT serotonin receptors
59
Fluoxetine increases 5HT serotonin receptor concentration at synapse, but what other effect do they have on 5HT receptors?
They are selective 5HT receptor inhibitors.
60
Fluoxetine has what effect?
Dulls depressive ideation
61
Which drug is more user friendly, imipramine or fluoxetine?
Fluoxetine has fewer problems with patient compliance
62
Name two MAO inhibitors.
Phenylzine + Tranylcypromine
63
Phenylzine is what class of drug?
Antidepressant, MAO inhibitor
64
Mechanism of phenylzine?
Irreversible inhibition of MAO increases levels of 5HT serotonin receptors, NE, and dopamine in the brain
65
Therapeutic latency of phenylzine?
2-3 weeks
66
MAO inhibitors are psychomotor ______________.
Stimulants
67
Do not use phenylzine with:
L-DOPA and tyramine
68
Side effects of phenylzine?
orthostatic hypotension, tremors, insomnia
69
Class of tranylcypromine?
Antidepressant; MAO inhibitor
70
Tranylcypromine mechanism of action?
Irreversible blockade of MAO causes increased levels of 5HT serotonin receptors, NE and dopamine PLUS inhibition of dopamine uptake
71
How does tranylcypromine differ from phenylzine?
Tranylcypromine has the same mechanism as phenylzine, but it also inhibits dopamine uptake.
72
Which is a more powerful psychomotor stimulant--tranylcypromine or phenylzine?
Tranylcypromine
73
Do not use tranylcypromine with:
L-DOPA or tyramine
74
Side effects of tranylcypromine?
orthostatic hypotension, tremors, insomnia
75
Lithium is an antipsychotic useful for treating:
acute mania
76
Class of lithium drug?
Antipsychotic for acute mania.
77
What two medications are useful in treating acute mania?
Lithium and Carbamezapine/Valproate
78
Lithium prevents metabolism of _____________ ____________ by blocking what enzyme?
inositol phosphate; inositol phosphatase
79
Lithium's calming effect is slow to develop, so it is recommended to use it with:
Haloperidol
80
Lithium is a prophylactic measure in treating what disease?
Bipolar disorder
81
Therapeutic index of Lithium?
2-3
82
Therapeutic blood levels of Lithium?
0.9 to 1.4 meq/L
83
Lithium becomes toxic at blood levels of
2 meq/L
84
Severe toxicity and possible death may result if Lithium concentration in the blood reaches
3 meq/L
85
In addition to treating acute mania, Carbamezapine/Valproate treats what condition?
Epilepsy
86
Carbamezapine/Valproate class?
Antipsychotic; acute mania and anti-epileptic

BAHS 505 (9 decks)

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