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Pharmacology > Psychiatric Disorders (Chapter 13) > Flashcards

Psychiatric Disorders (Chapter 13) Flashcards

1
Q

what is the prevalence of schizophrenia ?

A

1% of general population

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2
Q

explain the genetic predisposition towards schizophrenia

A

10% chance if parents have it.

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3
Q

what is the cause of schizophrenia ?

A

genetic predisposition + environmental factors affecting development in utero

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4
Q

when is the usual onset age of schizophrenia ?

A

from adolescence to age 40

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5
Q

why is life expectancy reduced in schizophrenia ?

A

many commit suicide

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6
Q

use of which substance is 3 times higher in schizophrenics ?

A

cigarettes

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7
Q

what are the three kinds of symptoms in schizophrenia ?

A

positive, negative, cognitive

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8
Q

what are positive symptoms in schizophrenia ? definition + 5 examples

A

distorted enhancement or exaggeration of normal functions

hallucinations
delusions 
paranoia
disordered speech 
agitation
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9
Q

what is the gender most affected by schizophrenia ?

A

both

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10
Q

what is the gender most affected by positive schizophrenic symptoms ?

A

women

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11
Q

what are negative symptoms in schizophrenia ? definition + 5 examples

A

reduction in normal function

decrease in logical conversation, motivation, emotional expression, hygiene, social interaction

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12
Q

what is the gender most affected by negative schizophrenic symptoms ?

A

male

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13
Q

what are 3 cognitive symptoms in schizophrenia

A

decrease in attention, memory, task solving ability

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14
Q

what are the schizophrenia symptoms caused by ?

A

altered levels of dopamine and serotonin, drugs block receptors for these NT

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15
Q

what is uncomplicated depression ?

A

caused by tragic life events

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16
Q

what is major depression ?

A

sustained and significant decrease in the ability of a patient to function normally

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17
Q

what is the diagnostic criteria for depression ?

A

symptoms for over 2 weeks

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18
Q

when is the onset of depression typically ?

A

in 20s

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19
Q

which gender is more affected by depression ?

A

women twice as much

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20
Q

what is a non-drug option for insomnia ?

A

sleep hygiene

use bed only for sleep

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21
Q

what is another name for bipolar disorder ?

A

manic depressive disorder

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22
Q

when does the first episode of bipolar disorder usually occur ?

A

20s

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23
Q

what is the gender difference in bipolar disorder ?

A

affects both the same, although may be difference in symptoms (more depressive symptoms in women)

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24
Q

what are the two components of bipolar ?

A 
major depression (longer period)
mania (requires close supervision, usually lasts a week)
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25
Q

what is hypomania ?

A

similar to mania, but less severe

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26
Q

what is mixed bipolar ?

A

when you feel mania and depression simultaneously

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27
Q

which kind of therapy is recommended for anxiety disorders ?

A

cognitive behavioral therapy

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28
Q

what are the diagnostic criteria for generalized anxiety disorder ?

A

most days for > 6 months

anxiety about several different activities

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29
Q

what are the diagnostic criteria for social anxiety disorder ?

A

persistent fear of social interactions

under 18 years old: for over 6 months

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30
Q

what are the diagnostic criteria for panic disorder ?

A

sudden onset of intense fear, peaking within 10 minutes with 4 of the following symptoms: racing heart, sweating, shortness of breath, choking feeling, nausea, fear of losing control, chills, hot flashes, fear of dying

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31
Q

what are the diagnostic criteria for OCD ?

A

excessive, repetitive action

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32
Q

what are the diagnostic criteria for PTSD ?

A

witnessed a traumatic event, reacted with intense fear / horror
event re-experienced with flashbacks, thoughts, hallucinations, dreams, reactions to triggers

avoids reminders of events
emotional numbing

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33
Q

what NT are ADHD patients lacking ?

A

dopamine and norepinephrine

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34
Q

what kind of drugs treat schizophrenia ?

A

anti-psychotic

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35
Q

what kind of drugs treat positive schizophrenia symptoms specifically ?

A

first generation typical antipsychotics

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36
Q

what kind of drugs treat all three symptoms of schizophrenia ?

A

atypical second generation antipsychotics

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37
Q

which antipsychotics have better effects ?

A

atypical (second generation)

less adverse effects and more efficacy

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38
Q

why is compliance crucial in antipsychotics ?

A

because they take weeks/months to have an effect

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39
Q

which receptors do first generation antipsychotics affect ?

A

block dopamine, ach, NE alpha, histamine H1 receptors

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40
Q

how do first generation antipsychotics affect serotonin receptors ?

A

they don’t

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41
Q

why do first generation antipsychotics have so many adverse effects ? what are they ?

A

they aren’t specifically for the CNS

spasms, slowness, drooling, tremors, fainting, constipation

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42
Q

what are the side effects of second generation antipsychotics ?

A

sedation, orthostatic hypotension

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43
Q

what health risks are more prevalent with 2nd generation antipsychotics ? why

A

weight gain, diabetes

appetite center in brain is affected, need to eat more

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44
Q

what is clozapine ?

A

a 2nd generation antipsychotic which is particularly dangerous

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45
Q

what are the two main kind of substances contraindicated with antipsychotics ?

A

anti-cholinergic (OTC cold remedies, sleep aids, motion sickness) and alcohol

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46
Q

how are antipsychotics administered ?

A

usually orally, sometimes injected

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47
Q

what is the washout period ?

A

you cant stop a drug and start a new one, there needs to be a period between the two

48
Q

what 4 drugs treat depression

A

tricyclic antidepressants (TCA)
selective serotonin reuptake inhibitor (SSRI)
monoamine oxygenase inhibitor (MAOI)
serotonin/norepinephrine reuptake inhibitor (SNRI)

49
Q

what is the cause of depression ?

A

thought to be lack of serotonin and norepinephrine

50
Q

what is the pharmacodynamic mechanism that treats depression ?

A

it is dangerous to induce NT

instead, you block clearance of NE and Ser

51
Q

how do tricyclic antidepressants work ?

A

by blocking reuptake of NE and Ser

also block histamine, ach, alpha-adrenergic receptors

52
Q

what are the side effects of tricyclic antidepressants ?

A

since histamine receptors are blocked, a lot of the side effects are anti-cholinergic

dry mouth, constipation, orthostatic hypotension, sedation

53
Q

what is the advantage of SSRI?

A

no anticholinergic effects

54
Q

what are two examples of SSRI?

A

Prozac, Paxil

55
Q

what is the main reason of non-compliance to SSRI ?

A

sexual dysfunction

56
Q

what drug are SSRI contraindicated with ?

A

MAOIs

57
Q

why arent MAOI used a lot ?

A

side effects

58
Q

what is the most dangerous side effect of MAOI?

A

hypertensive crisis

59
Q

how do MAOI work ?

A

inactivate dopamine, serotonin, norepinephrine

60
Q

what is MAOI action on the liver ?

A

helps detoxify chemicals

61
Q

how many antidepressants can you prescribe ?

A

only 1 !!!! even St John’s Wort can’t be mixed

62
Q

what foods are problematic if you take MAOI ?

A

those that contain tyramine like chocolate, cheese, aged meats, yeast, soy, beans, pickles

63
Q

what drugs are contraindicated with MAOI ?

A

adrenergic drugs (nasal decongestants, amphetamines, TCA, SSRI)

64
Q

how do SNRI work ?

A

inhibit reuptake of serotonin and NE

65
Q

how do SNRI block cholinergic or alpha adrenergic receptor ?

A

they don’t

66
Q

what are three kinds of drugs used to treat bipolar ?

A

mood stabilizers, antipsychotics, antidepressants

67
Q

what are three examples of a mood stabilizing drug that also treats mania ?

A

valproic acid
lithium
carbamazepine

68
Q

what is the classic antipsychotic ?

A

lithium

69
Q

what is the drug of choice for anxiety disorders ?

A

SSRI

70
Q

what substance should ppl with anxiety avoid ?

A

caffeine because it increases anxiety

71
Q

what drug targets anxiety ?

A

none

72
Q

what are the adverse effects of lithium ?

A

high toxicity (low TI)

73
Q

what drugs may interact with lithium ?

A

those that are involved in kidney function
like thiazide diuretics, ACE-inhibitors (because they decrease lithium excretion)
NSAID (except aspirin)

74
Q

which NSAID can be used on lithium ?

A

aspirin

75
Q

what is the preferred mood stabilizing drug ?

A

valproic acid

76
Q

what is the trade name for valproic acid ?

A

depakene

77
Q

what is the trade name for carbamazipine

A

equetro

78
Q

what is the advantage of valproic acid over lithium ?

A

fewer adverse effects

79
Q

SSRIs are the drug of choice for all the anxiety disorders except ?
what is the drug of choice ?

A

GAD

drug of choice is benzodiazepines

80
Q

what are the three main drugs used for anxiety disorders ?

A

SSRI
benzodiazepine
buspirone

81
Q

what are the disadvantages of benzodiazepines ?

A

addictive

bad withdrawal symptoms

82
Q

what is valium ?

A

a benzodiazepine

83
Q

what particularity in the structure of benzodiazepines makes it not recommended during pregnancy

A

lipid soluble therefore can cross into the placenta

84
Q

benzodiazepines interact with what receptors ?

A

GABA receptors

85
Q

why are SSRI’s recommended for anxiety disorders ?

A

because they are safer (no anticholinergic effects)

86
Q

what is PTSD usually treated with ? for how long ?

A

SSRI or MAOI (alternative)
throughout life
usually CBT

87
Q

what is buspirone ? what does it treat ?

A

treats generalized anxiety disorder for long term therapy more than acute symptoms

88
Q

what treats ADHD ?

A

stimulants that enhance the response of the brain to NE and dopamine

89
Q

what is the advantage of buspirone compared to benzodiazepines for GAD treatment ?

A

less abuse potential and adverse effects

90
Q

what is the generic name for ritalin ?

A

methylphenidate

91
Q

what is the generic name for Adderall

A

dextroamphetamine

92
Q

what are the two meds mostly used for OCD ?

A

ritalin (methylphenidate) and adderall (dextroamphetamine)

93
Q

why are OCD drugs addictive

A

because they produce euphoria

94
Q

what are other options for OCD ?

A

norepinephrine reuptake inhibitor

SSRI

95
Q

what is the main side effect of abuse potential in OCD meds ?

A

cardiovascular risks

96
Q

what are prescription drugs for insomnia called ?

A

hypnotics

97
Q

what treatment is preferable for insomnia ?

A

non drug approaches

98
Q

what is the preferred hypnotic drug for insomnia treatment ?

A

benzodiazepine

99
Q

what is melatonin ?

A

sedative properties, OTC supplement

100
Q

what is an approved drug for eating disorders ?

A

there is none

101
Q

what drugs can be used in eating disorders ?

A

SSRI to treat underlying depression

102
Q

what sporting events might be avoided if you’re taking benzodiazepines ? why

A

guns, racing

because drug causes sedation

103
Q

can an athlete compete if they’re taking medication ?

A

yeah, even if it’s a banned substance, you can apply for an exemption

104
Q

an athlete is feeling mentally unwell, and starts to take medication. what are the positive and negative outcomes ?

A

positive: might feel better
negative: performance may suffer from adverse effects, or lost training time

105
Q

in the Hammond paper, what was the sample ?

A

50 elite swimmers

106
Q

in the Hammond paper, what were the 4 outcome measures ?

A

Diagnosed depression was assessed using a semistructured interview, and symptoms of depression were also assessed by the Beck Depression Inventory II.
Performance was measured by changes in swimming time and athlete ranking

107
Q

in the Hammond paper, what was the study design ?

A

cross-sectional

108
Q

in the Hammond paper, what is the paradigm that was challenged?

A

that elite athletes are mentally tough and emotionally strong

109
Q

in the Hammond paper, what was the main hypothesis ? what was the second hypothesis ?

A

do elite athletes have depression that differs from general population ?

does elite athlete performance affect depression prevalence ?

110
Q

in the Hammond paper, what gender predominantly experienced depression ? what are the implications ?

A

predominantly females

expected, based on the general population

111
Q

in the Hammond paper, in the discussion, what explanation do they give as to why athletes would have an increased risk of depression ?

A

juggling high expectations, school, schedules, pressure to perform, media scrutiny

112
Q

in the Hammond paper, in the discussion, what explanation do they give as to why female athletes would have an increased risk of depression ?

A

females view themselves as having less social support, less encouraged to perform

113
Q

in the Hammond paper, how did the prevalence of depressive symptoms differ in elite athletes from non elite athletes ?

A

almost double- 66% versus 34%

114
Q

in the Hammond paper, how did the prevalence of depressive symptoms differ in athletes from the general population?

A

34% versus 17% (double)

115
Q

in the Hammond paper, what was the main criticism ?

A

lack of internal control group

116
Q

in the Hammond paper, was there a correlation between performance and prevalence of depressive episodes post-competition ?

A

yes !

117
Q

What is the difference between SNRI and TCA?

A

SNRI only blocks the serotonin and NE receptors

TCA blocks serotonin, NE, histamine, alpha-adrenergic, and ach

Pharmacology (15 decks)

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