Psychopharm drugs

Question 1

Sedative-hypnotic drugs goal

Answer 1

normalize sleep

decrease anxiety without sleep effect

Question 2

Sedative drug mechanism

Answer 2

increase GABAa effect
bind to specfic GABAa receptors
Increase Cl-, hyperpolarize cell

Question 3

Sedative newer drugs

Answer 3

z drugs that still bind to increase GABAa effect

milder side effects
less rebound effect

Question 4

New Anti-anxiety drugs

Answer 4

increase seratonin activity in CNS
decrease sedation/dependence side effects
mod effectiveness, slower onset

Question 5

Adverse effects of sedative/anti-anxiety drugs

Answer 5

rebound effect
behavior effect (sleep walking)
residual effect (hang over effect)
fall risk
tolerance/depedence/AD?

Question 6

Rehab concerns of sedative/antianxiety drug

Answer 6

treating symptoms not underlying cause
trend away from BZD
sedation vs benefits?

Question 7

List of Anti-depressant drugs

Answer 7

Selective Seratonin reuptake inhibitors (SSRI)
Seratonin Norepinepherine reuptake inhibitors (SNRI)
tricyclics- older drug
Mono amine oxidase inhibitor
others

Question 8

Mechanism of antidepressants

Answer 8

prevent recycling of amine (80%) through SSRI/SNRI

prevent amine breakdown (10-20$) through MAO inhibitors

increase amine=increase BDNF= neurogenesis in hippocampus to control mood

Question 9

Tricycles adverse effects

Answer 9

sedation
seizures
orthostatic hypotension
OD
cardiac issue
decrease AcH

Question 10

MAO inhibitors adverse effects

Answer 10

excitatory effect on CNS, increase BP especially with catechomine release

Question 11

SSRI/SNRI adverse effects

Answer 11

generally well tolerated

Seizures, GI problems

Question 12

Seratonin syndrome

Answer 12

can occur from all anti-depressants
increase BP/HR, hallucination, confusion, agitation, GI problems, shivers
fatal if not detected early

Question 13

OFF labeling

Answer 13

chronic pain
LBP
fibromyalgia
raynaud's disease
HA

Question 14

Rehab concerns of antidepressants

Answer 14

initial 6wk lag of effect
initial increase in depression
reorganization of mood change

Question 15

Bipolar condition treatment

Answer 15

lithium, anti-seizure/psychotic drugs

kidney toxicity greater than 15 mEa/L

Question 16

Adverse effects of lithium

Answer 16

mild- metallic taste, weakness, naseua, tremors
mod- decrease vision, vomit, diarrhea
severe- hallucination/confusion, nystagmus, dysarthria

Question 17

Antipsychotic drugs

Answer 17

traditional- block D2 receptors from hyperactivity

atypical- weaker D2 blockers, stronger blocking of seratonin

Question 18

Adverse effects of anti-psychotic drugs

Answer 18

atypical- affects lipid metabolism, weight gain

typical- sedation, orthostatic hypotension, anticholinergic effect

both have adverse extrapyramidal tract effects
tardive dyskinesia
pseudoparkinsons
akathisia
other dystonias

Question 19

Tardive dyskinesia

Answer 19

cause: denervation super sensitivity
risks: increase age, genetic, alcohol abuse, affective mood, >6month usage

Question 20

Neuroleptic Malignant syndrome

Answer 20

s/s: catatonia, rigidity, tremors, fever
risks: decrease mental function, high dosage
if not ID can be fatal

Question 21

Rehab concerns of anti-psychotics

Answer 21

orthostatic hypotension
sedation
extrapyramidal effects

Question 22

Goal/Mechanism of Alzheimer Drug

Answer 22

improve behavioral and cognitive functioning

cholinesterase inhibor- prolong effect of AcH

indicated for early AD to improve cog functioning

Question 23

Memantle

Answer 23

AD drug that blocks/inhibits NMDA receptor
normalizes Glutamate (disrupted in AD)
slows AD regression of memory/intellect

Question 24

AD implications

Answer 24

government curbs the use of antipsychotics
drug use should be specific to symptoms
non-pharm treatments (familiarize environment)