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NPE > Psychopharmacological Interventions > Flashcards

Psychopharmacological Interventions Flashcards

1
Q

what is Pharmacodynamics

A
  • What the drug does to the body

aka describes how the transmission of info via neurotransmitters is impacted when a psychotropic is taken

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2
Q

What are Psychotropic agents believed to do?

A

Change activities of receptors, enzymes, ion channels and chemical transporter systems (either by activating or inhibiting)
o Aka By which a psychotropic agent has an impact

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3
Q

what is Pharmacokinetics

A

what the body does to the drug

aka Process by which a psychotropic agent is passed through the body

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4
Q

how is Pharmacodynamics and Pharmacokinetics different?

A

Pharmacodynamics - What the drug does to the body
Pharmacokinetics - what the body does to the drug

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5
Q

what does Pharmacokinetics involve?

A

o Absorption (transfer into bloodstream after administration)
o Distribution (once in the bloodstream distribution refers to drug crossing into the CNS)
o Metabolism (generally in liver, changes to drugs molecular structure and its pharmacological properties)
o Elimination (removal of drug from body through urination and respiration)

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6
Q

what are Pharmacokinetics impacted by?

A
  • gastrointestinal motility, liver impairment and renal impairment
  • Characterisitcs such as age, physiological function, gender, disease and nutrition can all have an impact
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7
Q

what are Psychotropics

A
  • Substances which affect mood, perception or behaviour
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8
Q

what does Half-life mean?

A
  • Average time it takes to eliminate one half of the drug’s concentration from one’s system
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9
Q

what terms are associated with the therapeutic index?

A
  • Dose – is the drug concentration that gives desired response
  • Toxic dose- concentration causing mild or severe side effects
  • Therapeutic Index – ratio of the toxic to the therapeutic dose
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10
Q

is higher or lower therapeutic index better?

A

higher as this means lower risk of toxicity

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11
Q

what is Potentiation

A

when one drug may enhance the effect of a second

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12
Q

what is Synergism

A

when one drug may enhance the second significantly more than expected

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13
Q

what drugs come under depressants? (5)

A

alcohol,
sedatives,
hypnotics,
anxiolytics,
inhalants

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14
Q

what 3 drugs come under opioids?

A

heroin
morphine
codeine

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15
Q

what drugs come under hallucinogens?

A

LSD,
mescaline,
psilocybin,
PCP

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16
Q

what drugs come under stimulants?

A

amphetamines,
cocaine,
caffeine

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17
Q

what drugs come under Psychotropic medications

A

antidepressants,
antipsychotics
mood stabilisers

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18
Q

what part of nervous system are Psychotropics in?

A

CNS - brain, spinal cord and neuron network

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19
Q

what is the CNS responsible for?

A

sending, receiving and interpreting info from body

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20
Q

what are neurotransmitters ?

A

the chemicals that communicate info through brain and body by relaying signals between neurons

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21
Q

what is Acetylcholine related to

A

memory, learning and attention

22
Q

what is Epinephrine or adrenalin related to?

A

Secreted endocrine glands above the kidneys, adrenal glands.
Regulates fight/flight/freeze.
Often mentioned with anx.

23
Q

what is Norepinephrine related with?

A

wakefulness and alertness

24
Q

what is Dopamine related with?

A

Behavioural reg, movement, learning, mood and attention.
Can be both excitatory and inhibitory.
Discussed in relation to schizophrenia.
Receptors activated by amphetamines and cocaine

25
what is serotonin related to?
mood regulation, appetite and sleep inhibition of activity and behaviour.
26
what is Gamma-aminobutyric acid (GABA) related with?
preventing over excitation. Barbiturates and benzodiazepines increase GABA
27
what meds given for cluster A personality disorders?
 Atypical antipsychotic medication at low doses  E.g. risperidone, olanzapine, quetiapine (Risperdal, Zyprexa, Seroquel)
28
what meds given for cluster B personality disorders?
 For impulsive, depressive and angry: Duloxetine, SSRIs  for anx/sedation, decrease self-harm: gabapentin (Neurontin), naltrexone (Revia)
29
what meds given for cluster C personality disorders?
 Anxious/avoidant symptoms: SSRIS  Long acting benzo-diazepine such as clonazepam (Klonopin) and buspirone (Buspar)
30
What meds given for ADHD?
o Usually dexamphetamine or medinidate (Ritalin) o Vyvanse and Ritalin
31
What meds given for bipolar?
o Mania – sedation o Mood stabilities o Lithium (but requires close monitoring – excessive thirst and trembling) o Valproate (Epilmi) often used – can help insomnia and aggressiveness o Carbamazepine (Tegretol) – side effects ataxia, dizziness, stomach upset o Other antiepileptic drugs have modest effect for mood stabilising o Quetiapine (Seroquel) often used. o Usually antipsychotic drugs and mood stabiliser used
32
what meds given for dementia?
o Where mini mental state greater than 10 – donepezil (Aricept) used – aim to slow cog. dec. o Low dose antipsychotic meds, often risperidone (Risperdal) can be used
33
what meds given for anx?
o Many years: diazepam (Valium) and benzodiazepines been used o Often anti-depressant class drugs used o Beta blockers such as propranolol (Inderal) and atenolol (Noten) reduce sympathetic nervous system activity
34
what meds given for MDD?
o First antideps: tricyclic antideps such as amitriptyline (Endep) has many side effects (sedation, dizzy, stomach) o More modern antideps are more selective in their action – majority targeting serotonin system  Include: sertraline (Zoloft), citalopram (cipramil) and fluoxetine (Prozac) o If treatment ineffective then agents targeting noradrenaline system are used: mirtazapine (Avanza) o Combined effect drugs: desvenlafaxine (Pristiq) o New antidepressant targeting melatonin system: agomelatine (Valdoxan) – liver monitoring needed
35
what meds used in treatment resistance depression?
variety of strategies used: combining antideps, mood stabiliser/antipsychotic and hormonal treatments such as thyroxine.
36
what meds used for OCD?
o Antideps. o Clomipramine (Anafranil) appears to be more effective than newer antideps.
37
what meds used for schizophrenia?
o Antipsychotic meds. o Olanzapine (Zyprexa), risperidone (Risperdal- can cause gynaecomastia aka breast enlargement)), quetiapine (Seroquel) and others typically cause weight gain
38
what happens with treatment resistant schizophrenia?
resistance usually a different antipsychotic is trialled; repeated failure will lead to clozapine (Clozaril). Note - as the dose increases, there can be sedation, salivation, and seizures.  mood stabilisers may be added  non-adherence is sig. issue with poor insight accompanying delusions  long acting injectable forms now available: haloperidol (Haldol)  for managing sig. aggression: rapid onset short acting zuclopenthixone (Clopixol acuphase injection) used
39
what has long term use of antipsychotics been associated with?
tardive dyskinesia - permanent involuntary movement disorder
40
what meds used to treat sleep disorders?
o Modafinil (Modavigil) useful for persistent tiredness  Short term benzodiazepines such as temazepam (Temaze), oxazepam (Serepax)  Longer acting benzodiazepines include: nitrazepam (Mogadon)  Zopiclone (Stilnox) (but dissociative amnesia a side effect as well as impulsive night actions)
41
what meds used for alcohol dependence?
* Acamprosate (Campral) – (required 3 x per day – no side effects but often not adhered to cause of high freq. of dosing. Modest efficacy * Naltrexone (ReVia) – effective and often prescribed for 3 months (as part of treatment program)
42
what meds used for opioid addiction?
* Naltrexone (ReVia) – blocks subjective effect of opioids o When co-administered with opioid buprenorphine (Suboxone) it blocks dependence on morphine, heroin and other opioids * Methadone – used in chronic replacement programs
43
what does heroin/opiods do to the body?
o central nervous system depressants o produce slowed respiration, increase body temp, slurred speech and impaired memory o are analgesics as they stop brain from receiving pain signals o produces state of euphoria and sedation
44
what are included as Amphetamines
dextroamphetamine and methamphetamine
45
what is Dextroamphetamine ?
an upper and can create excess activity, decrease appetite, euphoria, alertness and increased libido – also anx, paranoia, psychosis, violence and tremors
46
what is Wernicke-korsakoff syndrome ?
caused by bit def of thiamine - alcohol  – eye movement disturbance, ataxia (lack of muscle control and coordination), confusion and short-term memory problems.  Can be treated with thiamine  If not treated psychosis can develop which can be permanent
47
what is the effect of inhalants?
o Effect is to depress the CNS and range from mild intoxication to unconsciousness
48
what is St John’s wort (hypericum perforatum)?
o Perineal herb with yellow flower used to treat nervous conditions since ancient Greek times o Popular for mild dep.
49
what do people need to be aware of with St John's Wart?
o Dry mouth, dizzy, photosensitivity, tummy issues, fatigue o Known to have complex effect on liver metabolism, inhibiting some but inducing other enzymes. Serious drug interactions o Efficacy unclear but some research indicating effectiveness for mild dep
50
- Practice research can focus on:
o Efficacy (whether you can measure a treatment effect) o Effectiveness (whether efficacious treatment has a measurable beneficial effect when applied in various setting and across populations) o Practice (identify how and which treatments/services are provided and evaluate how to improve treatment) o Service systems (Exploring large scale org. and policy related issues such as impact of public policy on service delivery)
51
- Why is the applied psych practice twofold?
o Psych science includes ongoing evaluation of one’s practice (outcome and process) o And also practitioners use science to informs how one practices

NPE (6 decks)

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