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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
Q

what is serotonin related to?

A

mood regulation, appetite and sleep

inhibition of activity and behaviour.

26
Q

what is Gamma-aminobutyric acid (GABA) related with?

A

preventing over excitation.
Barbiturates and benzodiazepines increase GABA

27
Q

what meds given for cluster A personality disorders?

A

 Atypical antipsychotic medication at low doses
 E.g. risperidone, olanzapine, quetiapine (Risperdal, Zyprexa, Seroquel)

28
Q

what meds given for cluster B personality disorders?

A

 For impulsive, depressive and angry: Duloxetine, SSRIs
 for anx/sedation, decrease self-harm: gabapentin (Neurontin), naltrexone (Revia)

29
Q

what meds given for cluster C personality disorders?

A

 Anxious/avoidant symptoms: SSRIS
 Long acting benzo-diazepine such as clonazepam (Klonopin) and buspirone (Buspar)

30
Q

What meds given for ADHD?

A

o Usually dexamphetamine or medinidate (Ritalin)
o Vyvanse and Ritalin

31
Q

What meds given for bipolar?

A

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
Q

what meds given for dementia?

A

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
Q

what meds given for anx?

A

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
Q

what meds given for MDD?

A

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
Q

what meds used in treatment resistance depression?

A

variety of strategies used: combining antideps, mood stabiliser/antipsychotic and hormonal treatments such as thyroxine.

36
Q

what meds used for OCD?

A

o Antideps.
o Clomipramine (Anafranil) appears to be more effective than newer antideps.

37
Q

what meds used for schizophrenia?

A

o Antipsychotic meds.
o Olanzapine (Zyprexa), risperidone (Risperdal- can cause gynaecomastia aka breast enlargement)), quetiapine (Seroquel) and others typically cause weight gain

38
Q

what happens with treatment resistant schizophrenia?

A

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
Q

what has long term use of antipsychotics been associated with?

A

tardive dyskinesia - permanent involuntary movement disorder

40
Q

what meds used to treat sleep disorders?

A

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
Q

what meds used for alcohol dependence?

A
  • 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
Q

what meds used for opioid addiction?

A
  • 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
Q

what does heroin/opiods do to the body?

A

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
Q

what are included as Amphetamines

A

dextroamphetamine and methamphetamine

45
Q

what is Dextroamphetamine ?

A

an upper and can create excess activity, decrease appetite, euphoria, alertness and increased libido – also anx, paranoia, psychosis, violence and tremors

46
Q

what is Wernicke-korsakoff syndrome ?

A

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
Q

what is the effect of inhalants?

A

o Effect is to depress the CNS and range from mild intoxication to unconsciousness

48
Q

what is St John’s wort (hypericum perforatum)?

A

o Perineal herb with yellow flower used to treat nervous conditions since ancient Greek times
o Popular for mild dep.

49
Q

what do people need to be aware of with St John’s Wart?

A

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
Q
  • Practice research can focus on:
A

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
Q
  • Why is the applied psych practice twofold?
A

o Psych science includes ongoing evaluation of one’s practice (outcome and process)
o And also practitioners use science to informs how one practices

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