Psychopharmacology Flashcards

Question

Name non-benzodiazepine sedatives

Answer 1

Droperidol / Haloperidol | Alpha 2 agonisists → clonidine

Answer 2

GABA receptors are found in the: - Limbic system - Spinal cord - Cerebellum - Brainstem Benzodiazepines enhance action of GABA (allosterically) at GABA-A receptor o bind to A-type GABA receptors on different site from GABA binding site to enhance GABA action of opening channels, allowing entry of chloride ions → hyperpolarization o reduce neuronal depolarization resulting in decreased action potentials in response to increased GABA inhibitory effect the body neuoradapts and causes decreased GABA inhibition effect and increased glutamate excitability → when diazepam is stopped there is hyperexcitability/withdrawal symptoms

Answer 3

Remember the order and names of the drugs by the mnemonic MOLD & remember that there is just a doubling pattern in ther elimination half-live M→ midozalam (ultra short-acting) - less than 6 hours O→ Oxazepam (short-acting) - 6-12 hours L→ Lorazepam (intermediate-acting) - 12-24 hours D→ Diazepam (long-acting) - 24 hours Note that short acting agents have greater tendency to cause overt dependency and withdrawal

Answer 4

Short acting→ the effects last for a short period | Rapid acting→ the effects occur rapidly

Answer 5

Acute aggressive behaviours - Lorazepam (sedating restless patient who can move around) and diazepam (for the restless patient who needs to be restrained) - Always ensure that resuscitation equipment and flumazenil (antidote is present) because sedation can cause respiratory failure Epilepsy – status epilepticus (state of having one seizure that lasts more than 5 minutes or having more than 1 seizure within 5 minutes without going back to normal level of consciousness between episodes) Anaesthesia Alcohol withdrawal syndrome/delirium tremens. Muscle tone disorders such as acute dystonia. Serotonin syndrome Anxiety disorders (not favoured at all, rather use antidepressant medication like SSRIs and SNRIs) Other - Quick relief of hypertension in drug overdoses, Treating tachycardia caused by stimulants like cocaine

Answer 6

Dystonia- give biperidine | - Treatment of EPSE caused by antipsychotics

Answer 7

The main problem with dependency is that it can occur even after several weeks of treatment with therapeutic doses. Without benzodiazepines, you see that GABA plays an inhibitory role on the VTA (Ventral tegmental area) where dopamine is produced. However, when benzodiazepines are used over time, you get neuroadaptation where there is decrease GABA activity in order to maintain homeostasis and overcome the drug effects. This results in disinhibition of dopamine producing neurons

Answer 8

Treatment should be kept to a minimum, reviewed regularly and discontinued as soon as possible. Do NOT use for anxiety states Longstanding anxiety disorders and panic disorders should be managed with counselling and low-dose antidepressants. Although the benzodiazepines have hypnotic properties, it is not desirable to use them in the routine management of insomnia Therapeutic relationship between client and doctor is very important: - Patients often do not view Benzo dependence as an addiction because their doctor prescribed the medication = denial is a big problem

Answer 9

Antipsychotic drugs are a class of medicines used to treat psychosis and other mental and emotional conditions

Answer 10

``` Typicals: •Chlorpromazine •Haloperidol •Flupentixol •Fluphenazine •Thioridazine ``` ``` Atypicals: •Clozapine •Olanzapine •Risperidone •Aripiprazole •Lurasidone ```

Answer 11

First generation antipsychotics act by blocking D2 receptors. They are non-selective and therefore block D2 receptors in all areas of the brain. They also block histaminic, noradrenergic and cholinergic receptors.

Answer 12

``` •Schizophrenia •Schizoaffective disorder •Bipolar disorder •Severe agitation •Dementia •Delirium •Major depressive disorder with psychotic features Non-psychiatric indications: nausea, vomiting, Tourette's' syndrome, Huntington 'disease, intractable hiccups ```

Answer 13

Parkinsonism, Acute dystonic reactions, Tardive dyskinesia ,Akathisia ,Neuroleptic malignant syndrome

Answer 14

``` Endocrine system Gastrointestinal system Cognition Seizure threshold Cardiovascular system Other side effects include blurred vision, hot flushes and weight gain ```

Answer 15

``` Known hypersensitivity Cardiac abnormalities Previous EPSEs Parkinson's disease Renal or hepatic insufficiency ```

Answer 16

Second-generation antipsychotics work by blocking D2 receptors as well as serotonin receptors. 5-HT2A and 5-HT2C subtypes of serotonin receptors are the most involved

Answer 17

* Treatment resistant schizophrenia * Bipolar mood disorder – mania or mixed * Major depressive disorder * Agitation

Answer 18

``` Prolactinoma Parkinsonism Tardive dyskinesia Severe neutropenia Bone marrow depression Previous neuroleptic syndrome ```

Answer 19

``` Prolactinoma Parkinsonism Tardive dyskinesia Severe neutropenia Bone marrow depression Previous neuroleptic syndrome ```

Answer 20

Weight gain , agranulocytosis, constipation, Hyperprolactinemia, Myocarditis, pericarditis, Convulsions