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PSYCHIATRY > PSYCHOPHARMACOLOGY > Flashcards

PSYCHOPHARMACOLOGY Flashcards

1
Q

What are the 4 targets of medicines used in psychiatry?

A

Receptors
NT reuptake sites
Ion channels
Enzymes

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2
Q

List examples of drugs that block enzyme activity

A

Monoamine oxidase inhibitors (MAOIs) - blocks breakdown of serotonin/noradrenaline - anxiety, depression

Acetylcholinesterase inhibitors - dementias

Lithium - blocks glycogen synthase kinase for mood stability

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3
Q

List examples of drugs that target receptors

A

Receptor antagonists:

  • Dopamine receptor blockers - schizophrenia
  • Serotonin receptor subtype antagonists - depression
  • Histamine receptor antagonists - sleep

Receptor agonists:

  • Benzodiazepines (enhance GABA) - sleep
  • Guanfacine (enhance noradrenaline) - ADHD
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4
Q

List examples of drugs that target reuptake sites

A

Reuptake site blockers:

  • Citalopram (SSRI) - depression, anxiety
  • Desipramine (NRI) - depression
  • Methylphenidate (DRI) - ADHD

Reuptake site direction switching to enhance release:
- Amfetamine - ADHD

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5
Q

What is the 5HT1A receptor responsible for?

A

5HT (serotonin) receptor which dampens activity in neurones. Enhancing serotonin for these receptors can treat anxiety/depression

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6
Q

What is the 5HT2A receptor responsible for?

A

Psychedelic drugs thought to work on this to cause their effects.

Involved in schizophrenia, eating and sleep regulation

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7
Q

How does serotonin inhibit its own release?

A

Acts on autoreceptors presynaptically.

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8
Q

List examples of drugs that target ion channels

A

Reduces neuronal excitability

Sodium channels:

  • Sodium valporate - epilepsy, mood stabilisation
  • Carbamazepine - epilepsy, mood stabilisation

Calcium channels:
- Gabapentin + pregablin - epilepsy, anxiety

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9
Q

What are the fast acting neurotransmitters (on/off switches) and what functions are they used in?

A

Glutamate (excitatory)
GABA (inhibitory)

Memory, movement, vision etc.

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10
Q

What are the slow acting neurotransmitters (modulators) and what functions are they used in?

A 
Dopamine
Serotonin
Noradrenaline
Acetylcholine
Endorphins and other peptides

Emotions, drives, valence of memory

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11
Q

What does an excess of glutamate cause and what are the treatments?

A

Epilepsy - Perampanel (blocker)

Alcoholism - Acamprosate (blocker), Ketamine (blocker)

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12
Q

What does a deficiency of GABA cause and what are the treatments?

A

Anxiety - Benzodiazepines (GABA enhancer)

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13
Q

What does a deficiency of 5-HT cause and what are the treatments?

A

Depression and anxiety

SRIs and MAOIs (serotonin enhancers)

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14
Q

What does an excess of dopamine cause and what are the treatments?

A

Psychosis

Dopamine receptor blockers

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15
Q

What does an excess of noradrenaline cause and what are the treatments?

A

Nightmares

Prazosin (blocker)

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16
Q

What does a deficiency of acetylcholine cause and what are the treatments?

A

Impaired memory/dementia

Acetylcholinesterase inhibitors

17
Q

What are all the types of drugs for depression?

A 
MAOI - phenelzine, moclobemide
SSRI - citaloprame, fluoxetine
TCA - clomipramine, amitriptyline
SNRI - venlafaxine
NRI - reboxetine
DRI - bupropion
Melatonin agonist
Receptor antagonist
Multimodal - vilazodone, vortioxetine
18
Q

Why might partial agonists be used and give some examples?

A

Improved safety especially in overdose
In states of high NTs/excess agonist medicine it acts as an antagonist

buprenorphine < heroin
varenicline < nicotine

19
Q

Whats the difference between partial agonists and full agonists?

A

Lower max efficacy

20
Q

What are inverse agonists and give examples?

A

A drug that binds to the same receptor as an agonist but induces a pharmacological response opposite to that of the agonist

GABA inverse agonist - dementias (pro-cog)
Histamine inverse agonist - ADHD (increased attention)

21
Q

Name 3 GABA A receptor subunits and what they do

A

Alpha1 - Inhibition from GABA interneurones onto pyramidal cells

Alpha2 - Controls output of pyramidal cells

Alpha5 - Dampens tonic activity in brain

Different receptor subtypes will have different subunits

22
Q

What is the orthosteric site?

A

Where the natural NT binds to on the receptor

23
Q

What substances bind to the allosteric sites of the GABA receptor and thus what do they cause?

A

Benzodiazepines
Barbituates
Alcohol
Neurosteroids

Enhance action of GABA so sedation, sleep, reduce anxiety, anti-epilepsy

PSYCHIATRY (5 decks)

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