Psychopharmacology Flashcards
The movement of the drug into the bloodstream. With oral agents this typically occurs in the small intestines.
Absorption
The transformation or breakdown of the drug in preparation for elimination from the body.
Metabolism
Unintended and undesired effects that occur when the medication is administered correctly. The severity of the impact may be dose dependent.
Adverse effects
The process by which substances (drugs, substrates, toxins) leave the body (feces, urine, skin).
Excretion
The pre-circulation process (uptake and conversion) by which the substrates (changed drug) are significantly reduced by the cytochrome P450 (CYP450) enzyme in the liver after enteric absorption. Non-enteric routes of medication bypass first pass effect.
First Pass Effect
Disorganized behavior with accompanying (one of three of the following): delusions, hallucinations, and/or disorganized speech (marked by frequent derailment or incoherence) lasting <1 day.
Psychosis
The PMHNP is monitoring a serum drug level for a med with a 24-hour half-life. How many hours will it take to reach steady state?A. 48B. 72C. 96D. 120
D. 120 hours. Steady state is achieved in five half-lives of the medication. (5 x 24 = 120)
Rapidly diminishing responsiveness to increasing doses of the medication; aka “poop-out” effect.
Tachyphylaxis
Rare life-threatening condition that can occur at any time in a patient receiving antipsychotic medication. It most commonly occurs with typical versus atypical antipsychotics within the first 2 weeks of starting treatment.
Neuroleptic Malignant Syndrome
Absent movement; difficulty standing; flat affect; avolition. Often mistaken for disinterest.
Akinesia
A drug that blocks receptors, inhibiting a biological response, is known as a(n): A. Partial agonistB. Inverse agonist C. AntagonistD. Agonist
C. An antagonist is a medication that blocks a receptor to inhibit a biological response even from endogenous agnists.
Shuffling gait, motor slowing, masked flat facial expression, tremor, and cogwheel rigidity.
Pseudo-Parkinson’s
A usually undesired but foreseeable effect that occurs regardless of dose, and often resolves after continued therapy without intervention.
Side effect
Involuntary muscle spasms.
Dystonia
When target symptoms cease to be acceptably controlled or mitigated.
Treatment failure
Dietary (tyramine) restrictions (for this drug class):- Aged cheese- Cured meat- Smoked meat- Fermented foods- Fish sauce- Alcohol- Soy products
MAOIs (Mono-amine Oxidase Inhibitors)
Which antipsychotic is associated with agranulocytosis?
Clozapine (Clozaril)
The time needed to clear 50% of the drug from the plasma.
Half-life
The movement of the drug through the bloodstream and to target receptors. The chemicals (substrates) bind to the protein for transport. The unbound (free) portion of the drug is considered active.
Distribution
The process of becoming desensitized and therefore less responsive to a particular dose of medication over time, necessitating increases; may eventually lead to “poop-out” effect.
Tolerance
A medication that works by receptor activation to produce a biological effect.
Agonist
Binds to a receptor but does not fully activate it, and produces a muted biological response
Partial agonist
The study of what the body does to a drug concerning absorption, distribution, metabolism, and excretion (ADME).
Pharmacokinetics
Inability to remain still; motor restlessness; often mistaken for anxiety.
Akathisia
The study of drug action on the body, specifically the relationship between drug concentration and effect (dose and response).
Pharmacodynamics
This drug class is known to prolong the QTc (except for aripiprazole).
Antipsychotics
Which of the following is an indication for monitoring of serum drug levels?A. Smoking cessationB. New diagnosis of diabetesC. Resolution of symptomsD. New diagnosis of hyperlipidemia
A. Smoking is a known inducer of the CYP450 pathway.
Syndrome associated with a rise in eosinophils, liver enzymes, renal insufficiency, and positive cardiac enzymes.
(DRESS) Syndrome
Drug rash with eosinophilia and systemic symptoms
Specific, life-threatening drug rash characterized by blisters giving way to dermis and hives on the lining of the mucous membranes.
Steven-Johnson Syndrome
It is essential to check the _______ level before treating the patient that is taking valproic acid.
Ammonia
Check these things before initiating any psychopharmacological intervention (particularly those known to affect these parameters).
- Hepatic and renal function
- Lipids
- Hemoglobin A1C
- Thyroid Function (TSH)
- 12-lead EKG for QTc prolongation
These 3 drug classes can precipitate SIADH. Also intermittently monitor sodium levels.
- SSRIs: Selective Serotonin Reuptake Inhibitors
- SNRIs: Serotonin-Norepinephrine Reuptake Inhibitors
- MAOIs: Monoamine Oxidase Inhibitors
Refusing to believe a painful reality.
EXAMPLE: A partner denies the evidence of a love affair.
Denial
Shifting an impulse toward a more acceptable object.
EXAMPLE: Kicking the dog in response to being disciplined.
Displacement
Self-justifying explanation instead of reality which is perceived as threatening.
EXAMPLE: An alcoholic who says she only drinks socially.
Rationalization
Disguising one’s impulse by attributing to others.
EXAMPLE: “All guys do this.”
Projection
Switching unacceptable impulses into the opposite impulse.
EXAMPLE: Displacing angry feelings with extreme friendliness.
Reaction formation
Retreating to a previously mastered developmental stage.
EXAMPLE: A child reverts to thumb-sucking or bed-wetting in response to a new stressor (new baby, new school, etc).
Regression
Psychological angst manifested as a physical symptom.
EXAMPLE: Abdominal pain with no organic etiology.
Conversion
Outer body experience, disconnected from the physical world.
EXAMPLE: Becoming inattentive or day-dreaming or freezing during an acute stress.
Dissociation
Seeking a funny aspect in a stressful situation to reduce associated anxiety.
EXAMPLE: No example needed.
Humor
