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Physiological psychology > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

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1
Q

Data collected in a survey of 242 million adults in the United States indicated that about ____ in ____ adults had filled one or more prescriptions for psychiatric drugs in 2013 (Moore & Mattison, 2016). In terms of type of drug, the largest number of adults reported filling prescriptions for ________ (12%), followed by ________ (8.3%) and ________ (1.6 percent).

A
  • 1 in 6
  • antidepressants
  • anxiolytics, sedatives, and hypnotics
  • antipsychotics
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2
Q

The first-generation antipsychotics (FGAs) are also known as traditional and conventional antipsychotics and include:

A
  • chlorpromazine (Thorazine)
  • haloperidol (Haldol)
  • thioridazine (Mellaril)
  • fluphenizine (Prolixin)
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3
Q

FGAs are used to treat ________ and other disorders with psychotic symptoms and are more effective for treating ________ than ________.

A
  • schizophrenia
  • positive symptoms
  • negative symptoms
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4
Q

The FGAs exert their therapeutic effects primarily by:

A

blocking dopamine (especially D2) receptors

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5
Q

The major side effects of the FGAs fall into three categories:

A

1) Anitcholinergic sides effects: (e.g., chlorpromazine and thioridazine)
2) Extrapyramidal side effects
3) Neuroleptic malignant syndrome (NMS)

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6
Q

Anticholinergic side effects are most likely with ________ (e.g., chlorpromazine and thioridazine) and include ________, ________, ________, ________, and ________.

A
  • low potency FGAs
  • dry mouth
  • blurred vision
  • urinary retention
  • constipation
  • tachycardia
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7
Q

Extrapyramidal side effects are most likely with ________ (e.g., haloperidol and fluphenizine) and include ________, ________, ________, and ________.

A
  • high-potency FGAs
  • parkinsonism (resting tremor, muscle rigidity, slowed movement)
  • dystonia (uncontrollable muscle contractions)
  • akathisia (a sense of inner restlessness)
  • tardive dyskinesia (involuntary, rhythmic movements of the tongue, face, and jaw and, over time, may also affect the limbs and trunk)
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8
Q

Tardive dyskinesia is:

A
  • potentially life threatening
  • begins after long-term drug use
  • more common in women and older adults
  • irreversible
  • treated by gradually withdrawing the drug, administering a benzodiazepine, or switching to a second-generation antipsychotic
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9
Q

Neuroleptic malignant syndrome (NMS) is a rare life-threatening side effect from FGA use. Its symptoms include ________, ________, ________, and ________.

A
  • muscle rigidity
  • a high fever
  • autonomic dysfunction (e.g., unstable blood pressure, tachycardia, excessive sweating)
  • an altered mental state (e.g., confusion, combativeness)
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10
Q

Treatment for neuroleptic malignant syndrome (NMS) involves:

A

having the person stop taking the drug at the first sign of symptoms and providing him/her with supportive therapy (e.g., hydration, cooling).

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11
Q

The second-generation antipsychotics (SGAs) are also known as atypical antipsychotics and include:

A
  • clozapine (Clozaril)
  • risperidone (Risperdal)
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)
  • aripiprazole (Abilify)
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12
Q

Like the FGAs, SGAs are used to treat ________ and other disorders with ________ symptoms, and some are FDA-approved as an adjunctive treatment for ________.

A

schizophrenia
psychotic
major depressive disorder

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13
Q

SGAs are as effective as or more effective than the FGAs for treating the ________ of schizophrenia and more effective than the FGAs for treating the ________, although this may be true for only some SGAs. In addition, an SGA (especially ________) may be effective when ________.

A

positive symptoms
negative symptoms
clozapine
FGAs have been ineffective

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14
Q

SGAs alleviate positive symptoms primarily by ________ and alleviate negative and cognitive symptoms primarily by ________.

A
  • blocking dopamine (especially D3 and D4) receptors
  • blocking serotonin receptors
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15
Q

The SGAs are ________ than the FGAs to cause ________; however, they can cause anticholinergic effects, neuroleptic malignant syndrome, and metabolic syndrome

A

less likely
extrapyramidal side effects

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16
Q

Metabolic syndrome from SGA use involves:

A
  • substantial weight gain
  • high blood pressure
  • insulin resistance
  • hyperglycemia
  • increased risk for diabetes mellitus and heart disease
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17
Q

Clozapine and, to a lesser extent, other SGAs can cause agranulocytosis, which is:

A
  • a potentially life-threatening condition that involves a dangerously low white blood cell count
  • requires regular white blood cell monitoring
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18
Q

The major antidepressants include:

A
  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • norepinephrine dopamine reuptake inhibitors (NDRIs)
  • tricyclic antidepressants (TCAs)
  • monoamine oxidase inhibitors (MAOIs)
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19
Q

The SSRIs include:

A
  • fluoxetine (Prozac, Sarafem)
  • fluvoxamine (Luvox)
  • paroxetine (Paxil)
  • sertraline (Zoloft),
  • citalopram (Celexa)
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20
Q

The SSRIs are the ________ prescribed antidepressants and are generally considered to be the first-line pharmacological treatment for________ and ________. Some are also used to treat other disorders including ________, ________, ________, ________, ________, ________, and ________.

A
  • most frequently
  • major depressive disorder
  • persistent depressive disorder
  • premenstrual dysphoric disorder
  • OCD
  • panic disorder
  • generalized anxiety disorder
  • PTSD
  • bulimia nervosa
  • premature ejaculation
21
Q

The SSRIs exert their therapeutic effects primarily by ________, thereby increasing its availability in the synaptic cleft. Because they increase the ________, the SSRIs are classified as ________ or ________.

A
  • blocking the presynaptic reuptake of serotonin
  • availability of serotonin
  • serotonin agonists
  • indirect agonists
22
Q

Compared to TCAs, the SSRIs are; ________ in terms of efficacy, have ________ side effects, are ________ (e.g., are less cardiotoxic), and are safer for ________.

A
  • comparable
  • fewer
  • safer in overdose
  • older adults
23
Q

Side effects for SSRIs include:

A
  • mild anticholinergic effects
  • gastrointestinal disturbances
  • insomnia
  • anxiety
  • sexual dysfunction
24
Q

Abrupt cessation of an SSRI can cause ________, which involves headaches, dizziness, mood lability, impaired concentration, sleep disturbances, and flu-like symptoms

A

discontinuation syndrome

25
Q

Combining an SSRI with an MAOI, lithium, or other serotonergic drug can cause ________, which is potentially fatal and involves ________, ________, ________, ________, ________, ________, and ________.

A

serotonin syndrome
extreme agitation
confusion
autonomic instability
hyperthermia
tremor
seizures
delirium

26
Q

Treatment for serotonin syndrome requires ________ of the serotonergic drugs and providing appropriate medical interventions for its symptoms.

A

immediate withdrawal

27
Q

The SSRIs have a ________ of therapeutic effects on depressive symptoms of about ________ weeks.

A
  • delayed onset
  • two to four
28
Q

The SNRIs include:

A
  • venlafaxine (Effexor)
  • duloxetine (Cymbalta)
  • desvenlafaxine (Pristiq)
29
Q

SNRIs used to treat ________, ________, ________ and other ________.

A
  • major depressive disorder
  • social anxiety disorder
  • neuropathic pain
  • pain disorders
30
Q

The SNRIs are ________ to the SSRIs in terms of efficacy, although there’s some evidence they may be more effective for ________.

A
  • similar
  • severe depression
31
Q

The therapeutic effects of SNRIs are due to:

A

the inhibition of the reuptake of serotonin and norepinephrine at synapses.

32
Q

The side effects of the SNRIs are ________ to those of the SSRIs and, like the SSRIs, they can cause ________ when abruptly stopped and ________ when combined with other serotonergic drugs. Because of their effects on norepinephrine, they can ________ and may be contraindicated for patients with ________.

A
  • similar
  • discontinuation syndrome
  • serotonin syndrome
  • elevate blood pressure
  • hypertension or heart problems
33
Q

The NDRIs include ________, which is used to treat ________ and assist with ________ and exerts its therapeutic effects by ________ at synapses.

A
  • bupropion (Wellbutrin, Zyban)
  • major depressive disorder
  • smoking cessation
  • inhibiting the reuptake of norepinephrine and dopamine
34
Q

The side effects of NDRIs include:

A
  • skin rash
  • decreased appetite and weight loss
  • agitation
  • insomnia
  • dizziness
  • seizures
35
Q

Advantages of bupropion are that it causes few ________, does not cause ________, and is not ________.

A
  • anticholinergic effects
  • sexual dysfunction
  • cardiotoxic
36
Q

Bupropion and other antidepressants that increase levels of norepinephrine and dopamine have an ________, which means they’re useful for patients who have ________ but not for those who have ________.

A
  • energizing effect
  • low energy and motivation
  • insomnia or are very anxious
37
Q

Of the TCAs, the tertiary amines include:

A
  • amitriptyline (Elavil)
  • imipramine (Tofranil)
  • clomipramine (Anafranil)
  • doxepin (Sinequan)
38
Q

Of the TCAs, the tertiary amines exert their effects by ________, with some having a stronger effect on ________.

A
  • inhibiting the reuptake of both serotonin and norepinephrine
  • serotonin
39
Q

Of the TCAs, secondary amines include ________ and ________ and are more potent at ________.

A
  • nortriptyline (Pamelor)
  • desipramine (Norpramin)
  • inhibiting the reuptake of norepinephrine than serotonin
40
Q

The TCAs are used to treat ________, ________, ________, and ________.

A
  • major depressive disorder
  • panic disorder
  • obsessive-compulsive disorder (especially clomipramine)
  • neuropathic pain (especially nortriptyline and amitriptyline).
41
Q

The side effects of the TCAs include ________, ________, ________, ________, and ________.

A
  • cardiovascular effects (e.g., hypertension, tachycardia, orthostatic hypotension)
  • anticholinergic effects
  • sedation
  • weight gain
  • sexual dysfunction
42
Q

The secondary amines have ________ side effects than the tertiary amines (e.g., they are ________ to cause sedation and anticholinergic effects).

A
  • fewer
  • less likely
43
Q

Because the TCAs are ________ and ________, they must be prescribed with caution for patients who have heart disease or are ________.

A
  • cardiotoxic
  • lethal in overdose
  • suicidal
44
Q

The MAOIs include:

A
  • phenelzine (Nardil)
  • isocarboxazid (Marplan)
  • tranylcypromine (Parnate)
45
Q

The MAOs are useful for patients with ________ or ________, which involves reversed vegetative symptoms such as hypersomnia, increased appetite, and reactive dysphoria.

A
  • treatment-resistant depression
  • atypical depression
46
Q

The enzyme monoamine oxidase ________ norepinephrine, serotonin, and dopamine, and the MAOIs increase the levels of these neurotransmitters by ________ of this enzyme.

A
  • deactivates
  • inhibiting the activity
47
Q

The side effects of MAOs include:

A
  • anticholinergic effects
  • orthostatic hypotension
  • sedation
  • sexual dysfunction
48
Q

MOAs may produce a ________ when taken in conjunction with certain drugs (e.g., amphetamines, antihistamines) or food containing ________ (e.g., aged cheese and meat, soy products, beer, red wine, sauerkraut, fava beans, ripe bananas).

A
  • hypertensive crisis
  • tyramine
49
Q

Symptoms of a hypertensive crisis include:

A
  • a severe throbbing headache
  • neck pain or stiffness
  • rapid heart rate
  • nausea and vomiting
  • sweating
  • sensitivity to light
  • confusion
  • delirium

Physiological psychology (5 decks)

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