psychopharmacology Flashcards
What’s in the body of a neuron
nucleus
The dark spot on the figure of the soma is the cell nucleus, which contains the genetic material of the cell
soma
cell body of neuron
dendrite
which are structures that receive inputs or messages from other cells through receptors.
vesicle
sacks of neurotransmitter molecules
synaptic cleft
space between the presynaptic neuron and post synaptic neuron
reuptake of neurotransmitter
recycing of neurotransmitter back into cell via a protein
neurotransmitters
checmical messengers
presynaptic terminals
at the end of the axon are terminal buttons that contain synaptic vesicles
receptor
basic chains of proteins that act as communication devices, allowing neurotransmitters to bind to them.
postsynaptic neuron
postsynaptic neuron refers to a neuron that receives signals from a presynaptic neuron through a junction called a synapse.
fill in the process of neurotransmission
picture
describe the process of neurotransmission
1 synthesis of neurotransmitters and vesicles in the cell body
1b synthesis of smaller neurotransmitters in the presynaptic terminal
2 transport neurotransmitters
3 action potential causes calcium to enter, releasing neurotransmitters from presynaptic terminal to synaptic cleft
4 neurotransmitter binds to the receptor of postsynaptic neuron
5 neurotransmitters separate from receptors
6 reuptake of neurotransmitter by a transporter protein
Titration
The process of arriving at an optimal maintenance dose is called titration. When a doctor increases or decreases the amount of the drug to maximize therapeutic response we say she is titrating the dose up or down.
Agonism
Something that assists or facilitates a cell’s functions
Antagonism
Something that interferes with an action is an antagonist
Steady state
the amount of a drug in a person’s blood with regular dosing
maintenance dose
maintenance dose, the dose needed to maintain levels of the drug linked to therapeutic response.
half-life
how long the medication stays in a person’s body and how long it takes for 50% of the medication to leave the body
Agranulocytosis
potentially dangerous side effect of clozapine/Clozaril where a hematologic side effect causes white blood cells to drop dramatically, it happens to 1.2% of people
What are the mechanisms of action in lithium?
it is not lipid soulble so it must be carried accoss the bbb by other means
Lithium mechanism of action on Serotonin
Increase in tryptophan (precursor) uptake after short- and long-term treatment.
General increases in serotonin levels.
Increased release of serotonin in the hippocampus, hypothalamus, and parietal cortex.
Serotonin receptor decreases in the hippocampus.
Long-term administration causes downregulation of 5-HT1 and 5-HT2 receptors.
Lithium mechanism of action on
Dopamine
Long-term administration diminishes neostriatal dopamine activity.
May block the effects of highly sensitive DA receptors, thus decreasing the behaviors associated with DA stimulation
Lithium mechanism of action on
Norepinephrine
Increases and decreases rate of synthesis of NE in different parts of the brain
Decreases the excretion of NE metabolites in manic patients
increases the excretion of NE metabolites in depressed patients
Lithium mechanism of action 2ndary messenger systems
Lithium appears to reduce the activity of second-messenger systems in undetermined ways.
Lithium Ionic effects
Lithium, being a positively charged metal ion, may have stabilizing effects on neurons in the CNS.
Lithium inhibiting Intracellular Enzymes action
Inhibition of glycogen synthase kinase-3 (GSK-3) increases Beta-catenin that stimulates axon growth and cell survival.
Lithium neuroprotection action
Antioxidant properties may protect the brain from oxidative stress
Steps of pharmacokinetics
Administration
Absorption
Binding/distribution
Metabolization
Excretion
Who’s job is it to ENSURE adherence and compliance? Hint…not yours
Primary care provider and/or psychaitrist
Positive symptoms of schizophrenia
hallucinations, illusions, delusions, and paranoia
negative symptoms of schizophrenia
anhedonia (lack of pleasure in life), isolation, withdrawal, flat affect, and reduced motivation.
Polypharmacy
multiple psychotropic medications to bring about symptom relief.
What is the overall effectiveness of antidepressants? Hint…it is a percentage
modest at best at only 50%
What must a substance be or do to be considered a neurotransmitter?
Synthesis
The chemical must be produced within a neuron or be present in it as a precursor molecule
Release
When a neuron is activated, the chemical must be released
Response
The chemical must cause a biological effect by binding to receptors on a postsynaptic cell
Removal
There must be a mechanism to remove the chemical from its site of action after it’s done signaling
The difference between tolerance and dependence
Tolerance refers to the body getting used to taking a substance and requiring higher doses.
Dependence, refers to the physical or psychological symptoms that make someone feel like they must continue taking a substance.
What are common 2nd-generation antidepressants?
Citalopram/Celexa
Escitalopram oxalate/Lexapro
Fluoxetine/Prozac
Fluvoxamine/Luvox
Paroxetine/Paxil
Sertraline/Zoloft
What are common third-generation antidepressants?
Bupropion/Wellbutrin
Remeron/Mirtazapine
Venlafaxine/Effexor
Reboxetine/Edronax/Vestra
Duloxetine/Cymbalta
Desvenlafaxine/Prestiq
Risperidone/Resperdal is used to treat what?
schizophrenia, bipolar disorder and some symptoms of autism
Quetiapine/Seroquel is used to treat what?
schizophrenia bipolar disorder with mixed or manic specifiers as well as the maintenance phase of Bipolar I Disorder.
Aripiprazole/Abilify is used to treat what?
schizophrenia, the maintenance phase of Bipolar I Disorder, as an adjunctive treatment for depression and for irritability associated with Autism Spectrum Disorders
Olanzapine/Zyprexa is used to treat what?
schizophrenia bipolar disorder with mixed or manic specifiers as well as the maintenance phase of Bipolar I Disorder
Why are tricyclics called tricyclics?
Tricyclic antidepressants get their name from their chemical structure, which contains three rings with one side chain.
How would you define pharmacodynamics?
how drugs act on the body
what are the four perspectives discussed in your textbook
biological, psychological, cultural, social
Biological perspective or medical model
It is characterized by its focus on objective, measurable data related to individuals.
psychological perspective
the conscious experience or what consciousness feels like on the inside of a person
Studying the mind and soul
Cultural perspective
Culture, shared beliefs, worldviews and ways of living that groups of humans transmit from one generation to another to understand the world and their place in it.
Social perspective
deals with measurable, observable data about groups and particularly institutions.
Lexapro, Zoloft, Prozac what do they primarily treat
Depression
Neurotransmitters that are most aligned with the concept of pleasure.
Serotonin & dopamine
Contrast pharmacology and psychopharmacology.
Pharmacology is the science of the preparation, uses, and effects of drugs.
Psychopharmacology is the branch related to the psychological effects of drugs and their use to treat mental and emotional disorders.
Primary diagnosis of Zyprexa, Abilify, Risperidone, Seroquel
Schizophrenia and bipolar mania
2 neurotransmitters that are associated with anxiety
serotonin & Gaba
Define and differentiate pharmacokinetics and pharmacodynamics.
Pharmacokinetics examines the movement of drugs through the body, and pharmacodynamics examines the effects of drugs on the body.
What drug replaced barbiturates
Benzodiazepines
History of barbiturates
The name “barbiturate” is said to have been cho- sen either because the urine of a girl named Barbara was used to derive the compound or because it was synthesized on St. Barbara’s Day (Snyder, 1996).
What 3 neurotransmitters have been the focus of depression
serotonin, norepinephrine, and dopamine
Tardive dyskinesia is
involuntary movement disorder side effect of older antipsychotic medications or neuroleptics Halodol, Therzine
Euthymic state - what drugs help Euthymic state
normal mood tranquil or joyous,
mood stabilizers - Depakote
PDD persistent depressive disorder
dysthymia
Neurotransmitters that are
associated with mechanisms of
action in lithium
Serotonin, Dopamine, Glutamate
What is the 1st third gen Antipsychotic
aripirpazole
What percentage of all medications have been prescribed to children that have not been studied for safety and benefit of these populations
80%
What percentage of people on lithium experience side effects
75%
How does lithium work?
We don’t know
This dopamine pathway projects from the substantia nigra of the brain stem to the basal ganglia and are part of the extrapyramidal nervous system?
the Nigro striatum
