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Case 10 > Psychopharmacology 2 > Flashcards

Psychopharmacology 2 Flashcards

1
Q

Which drug binds to D1, D2 receptors in the treatment of Schizophrenia

A

Chlorpromazine

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2
Q

Which antipsychotic binds to D2 over D4 in the treatment for schizophrenia

A

Clozapine

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3
Q

Dopamine indirect/ direct measures

A

Homovanillic acid in CSF/blood
Dopamine receptor binding
18F metabolised by DOPA carboxylase
Uptake represents dopamine synthesis- increased 20% in schizophrenia

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4
Q

Dopamine mesolimbic pathway positive symptoms

A

Delusions, hallucinations

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5
Q

Dopamine mesocortical pathway negative/cognitive symptoms

A

Alogia, anhedonia, apathy, amotivation, social withdrawal

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6
Q

Serotonin development of atypical antipsychotics

A

Wider receptor binding

5-HT2A antagonism

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7
Q

Glutamate - drugs MOA

A

NMDA receptor antagonists produce psychosis- ketamine, PCP

Reduce glutamate levels in CSF in schizophrenia, mainly in hippocampus/PFC

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8
Q

GABA role

A

Main inhibitory neurotransmitter

GABA release inhibits excitatory neurons

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9
Q

All antipsychotics are ……………… antagonists

A

Dopamine

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10
Q

Motor abnormalities of dopamine antagonists

A

Tardive dyskinesia, akathisia

Procyclidine- balances cholinergic and dopaminergic activity in basal ganglia

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11
Q

What happens when dopamine is blocked in anterior pituitary?

A

Disinhibition of prolactin release

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12
Q

Effect of antipsychotics on K+ channel

A

block repolarisation of K+ channel in myocardium

  • prolong the QT intervation
  • increased risk of sudden cardiac death-Torsade de pointes
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13
Q

Haloperiodol, aripiprazole effects on the risk of sudden cardiac death

A

Haloperidol- higher risk

Ariprazole- lower risk

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14
Q

Clozapine effect on the heart

A

Increased risk of Myocarditic

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15
Q

Side effects of anticholinergic effects at muscarinic receptors

A

Disrupt parasympathetic neuron signalling
Rest and digest
Blockade: tachycardia, dry mouth, urinary retention, constipation, disrupt cognitive function, balance, delirium
M3 receptor antagonism
Weight gain

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16
Q

In antipsychotics, which neurotransmitter input is blocked into the nigrostriatal input into the basal ganglia

A

Dopamine

17
Q

M3 receptor antagonism side effects

A

Weight gain

Metabolic syndrome

18
Q

Neuro Muscular syndrome features

A

Rare but severe

Muscle rigidity, decreased GCS, autonomic instability

19
Q

Serotonin syndrome features

A

Muscle rigidity, decreased GCS, autonomic instability, dilated pupils, increased bowel sounds

20
Q

Treatment of neuromuscular syndrome

A
  • Immediate withdrawal of antipsychotics
  • Dantrolene (reduce muscle spasm)
  • Dopamine receptor agonist (Bromocriptine)
  • ICU
21
Q

Anxiety- which is the main receptor that is targeted

A

GABA receptor
GABA opens central pore
Hyperpolarisation, inhibitory

22
Q

Positive allosteric modulators to regulate anxiety

A

Benzodiazepines
Z-drugs
Barbiturates

23
Q

Features of the voltage gated calcium channel in anxiety

A
  • Found in membrane of excitable cells
    Highly permeable to calcium
    Closed at resting potential
    Opening leads to calcium entry and excitability
24
Q

SNS in anxiety

A

Fight or flight - tremor, sweating, palpitations
Activated by stimulation of beta-adrenergic receptors
Beta-blockers
Peripheral or central action

25
Q

Which part of the brain has increased dopamine to various extents when intaking drugs of abuse

A

Nucleus accumbens- high levels of D3 receptors

Dopamine release in amygdala -significant events

26
Q

Alcohol effects on the brain

A

-Positive modulator at GABA receptors
Different subunits confer different vulnerabilities
Use of BDZ in withdrawal

27
Q

Opioids effects on the brain

A

Mu- receptor agonists - analgesia, euphoria, resp. depression

  • Inhibits noradrenaline- compensatory upregulation
  • Revealed on withdrawal (insomnia, restlessness, diarrhoea)
28
Q

Cocaine, Amphetamines, Cannabis effects

A

Cocaine- inhibits dopamine reuptake, sodium channel blocker

  • Fast uptake
  • Reduced dopamine reuptake and stimulates dopamine release
Cannabis - partial agonist on cannibinoid CB1 receptors (brain) 
Excitatory effects (increased cortical blood flow) 
Depression of mesolimbic dopaminergic neurons

Case 10 (5 decks)

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