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AATBS EPPP 2017 > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

effects of psychoactive drugs

A

agonists –> produces effect similar to neurotrans
—direct agonist: mimics the effect of neurotrans
–indirect agonist: attach to receptor site to facilitate action of the neurotrans
inverse agonists –> produces opposite effect of neurotrans
partial agonists –> produces similar but lesser effect
antagonists –> reduce or block effects of neurotrans
–direct antagonist: attach to receptor site to block
–indirect antagonist: attach to site and interfere with action of neurotrans

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2
Q

Traditional/conventional vs atypical/novel antipsychotics

A

traditional = effective for + Sx, less effective for -
used for: schizophrenia, acute mania, delusions/hallucinations from MDD, organic psychoses
atypical= effective for both + and - Sx
used for: schizophrenia, Clozapine used for bipolar not responding to mood stabilizer, depression and suicidality, addiction, hostility, motor Sx of Huntington’s and Parkinson’s

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3
Q

side effects of traditional antipsychotics

A

1) extrapyramidal effects: due to effects on dopamine receptors in caudate nucleus
e.g., tardive dyskinesia (late-occuring, more in females and older patients)
TD can be relieved by discontinuing drug, adding a benzo or other GABA agonist.
Haloperidol = most severe side effects
2) anticholinergic effects: “dry” Sx, tachycardia
3) neuroleptic malignant syndrome (NMS): rapid onset of motor, mental and autonomic Sx

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4
Q

conventional/typical antipsychotics

A

holperidol (Haldol)
thiothixene (Narvane)
fluphenazine (Prolixin)
chlorpromazine (Thorazine)

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5
Q

atypical antipsychotics

A

clozapine (Clozaril)
resperidone (Risperdal)
olanzapine (Zyprexa)
quetiapine (Seroquel)

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6
Q

traditional antipsychotics exert effects by ______

A

blocking dopamine receptors (at D2 receptors)

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7
Q

atypical/novel antipsychotics exert effects by _____

A

blocking D4 dopamine receptors AND receptors for serotonin and glutamate

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8
Q

side effects of atypical antipsychotics

A 
anticholinergic effects
lowered seizure threshold
sedation
less common extrapyramidal side effects (except for akathisia)
agranulocytosis
neuroleptic malignant syndrome (NMS)
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9
Q

Tricyclic antidepressants

A 
amitriptyline (Elavil, Endep)
nortriptyline (Pamelor)
doxepin (Sinequan, Adapin)
imipramine (Trofanil)
clomipramine (Anafranil)
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10
Q

TCAs most effective for ______

A 
depression with vegetative, somatic Sx
Panic Disorder
Agoraphobia
Bulimia
OCD (esp chlomipramine)
enuresis (imipramine)
neuropathic pain (amitriptyline, nortriptyline)
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11
Q

mode of action of TCAs

A

block reuptake of norepi, serotonin, and/or dopamine

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12
Q

catecholamine hypothesis

A

depression caused by deficiency of norepinephrine

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13
Q

side effects of TCAs

A 
***CARDIOTOXIC***
anticholinergic effects
confusion
drowsiness
fatigue
weight gain
fine tremor
paresthesia
blood dyscrasia
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14
Q

SSRIs

A

fluoxetine (Prozac)
fluvoxamine (Faverin, Luvox)
paroxetine (Paxil)
setraline (Zoloft)

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15
Q

SSRIs most effective for _____

A 
melancholic depressions
OCD
Bulimia
Panic Disorder
PTSD
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16
Q

Side effects of SSRIs

A 
GI disturbance
insomnia
anxiety
headache
sissiness
anorexia
tremor 
frequent urination
sexual dysfunction
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17
Q

advantages of SSRIs over TCIs

A

less cardiotoxic
safer in overdose
cognitive impairment less likely

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18
Q

serotonin syndrome

A

neurological effects (headache, nystagmus, tremor, dizziness, unsteady gait)
cardiac arrhythmia
coma/death

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19
Q

MAOIs

A

isocarboxazid (Marplan)
phenelzine (Nardil)
tranylcypromine (Parnate)

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20
Q

MAOIs best for treating _____

A

atypical depressions involving anxiety, reversed vegetative Sx, interpersonal sensitivity

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21
Q

MAOIs side effects

A 
hypertensive crisis -- when taken with tyramine foods
anticholinergic effects
insomnia
agitation
confusion
skin rash
weight gain
edema
headache
dizziness
tremor
blood dycrasia
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22
Q

tyramine-rich foods

A

aged cheeses and meats, beer, red wine, chicken liver, avocados, bananas, lava beans, soy sauce

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23
Q

Sx of hypertensive crisis

A 
severe headache
stiff neck
rapid heart rate
nausea/vomiting
sweating
sensitivity to light
24
Q

NDRIs (norepi dopamine reuptake inhibitor)

A

buproprion (Wellbutrin)
used for MDD, depressive phase of BP
used under name Zyban for smoking cessation
can aggregate preexisting psychosis and seizures

25
Q

SNRIs (serotonin norepi reuptake inhibitor)

A

venlafaxine (Effexor)
duloxetine (Cymbalta)
used of MDD, GAD, social anxiety, OCD
some pain syndromes (fibromyalgia, mixed headaches, back pain, peripheral nueropathic pain)

26
Q

Modd stabilizers

A

lithium

carbamazepine

27
Q

lithium best for ____

A

“classic” BP with manic episodes with elevated mood and without rapid cycling
reduces or eliminates manic symptoms and suppresses mood swings

28
Q

lithium toxicity

A 
diarrhea
ataxia
drowsiness
slurred speech
confusion
coarse tremor
can result in seizures, coma and death
must regulate serum lithium levels in blood
29
Q

if taking lithium, must avoid ____

A 
fluctuations in salt intake
caffeine
alcohol
other diuretics
contraindicated for: cardiovascular, thyroid, kidney, liver and GI problems
30
Q

Carbamazepine (Tegretol)

A

was anticonvulsant drug
also effective for mania
“rapid cycling” BP + dysphoric mania
also valproic acid (Depakote) and clonazepam (Klonopin)

31
Q

side effects of carbamazepine

A 
dizziness
ataxia
visual disturbances
anorexia
nausea
rash
bad for cardio conduction patients
slight risk for agranulocytosis and aplastic anemia
32
Q

sedative-hypnotics include _____

A

barbiturates
anxiolytics
alcohol

33
Q

withdrawal Sx of sedative-hypnotics

A 
tremors
anxiety
nausea/vomiting
paranoia
extreme cases: hallucinations, delirium, convulsive seizures
34
Q

barbiturates exert effect by ____

A

interrupting impulses to the RAS

35
Q

benzodiazepines

A 
diazepam (Valium)
alprazolam (Xanax)
oxapam (Serax)
triazolam (Halcion)
chlordiazepoxide (Librium)
lorazepam (Ativan)
36
Q

benzodiazepines work by ____

A

stimulating inhibitory action of GABA

37
Q

side effects of benzodiazepines

A 
drowsiness
dizziness
lethargy
slurred speech
ataxia
impaired psychomotor ability
----------
irritability, hostility, paradoxical agitation, increased disorientation, sleep disturbance (reduced REM), ante grade amnesia, depression
38
Q

azapirone (buspirone)

A

first anxiolytic without sedation

need to take for several weeks before effective

39
Q

Beta-Blockers used for ____

A 
high blood pressure
angina/cardiovascular disorders
tremors
migraines
glaucoma
reducing palpitations, tremor and excessive sweating from anxiety
40
Q

beta-blockers work by _____

A

blocking beta-andrenergic receptors (which respond to epinephrine and norepinephrine)
Propranolol (Inderal)

41
Q

side effects of propranolol

A 
bradycardia
shortness of breath
arterial insufficiency (like Raynaud's)
nausea
diarrhea
depression
dizziness
sexual dysfunction
trouble sleeping
numbness/tingling in fingers/toes
42
Q

propranolol is potentially lethal for people with ____

A

respiratory issues

obstructive pulmonary disease

43
Q

narcotics-analgesics (opiods)

A 
natural opiods (opium, morphine, codeine)
semi-synthetics of morphine (heroin, Percodan, Dilaudid)
pure synthetics (Demerol, Darvon, methadone)
44
Q

narcotics-analgesics (opiods) work by ____

A

opiod receptors in the spinal cord and amygdala, thalamus and hypothalamus

45
Q

enkephalins are ____

A

beta-endorphins

46
Q

signs of narcotic use are:

A 
constricted pupils
decreased visual acuity increased perspiration
constipation
nausea/vomiting
respiratory depression
47
Q

narcotics overdose:

A 
slow/shallow breathing
muscle rigidity
catalepsy
clammy skin
decreased blood pressure and pulse rate
convulsions
coma/death
48
Q

narcotics/opiod withdrawal symptoms

A 
flu-like Sx
stomach cramps
nausea/vomiting
weakness
fever
muscle and joint pain
sweating
insomnia
49
Q

psychostimulants

A

amphetamines (dexamphetamine sulphate) - for narcolepsy and ADHD
methylphenidate (Ritalin, Concerta, Metadate) for ADHD

50
Q

psychostimulants work by ___

A

potentiating the release of norephinephrine and dopamine and block their reuptake

51
Q

side effects of amphetamines

A 
restlessness
insomnia
poor appetite
tremor
palpitations
cardia arrhythmia
52
Q

side effects of methyphenidate

A 
decreased appetite
insomnia
dysphoria
abdominal pain
tachycardia
53
Q

anti-alcohol drugs

A

disulfiram (Antabuse) – inhibits alcohol metabolism, causing accumulation of acetaldehyde and unpleasant reactions (nausea, vomiting, seating, headache, tachycardia, hypotension)

naltrexone (ReVia, Vivitrol) – opiod receptor antagonist - blocks craving for alcohol

54
Q

side effects of disulfam (Antabuse)

A 
drowsiness
depression
disorientation
headache
restlessness
impotence
blood dyscrasia
55
Q

side effects of naltrexone

A 
abdominal cramping
nausea/vomiting
insomnia
nervousness
headache
joint and muscle pain

AATBS EPPP 2017 (10 decks)

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