Psychopharmacology Flashcards

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1
Q

_________________ produce effects similar to those produced by a neurotransmitter. ____________________ exert their effects by mimicking the effect of a neurotransmitter at a receptor site, while ____________________ attach to a binding site on a receptor cell (a site other than the one used by the neurotransmitter) and facilitate the action of the neurotransmiter).

A

Agonists.

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2
Q

________________ produce an effect opposite the effect produced by a neurotransmitter or an agonist.

A

Inverse agonists.

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3
Q

___________________ produce effects that are similar to (but less than) the effects produced by a neurotransmitter or an agonist.

A

Partial agonists.

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4
Q

___________________ produce no activity in the cell on their own but, instead, reduce or block the effects of a neurotransmitter or agonist. __________________ exert their effects by attaching to a neurotransmitter’s receptor site, while _____________________ attach to a binding site on a receptor cell (a site other than the one used by the neurotransmitter) and interfere with the action of the neurotransmitter.

A

Antagonists.

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5
Q

Because of the increased risk for adverse drug effects, a general rule when prescribing drugs for ______________ is to “start low and go slow.”

A

Older adults.

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6
Q

In comparison to Caucasians, higher proportions of ____________ and, to somewhat lesser degree, __________________ are slower or poorer metabolizers of specific isoenzymes, which explains why they are more sensitive to the therapeutic and side effects of certain drugs such as neuroleptics, benzodiazepines, lithium, and some antidepressants.

A
  • Asians
  • African-Americans
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7
Q

Chlorpromazine

A
  • Thorazine
  • Conventional AntiPsychotic
  • Parent drug: Phenothiazine
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8
Q

Fluphenazine

A
  • Prolixin
  • Conventional Antipsychotic
  • Parent drug: Phenothiazine
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9
Q

Thiothixene

A
  • Narvane
  • Conventional Antipsychotic
  • Parent drug: Thioxanthene
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10
Q

Haloperidol

A
  • Haldol
  • Conventional Antipsychotic
  • Parent drug: Butyrophenone
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11
Q

Clozapine

A
  • Clozaril
  • Atypical Antipsychotic
  • Parent drug: Dibenzodiazepine
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12
Q

Resperidone

A
  • Risperdal
  • Atypical Antipsychotic
  • Parent drug: Benzisoxazole
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13
Q

Olanzapine

A
  • Zyprexa
  • Atypical Antipsychotic
  • Parent drug: Thienobenzodiazepine
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14
Q

Quetiapine

A
  • Seroquel
  • Atypical Antipsychotic
  • Dibenzothiazepine
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15
Q

Amitriptyline

A
  • Elavil, Endep
  • Tricyclic Antidepressant (TCA)
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16
Q

Doxepin

A
  • Sinequan, Adaptin
  • Tricyclic Antidepressant (TCA)
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17
Q

Imipramine

A
  • Trofranil
  • Tricyclic Antidepressant (TCA)
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18
Q

Clomipramine

A
  • Anafranil
  • Tricyclic Antidepressant (TCA)
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19
Q

Nortriptyline

A
  • Pamelor
  • Tricyclic Antidepressant (TCA)
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20
Q

Fluoxetine

A
  • Prozac
  • SSRI
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21
Q

Fluvoxamine

A
  • Faverin, Luvox
  • SSRI
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22
Q

Paroxetine

A
  • Paxil
  • SSRI
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23
Q

Sertraline

A
  • Zoloft
  • SSRI
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24
Q

Isocarboxazid

A
  • Marplan
  • MAOI
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25
Q

Phenelzine

A
  • Nardil
  • MAOI
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26
Q

Tranylcypromine

A
  • Parnate
  • MAOI
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27
Q

Diazepam

A
  • Valium
  • Benzodiazepine
28
Q

Alprazolam

A
  • Xanax
  • Benzodiazepine
29
Q

Oxazepam

A
  • Serax
  • Benzodiazepine
30
Q

Triazolam

A
  • Halcion
  • Benzodiazepine
31
Q

Chlordiazepoxide

A
  • Librium
  • Benzodiazepine
32
Q

Lorazepam

A
  • Ativan
  • Benzodiazepine
33
Q

As defined by the National Center on Health Statistics (NCHS) ________________ include primary care offices, surgical specialty offices, medical specialty offices, hopsital outpatient departments, and hospital emergency departments.

A

Ambulatory Care Settings.

Bonus: With some exceptions, psychotropic drugs are most frequently provided, prescribed, or continued at ambulatory care visits in primary care offices followed by medical specialty offices.

Antipsychotics and antimanics are most often provided, prescribed, or continued in medical specialty offices.

34
Q

The antipsychotic drugs are also known as ___________________ and _____________________.

A
  • Major tranquilizers
  • Neuroleptics
35
Q

The _____________________ are effective for alleviation psychotic symptoms and are most often prescribed as a treatment for Schizophrenia. While these drugs alleviate hallucinations, delusions, agitation and other positive symptoms of Schizophrenia, they are much less effective for its negative symptoms.

A

Traditional antipsychotics.

36
Q

Traditional antipsychotic drugs exert their effects by blocking ___________ receptors in the brain (especially D2 receptors). Side effects include:

  • ____________ effects
  • ____________ effects
  • Neuroleptic malignant syndrome
A
  • Dopamine
  • Anticholinergic
  • Extrapyramidal
37
Q

__________________ include dry mouth, blurred vision, urinary retention, constipation, tachycardia, and delayed ejaculation.

A

Anticholinergic effects.

38
Q

__________________ are believed to be caused by the effects of the drugs on dopamine receptors, especially in the caudate nucleus. Parkinsonism, akathisia (extreme motor restlessness), and acute dystonia (muscle spasms in the mouth, face, and neck) are the most common.

A

Extrapyramidal side effects.

39
Q

__________________, the most serious of the extrapyramidal effects, is late-occurring and is more common in females and older patients. Symptoms include involluntary rhythmic movements of the jaw, lips, tongue, and extremities.

A

Tardive Dyskinesia.

Bonus: Haloperidol, the most potent of the antipsychotics, is associated with the most severe extrapyramidal effects.

40
Q

____________________ is characterized by a rapid onset of motor, mental, and autonomic symptoms including muscle rigidity, tachycardia, hyperthermia, and altered consciousness. To avoid a potentially fatal outcome, the drug must be stopped as soon as symptoms of this syndrome develop.

A

Neuroleptic Malignant Syndrome.

41
Q

Two advantages of the atypical antipsychotics is that they…?

A
  • Alleviate both the positive and negative symptoms of Schizophrenia
  • Are often effective when other antipsychotics fail
42
Q

The _________ are most effective for depressions that involve decreased appetite and weight loss, early morning awakening and other sleep disturbances, psychomotor retardation, and depression. They are particularly useful for alleviating the vegetative, somatic symptoms of depression. They are also used for Panic Disorder, Agoraphobia, Bulimia, OCD, enuresis, and neuropathic pain.

A

TCAs.

43
Q

The most serious problem with the TCAs is that they are __________________, producing such symptoms as tachycardia, palpitations, hypertension, severe hypotension (drop in blood pressure), and cardiac arrhythmia.

A

Cardiotoxic.

44
Q

Symptoms of __________________ include ataxia, impaired concentration, agitation, severe hypotension, fever, cardiac arrhythmia, delirium, seizures, and coma. This can be lethal.

A

TCA overdose.

45
Q

Adverse side effects - ________________: Cardiovascular symptoms, anticholinergic effects, confusion, drowsiness, fatigue, weight gain, fine tremor, paresthesia, blood dyscrasia.

A

TCAs.

46
Q

Adverse side effects - ______________: Gastrointestinal disturbances, insomnia, anxiety, headache, dizziness, anorexia, tremor, frequent urination, sexual dysfunction.

A

SSRIs.

47
Q

Adverse side effects - __________________: Anticholinergic effects, insomnia, agitation, confusion, skin rash, weight gain, edema, headache, dizziness, tremor, blood dyscrasia, hypertensive crisis.

A

MAOIs.

48
Q

__________ are particularly effective for melancholic depression. Several are also prescribed for obsessive-compulsive symptoms, Bulimia, Panic Disorder, and PTSD.

A

SSRIs.

49
Q

Administration of an SSRI in conjunction with an MAOI or other serotonergic agent may result in _________________; symptoms include neurological effects (headache, nystagmus, tremor, dizziness, unsteady gait), changes in mental state (irritability, confusion, delirium), and cardiac arrhythmia and can progress to coma and death.

A

Serotonin syndrome.

50
Q

The ___________ are most effective for treating non-endogenous and atypical depressions that involve anxiety, reversed vegetative symptoms (e.g., hypersomnia, hyperphagia), and interpersonal sensitivity.

A

MAOIs.

51
Q

The most dangerous side effect of MAOIs is _______________, which can occur when an MAOI is taken in conjunction with barbiturates, amphetamines, antihistamines, or certain other drugs or with foods containing the amino acid tyramine (avocados, bananas, fava beans, soy sauce). Symptoms include a severe headache, stiff neck, rapid heart rate, nausea, vomiting, sweating, and sensitivity to light.

A

Hypertensive crisis.

52
Q

Buproprion (Wellbutrin) is a ___________________ and is used to treat Major Depression and the depressive phase of Bipolar Disorder.

A

Norepinephrine Dopamine Reuptake Inhibitor (NDRI).

53
Q

Venlafaxine (Effexor) is a ______________________ and is prescribed for Major Depression, GAD, Social Anxiety Disorder, and OCD. It has also been identified as an effective drug for certain pain syndromes including fibromyalgia, mixed headaches, back pain, and peripheral neuropathic pain.

A

Serotonin Norepinephrine Reuptake Inhibitor (NDRI).

Bonus: Cymbalta also falls into this class.

54
Q

___________ is considered the drug treatment of choice for Bipolar Disorder, especially “classic” Bipolar Disorder involving manic episodes with elevated (as opposed to irritable or dysphoric) mood and without a rapid cycling of moods. It not only reduces or eliminates manic symptoms, but also suppresses mood swings.

A

Lithium.

Bonus: Effects appear to be related to the reuptake of serotonin and norepinephrine.

55
Q

______________________ was initiallly used as an anticonvulsant drug, but has also been found effective for mania. Other anticonvulsant drugs that are useful as mood stabilizers include valproic acid (Depakote) and clonazepam (Klonopin). There is some evidence that it is more beneficial than Lithium for those who experience frequent mood swings (“rapid cyclers”) and those with dysphoric mania.

A

Carbamazepine (tegretol).

56
Q

The _________________ include barbiturates, anxiolytics, and alcohol. These drugs are generalized CNS depressants, and their effects, for the most part, are dose-dependent. The initial increase in activity and feelings of elation produced by thees drugs are due to their suppression of inhibitory mechanisms in the brain, while their subsequent sedating and hypnotic effects result from suppression of excitatory mechanisms.

A

Sedative-hypnotics.

57
Q

In the past, ________________ were frequently used as sedatives and anesthetic agents but, due to recognition of their lethal effects and the development of safer and more effective drugs, they are now infrequently prescribed. In young children, older adults, and people experiencing pain, these can sometimes produce paradoxical excitement.

A

Barbiturates.

58
Q

Barbiturates exert their effects by interrupting impulses to the _____________________.

A

Reticular Activating System (RAS).

59
Q

The ________________ are prescribed primarily to relieve anxiety, but are also used to treat sleep disturbances, seizures, cerebral palsy and other disorders involving muscle spasms, and alcohol withdrawal. They stimulate the inhibitory action of the neurotransmitter GABA.

A

Benzodiazepines.

60
Q

____________________ is the first anxiolytic that reduces anxiety without sedation. However, it must be taken for several weeks before it is effective.

A

Azapirone (buspirone - Buspar).

61
Q

Propranolol (Inderal) is a type of _______________.

A

Beta-blocker.

62
Q

____________________ are used to treat high blood pressure, angina, and other cardiovascular disorders, tremors, migraine headache, and glaucoma. They have also been found useful for reducing the palpitations, tremor, excessive sweating, and other physical symptoms associated with anxiety. They operate by ___________________, which respond to epinephrine and norepinephrine.

A
  • Beta-blockers
  • Blocking beta-adrenergic receptors
63
Q

Side effects of propranolol include bradycardia, ______________, arterial insufficiency (usually of the ____________ type), nausea, diarrhea, depression, ______________, sexual dysfunction, trouble sleeping, and numbness or tingling in the fingers and toes.

A
  • Shortness of breath
  • Raynaud’s
  • Dizziness
64
Q

Included in the class of narcotic-analgesics (opioids) are the ________________ (opium, morphine, and codeine), the _____________________ (heroin, Percodan, Dilaudid), and the _________________ (Demerol, Darvon, methadone).

A
  • Natural opioids
  • Semi-synthetic derivatives of morphine
  • Pure synthetics
65
Q

_______________ (e.g., dexamphetamine suphate) are used to treat narcolepsy and ADHD; _________________ (Ritalin, Concerta, Metadate) is used to treat ADHD in children and adults.

A
  • Methamphetamine
  • Methylphenidate
66
Q

The psychostimulant drugs potentiate the release of _______________ and ________________ and block their reuptake.

A
  • Norepinephrine
  • Dopamine