psychopharmacology Flashcards
what is psychopharmacology
the use of drugs to alleviate the symptoms of mental illnesses and disorders.
extrapyramidal symptoms: cause and defintions
the extrapyramidal system is a neural network that is part of the motor system that causes involuntary reflexes and movement, and movement coordination. this system uses dopamine to regulate motor function
d2 antagonist–>dec Da signaling–>inc ACh signaling—>imbalance of DA and Ach signaling –>EPS
neuroleptic malignant syndrome
a life threatening idiosyncratic reaction to antipsychotic drugs.
characterized by fever, altered mental status, muscle rigidity and autonomic dysfunction
treatment: cessation of antipsychotic drugs, active cooling, amantadine (inc dopamine) and dantrolene (muscle relaxant)
typical vs. atypical anti psychotic drugs
typical : inc extrapyramidal symptoms and hyperprolactinemia. effective against positive symptoms
atypical: diabetes, lipid abnormalities and weight gain . effective against positive and negative symptoms
hallucinations
sensory perception without stimuli
delusions
unshakable belief on something untrue
schizophrenia
hallucination and delusion, disordered
thinking, social and work dysfunction, > 6 months
Schizoaffective disorder
Schizophrenia plus a mood
disorder such as depression and bipolar disorder
schizophreniform disorder
between 1 and 6 months
brief psychotic disorder
event-induced, <1 month
positive and negative symptoms of schizophrenia
positive symptoms: abnormal behavior is showing
negative symptoms: normal behavior missing.
example of positive symptom of schizophrenia
hallucination and delusion.
treatment of schizophrenia
dampen D2 mediated-dopamine signaling. antipsychotic drugs are used for treatment.
MOA: dopamine antagonist (binding of d2 receptor to block dopamine signaling)
extrapyramidal symptoms
side effects caused by antipsychotic drugs.... dystonia akathisia akinesia tardive dyskinesia parkinsonism
dystonia
involuntary muscles contraction,
causing repetitive or twisting movements
akathisia
an inner feeling of restlessness
treatment of schizophrenia
dampen D2 mediated-dopamine signaling. antipsychotic drugs are used for treatment.
MOA (mechanism of action): dopamine antagonist (binding of d2 receptor to block dopamine signaling)
tardive dyskinesia
repeated and uncontrollable oral facial movements (long term-or permanent )
tardive dyskinesia
repeated and uncontrollable oral facial movements (long term-or permanent )**MUST KNOW THIS
parkinsonism
Parkinson like motor symptoms
chlorpromazine
typical (1st generation) first antipsychotic, sedating, EPS (moderate), inc prolactin, cornea deposits.
haloperidol
typical (1st generation) very strong D2 anatgonist, used in condtion that physical restrains is necessary to control patients, EPS (very high), inc prolactin
clozapine
atypical (2nd generation )very effective in treating schizophrenia, sedating, weight gain, agranulocytosis
olanzapine
atypical (2nd generation) very effective in schizophrenia, weight gain.
risperidone
atypical (2nd generation). less sedating, inc prolactin, weight gain (low )
bipolar disorder
Formerly called manic depression, is a mental health
condition that causes extreme mood swings that include
emotional highs (mania or hypomania) and lows (depression).
CAUSE UNKNOWN
bipolar disorder treatment
medications, and psychotherapy
use mood stabilizers (lithium)
bipolar disorder treamtment
lithium: old but effective, unknown mechanism of action (MOA), normally combined with antipsychotics
lithium
lithium: old but effective, unknown mechanism of action (MOA), normally combined with antipsychotics. used to treat bipolar disorders.
clinical concerns of lithium
The therapeutic index for lithium is small, and plasma
titers of Li+ must be carefully monitored
Adverse effects- GI irritation, hand tremor, muscular
weakness, polyuria, thirst, dry mouth, sleepiness,
lethargy, cold feeling, hair loss, and impotence
Sodium-restricted diets → ⇑ renal retention of lithium
Thiazide diuretics → ⇑ renal retention of lithium
lithium can give you hypothyroidism sometimes
dental complications of schizophrenia and bipolar disorder
Antipsychotics cause extrapyramidal symptoms
Clozapine ⇢ agranulocytosis ⇢ oral candidiasis
Clozapine ⇢ hyper salivation = problem for dental procedures
Lithium for bipolar disease ⇢ xerostomia ⇢ ⇑ dental caries
NSAIDs ⇢ ⇩ renal excretion of lithium ⇢ systemic toxicity
Lithium ⇢ a metallic taste that can alter the palatability of food
