Psychopharmacology Flashcards
Mirtazapine.
Noradrenaline and serotonin specific antidepressant (NaSSa)
5HT2 antagonist, 5HT3 antagonist, H1 antagonist, alpha 1 and alpha 2 antagonist, moderate muscarinic antagonist
Venlafaxine, Duloxetine.
SNRI Serotonin and noradrenaline reuptake inhibitor
Reboxetine
Noradrenaline reuptake inhibitor (NaRI)
St Johns Wort
Weak MAOI and weak SNRI (also considered by some to be a weak SSRI)
Trazadone
Weak antagonist and SARI (Serotonin antagonist and reuptake inhibitor)
Moclobemide
Reversible inhibitor of monoamine oxidase type A
Agomelatine
Melatonergic agonist (MT1 and MT2 receptors) and 5-HT2C antagonist
Bupropion
Norepinephrine-dopamine reuptake inhibitor (NDRI), and nicotinic acetylcholine receptor antagonist
Lofexidine
Clonidine
Used in symptoms of opiate withdrawal.
ALpha agonist.
The ‘other’ NASSA?
Mianserin.
Benzodiazepines are metabolised by?
Cytochrome 3A4
What is the ‘big’ NARI (noradrenalin reuptake inhibitor)?
What is the other one?
Reboxetine.
Atomexetine.
5 typical antipsychotics
5 atypical antipsychotics
Other classification systems?
Typical: Haloperidol Clopixol (zupen) Sulpride Chlorpromazine Flupenthixol
Atypical: Clozapine Risperidone Quetiapine Olanzapine Amisulpride
Butyrophenones- haloperidol Dibenzodiazepines - clozapine Dibenzothiazepines- quetiapine Thienodiazepines - olanzapine Phenothiazines (Aliphatic side chain) - chlorpromazine
Classification of Tricyclics?
Secondary Amines Desipramine Nortriptyline Protriptyline Amoxapine
Tertiary Amines Amitriptyline Lofepramine Imipramine Clomipramine Dosulepin (Dothiepin) Doxepin Trimipramine Butriptyline
Common SEs of tricyclics
drowsiness dry mouth blurred vision constipation urinary retention
Zero order kinetics.
What is it?
What drugs fit this?
Linear or non-linear?
Same amount of drug emitted per unit of time.
Alcohol, phenytoin.
Non-linear.
First order kinetics.
What is it?
What drugs fits this?
Linear or non-linear?
Same fraction of drug emitted per unit of time.
Most drugs.
Linear.
What drugs can you not have with MAOIs.
Tricyclics usually safe (other than CLOMIPRAMINE).
CAnnot have SSRIs.
Cannot have ephedrine.
What processes form part of pharmacokinetics?
Absorption.
Distributuon
Metabolism (involving reduction/hydrolysis, then conjugation)
Excretion
In which order of drug kinetics is the half life constant?
First order.
Linear kinetics.
ZOCFLAP
What are the three catecholeamines?
Dopamine.
Noradrenalin.
Adrenalin.
Bupropion.
Norepinephrine-dopamine reuptake inhibitor (NDRI), and nicotinic acetylcholine receptor antagonist
Name three pharmacodynamic drug interactions
Synergism
Inhibition of drug uptake and transport
Interaction at receptors
Name three pharmacokinetics drug interactions
Enzyme induction/ inhibition (interference with metabolism)
Changes in gastrointestinal tract motility and pH (interference with absorption)
Chelation
Competition for renal tubular transport (interference with excretion)
Changes in protein binding
two key antipsychotics to avoid in renal impairment
sulpride and amisulpride
Acamprosate
Metabotropic glutamate receptor antagonist and GABA-A agonist
WHat is GABA made from?
Glutamate.
Antagonism of which receptor causes priapism
Alpha 1
Biological amine neurotransmitters?
aka biogenic amines
Biogenic amines are compounds derived from amino acids
Catecholamines (adrenaline, noradrenaline, and dopamine)
Serotonin
Histamine
Benzo half lives Diazepam Lorazepam Nitrazepam Temazepam
Zopiclone
Zolpidem
Diazepam 20-100 hrs (36-200 hrs for active metabolite)
Lorazepam 10-20hrs
Chlordiazepoxide 5-30 hrs (36-200 hrs for active metabolite)
Nitrazepam 15-38 hrs
Temazepam 8-22 hrs
Zopiclone 4-6 hrs
Zolpidem 2-6 hrs
Frequent SE of carbamazepine
ataxia
Cytochrome enzyme most commonly found to metabolise antidepressants?
2D6
codes for debrisquine hydroxylase.
Which antipsychotics never alters EEG
Which alters it most
Quetiapine Clozapine (in 45% there is a change)
Valproate
GABA agonist and NMDA antagonist
Topiramate
GABA agonist, NMDA antagonist, and Na channel stabiliser
Carbamazepine
Stabilises Na channels
Phenytoin
Stabilises Na channels
Reduces contraceptive effect?
The drug not to take due to teratogenic effects is…
St John's Wort Carbamazepine Phenytoin Topiramate Barbiturates
(B) Valproate [does not reduce contraceptive effect]
Side effects of stimulant drugs?
Sleep disturbance.
Appetite suppression.
Abdo pain.
3 stimulant drugs for ADHD and how they work
Dexamphetamine - Inhibits DA and NA uptake
Lisdexamfetamine - Prodrug, absorbed by GI tract, converted to dexamfetamine which inhibits the reuptake of NA and DA.
Methylphenidate - Inhibit DA and NA uptake
3 non-stimulant drugs for ADHD?
Clonidine - A2 receptor agonist
Atomexetine - inhibits NA (NARI)
Guanfacine - alpha receptor agonist