Psychopharmacology

Question 1

Methylphenidiate

Answer 1

Also known as Ritalin- Psychostimulant for ADHD
potentiate the release of norephineprine and dopamine and block their reuptake
Side effects: include decreased appetite, insomnia, dysphoria, ( anxiety, irritability, depression, euphoria, sadness,

Question 2

Drug holiday

Answer 2

used for psychostimulants for kids where they take a break from medication for summer and end of year vacation can be used to minimize growth suppression and other adverse effects.

Question 3

Agonists

Answer 3

produce effects similar to those produced by a neurotransmitter,
Direct agonists exert their effects by mimicking the effect of a neurotransmitter at a receptor site
Indirect agonists- attach to a binding site on a receptor cell and facilitate the action of a neurotransmitter

Question 4

Inverse Agonists-

Answer 4

produce an effect opposite the effect produced by neurotrasnmitter

Question 5

Partial Agonists-

Answer 5

produce effects that are similar to but less than effects produced by a neurotransmitter

Question 6

Antagonists-

Answer 6

produce no activity on their own, but reduce or block the effects of a neurotransmitter or agonist.
Direct antagonists- exert their effects by attaching to a neurotransmitter receptor site

Question 7

Drugs and older adults

Answer 7

medication related prolems are a common hospital admission over age 65
Changes in sesnivity are due to changes in drug absoprtion, distrubution, metablosim,
*age related decrease in metabolism may extend the half life of some drugs( benzodiazepines) resulting in increase in toxicity. (Half life refers to the time it takes for the plasma concentration of the drug to drop by 50%)
*start low and go slow

Question 8

Drugs and Race/Ethnicity

Answer 8

Higher proportions of asians, are slower or poorer metabolizers of specific isenzymes, which explains why they are more sensitive to to the therapeutic and side effects of certan drugs such as neuroleptics, benzodiazpeines, lithium,
begin with a low dose, and gradually move upward until desired effect are achieved

Question 9

Traditional ( Antipsychotic Drugs)

Answer 9

Chlorpromazine(thorazine), Fluphenazine, Thiothixene, Haloperidol( Haldol)

Question 10

Traditional Antipsychotic Drug Use:

Answer 10

effective for alleviating positive symptoms and are most often prescribed as a treatment for schizophrenia, mania, much less effective for negative symptoms

Question 11

Traditional Antipsychotic Mode of action:

Answer 11

blocking dopamine receptors in the brain( D2 receptors)
Dopamine hypothesis of schizophrenia- related to overactivity at dopamine receptors as the result of excessive dopamine,

Question 12

Traditional Antipsychotics Side effects:

Answer 12

Anticholingeric effects such as dry mouth, blurred vision, urinary retention, tachycardia, early effects
Extrapyrimdal side effects cause by effect of drugs on dopamine receptors in caduate nucleus such as akathisia( motor restlessnes)
Tardive dyskinesa- most serious of the symptoms , late occurring more common in females and older patients. *symptoms are similar to those of Huntington’s disease and include involuntary movement, of jaw, lips, tongue, extremities. *symptoms may improve when drug is gradually withdrawn, or use of benzodiazepine
*halperidol- most severe side effects

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Question 13

Neuroleptic maligant syndrome

Answer 13

potentially fatal side effect of traditional antipsychotics - rapid onset of motor mental and autonomic symptoms including muscle rigidity, altered consciousness, drug must be stopped as soon as symptoms occur

Question 14

Atypical Antipsychotics

Answer 14

Clozapine, Resperidone, Olanzapine, Quetiapine

Question 15

Atypical Antipsychotic Use:

Answer 15

used to treat schizophrenia and other disorders with psychotic symptoms, clozapine is useful for treating Bipolar Disorder that has not responded to mood stabilizer, depression, suicidailty, and motor symptoms of Huntington’s disease,

• alleviate both the positive and negative side effects of Schizophrenia and effective when traditional antipsychotics have failed,
• slower onset of therapeutic effects

Question 16

Atypical Antipsychotics mode of action:

Answer 16

atypical antipsychotics act of D4 and other dopamine receptors as well as receptors including serotonin and glutamate

Question 17

Atypical Antipsychotic Side effects:

Answer 17

anticholingeric side effects, lowered seizure threshold, and sedation
*extrapyamidal side effects- much less common ( except for akasthia) and less likely to cause tardive dyskinesia, may produce agranulocytosis ( marked decrease in certain type of white blood cell)

Question 18

Tricyclics:

Answer 18

Amitriptyline, Doxepin, Imipramine, Clomipramine, Nortriplyline

Question 19

Tricyclics use:

Answer 19

most effective for depression that involves decreased appettite and weight loss, early morning awakening, psychomotor retardation, depression, panic disorder, agoraphobia, Bulimia, OCD( clomipramine) eneuresis( imipramine, neuropathic pain( amitripyline and nortitrpyline)
2-4 weeks to exert symptoms, ECT is sometimes preferred for patients with severe depression and high risk for suicide ,

Question 20

Tricyclics mode of action:

Answer 20

block the reuptake of noephinephrine, serotonin and or dopamine,
Catecholamine hypothesis of depression

Question 21

Tricyclics side effects:

Answer 21

cardiotoxic, tachycardia, palpiations, hypertension, hypotension, and cardiac arrhythimia,
*symtptoms of overdose include ataxia, impaired concentraion, agitation, fever, delirium, siezues and coma

Question 22

SSRI

Answer 22

Fluoxetine, Fluvoxamine, Paroxetine, Sertraline

Question 23

SSRI use

Answer 23

treat depression and particularly effective for melancholinc depression, also used for OCD, bulimia, panic disorder and PTSD

Question 24

SSRI mode of action

Answer 24

block the reuptake of serotonin and increase levels of serotonin

Question 25

SSRI side effects:

Answer 25

less cardiotoxic, safer in overdose, less likely to produce cognitive impairment, fairly rapid onset of theraputic effects,
2-4 weeks , full effects around 8 weeks,
fluoxetine( prozac) widely prescribed antidepressant
SSRI with MAOI can cause serotonin syndrome- neurlogicla symptoms such as headache, tremor, dizziness, cardiac arrhytmia

Question 26

MAOI

Answer 26

Isocarboxiadid, Phenelzine, Tranylcpromine

Question 27

MAOI Use:

Answer 27

non endogenous and aytpical depression that involves anxiety, reversed vegetative symptoms, and interpersonal sensitivity

Question 28

MAOI mode of action

Answer 28

inhibit the enzyme monomine oxidase, involved in deactivating dopamine, noerpinephrine and serotonin

Question 29

MAOI side effects

Answer 29

hypertensive crisis- can occur when an MAOI is taken in conjuction with barbiturates, antihistamines, or other drugs, foods containing amino acid tyramine( aged cheese and meat, beer, red wine, avocados, bananas, soy sauce ) include severe headache, stiff neck, rapid heart rate, nauseau, vomitting, sweating, and sesnivity to light

Question 30

NDRI’s

Answer 30

Bupropion( Wellbutrin) noepinephrine dopamine inhibitor used to treat Bipolar Disorder and depressive phase of Bipolar Disorder, less caridotoxic, may aggravate prexisting psychosis

Question 31

SNRI’s-

Answer 31

Venlafaxine( Effexor) serotonin norephinephrine reputake inhibitor prescribed for MDD, GAD, and OCD, fibromlglia, mixed headaches, and neuropathic pain, may increase blood pressure

Question 32

Lithium:

Answer 32

Mood stabilizing drug for Bipolar Disorder , especially classic bipolar disorder with manic episodes with elevated mood and without a rapid cycling of moods, not only reduces or eliminates manic symptoms but supresses mood swings

Question 33

Lithium Mode of action:

Answer 33

reuptake of serontonin and norephineprhine

Question 34

Lithium Side effects:

Answer 34

gastrointenstinal side effects subside in a few weeks and include nausea, vomitting, diarrhea, metallic taste, and weight gain. Fine hand tremor, shakiness, fatigue, restlessness,
*major danger is toxicity- when dose is too high- diarrhea, ataxia, drowsiness, slurred speech, confusion, coarse tremor , seizures coma, death
avoid fluctuation in salt intake, avoid caffeine, alcohol,

Question 35

Cabamazepine-

Answer 35

anticonvulsant drug effect for mania, also valproic acid( Depakote and clonazepam( Klonopin)

Question 36

Cabamazepine use:

Answer 36

effective treatment for bipolar disorder who have no responded to lithium, more benefical for those who are rapid cyclers, frequent mood swings , affect serotonin levels

Question 37

Cabamazepine side effects:

Answer 37

dizziness, ataxia, visual disturbances, anorexia, nausea, rash,

Question 38

Barbiturates:

Answer 38

amobarbital, pentobarbital, secobarbital, and phenobarbital.

Question 39

Barbiturates Use:

Answer 39

used as sedatives but now due to recognition of their lethal effects and development of safer drugs, infrequetly prescribed,, may produce paradoxical excitement

Question 40

Barbiurates mode of action:

Answer 40

interrupting impulses to the reticular activating system

Question 41

Barbiurates side effects

Answer 41

slurred speech, nystagmus, dizziness, irratability, impaired motor and cognitive performance,

Question 42

Benzodiazepines:

Answer 42

anxiolytics- minor tranquilezers and anti anxiety drugs, most widely used medication, diazepam, alprazolam, oxazepam, trizolam, lorazepam

Question 43

Benzodiazepines:

Answer 43

used primarily to relieve anxiety but used to treat sleep disturbances, seizures, cerebral palsy, disorders involving muscle spasms, and alcohol withdrawl

Question 44

Benzodiazepines Mode of action:

Answer 44

stimulate the inhibitory action of the neurotransmitter GABA

Question 45

Benzodiazepines side effects

Answer 45

drowsiness, dizziness, lethargy, slurred speech, ataxia, impaired psychomotor ability, agitation, weight gain, sleep disturbances,
*chronic use can result in tolerance and physical dependence

Question 46

Azaprione:

Answer 46

buspirone- anxiolytic that reduce anxiety without sedation, non addictive, non habit forming , takes serveral weeks for effects

Question 47

Beta Blockers:

Answer 47

Propranolol( inderal) - treat high blood pressure anginga, tremor, migraine headache and glaucoma, reducing palpitations, tremor, excessive sweating, and other physical symptoms
Mode of action: block beta adrenergic receptors, respond to ephinirphrine and norephinephrine

Question 48

Beta Blocker Side Effects:

Answer 48

braychardia, shortness of breath, arterial suffiency, nauseua, dirrehea, depression, dizziness,

Question 49

Narcotic- analgesics-

Answer 49

opium, morphine, codeine, demerol, Darvon, methadone

Question 50

Narcotic- analgesics use”

Answer 50

medical treatment for diarrhea, cough suppressants, immediate sense of euphoria, drowsiness, apathy, decreased physical activity, and impaired attention and memory

Question 51

Narcotic- analgesics mode of action

Answer 51

opiod receptors in the spinal cord, and various reigons of the brain including amygdala, thalamus, hypothalmus,

Question 52

Narcotic- analgesics side effects

Answer 52

constricted pupils, decreased visual acuity, increased perspiration, vomitting, nauseau,
overdose(toxicity) can produce slow and shallow breathing, clammy skin, catalepsy ,
*chronic use results in tolerance, whithdrawl symptoms resemble those of the flu, stomach cramps, nausea, vomitting, weakness, fever, muscle and joint pain, sweating and insomnia,

Question 53

Methadone:

Answer 53

used in heroin detoxification programs , withdrawal symptoms are milder

Question 54

Anti Alcohol Drugs:

Answer 54

Disulfiram, and naltrexone, used to prevent alcohol use in individuals with alcohol use disorder

Question 55

Anti Alcohol Mode of Action:

Answer 55

inhibits alcohol metasbolism, nausea, vomitting, sweating, hypertension that deter individual from drinking alcohol , opiod receptor antagonist

Side effects: drowsiness, depression, disorientation reslesstness, blood dyscrasis,