Psychopharmacology Flashcards

1
Q

types of treatments in medicine with psychiatric examples

A

Chemical – drugs e.g. drugs for psychosis/depression
Electrical stimulation e.g. ECT for depression, neurostimulation for pain syndromes
Structural rearrangement - surgery & orthopaedics e.g. psychosurgery/deep brain stimulation for severe depression
Talking therapies e.g CBT, exposure for phobias

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2
Q

list 3 ways to classify drug treatments

A

chemical structure
the disease they treat
pharmacology

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3
Q

pro of classifying drug by chemical structure

A

each drug has unique structure, easy to allocate data

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4
Q

con of classifying drug by chemical structure

A

no use in clinical decision making

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5
Q

what is the 1st drug for schizophrenia?

A

chloropromazine

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6
Q

what is the 2nd drug for schizophrenia?

A

haloperidol

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7
Q

pro of classifying drug based on illness they treat

A

easy for Drs to choose a drug as docs make diagnosis

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8
Q

cons of classifying drug based on illness they treat

A

many psychiatric medicines work in several disorders e.g. antidepressants also treat anxiety and OCD
most psychiatric disorders have multiple symptoms and a single medicine might not treat them all

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9
Q

what is neuroscience based nomenclature?

A

instead of antipsychotic > say dopamine blocker
instead of antidepressant > say serotonin enhancer
instead of hypnotic > say GABA enhancer

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10
Q

list drug targets types of psychiatric medications

A

receptors
neurotransmitter reuptake sites
ion channels
enzymes

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11
Q

in general, psychiatric medicine that targets enzymes have what effect?

A

blocks enzyme activity

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12
Q

list examples of psychiatric medication that target enzymes

A

monoamine oxidase inhibitors > anxiety and depression
acetylcholinesterase inhibitors > dementias
lithium blocks glycogen synthase kinase > mood stability

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13
Q

list examples of psychiatric medication that are receptor antagonists

A

dopamine receptor blockers > schizophrenia
serotonin receptor subtype antagonists > depression
histamine receptor antagonists > sleep

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14
Q

list examples of psychiatric medication that are receptor agonists

A

benzodiazepines enhance GABA > sleep

guanfacine enhance noradrenaline > ADHD

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15
Q

list examples of psychiatric medication that block neurotransmitter reuptake

A

citalopram > serotonin > depression and anxiety
desipramine > noradrenaline > depression
methylphenidate > dopamine > ADHD

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16
Q

list examples of psychiatric medication that enhance neurotransmitter release

A

amfetamine > ADHD

17
Q

list examples of psychiatric medication that block sodium channels

A

sodium valproate- epilepsy and mood stabilisation

carbamazepine - epilepsy and mood stabilisation

18
Q

list examples of psychiatric medication that block calcium channels

A

gabapentin & pregabalin – epilepsy + anxiety

19
Q

fast acting (on/off switch) excitatory neurotransmitter

A

glutamate

20
Q

fast acting (on/off switch) inhibitory neurotransmitter

A

GABA

21
Q

slow acting (modulators) neurotransmitters

A
dopamine
serotonin
noradrenaline
acetylcholine
endorphins
22
Q

why are partial agonists helpful?

A

improved safety, especially in overdose

23
Q

in what conditions can partial agonists act as antagonists?

A

high neurotransmitter

excess agonist medicine

24
Q

list examples of partial agonists

A

buprenorphine < heroin
aripiprazole < haloperidol
varenicline < nicotine
(partial agonist < agonist)

25
Q

inverse agonists

A

Opposite effects to agonists
GABA – pro-cognitive - ? dementias
Histamine – increased attention – ADHD

26
Q

examples of drugs that work at allosteric sites

A

benzodiazepines
barbiturates
alcohol
neurosteroids

27
Q

compare selectivity (and adverse effects) of haloperidol and clozapine

A

haloperidol: very selective for dopamine receptor > adverse effects due to dopamine receptor block
clozapine: non-selective > lots of adverse effects due to off-target effects
e. g. sedation, weight gain, metabolic syndrome

28
Q

compare selectivity (and adverse effects) of amitriptyline and citalopram

A

amitriptyline: “tricyclic” structure> adverse effects from histamine and acetylcholine receptor blockade
citalopram: SSRI > adverse effects driven solely by increased serotonin