Psychopharmacology: Antipsychotic and Antidepressant Drugs Flashcards
1
Q
Study of the drugs that affect cognition, affect, and behavior of an individual
A
Psychopharmacology
2
Q
Inability to distinguish between what is real and what is not real
A
psychosis
3
Q
most common psychotic disorder
A
Schizophrenia
4
Q
Structural and functional changes in the brain
A
Schizophrenia
5
Q
Dysregulated neurotransmitters
A
Schizophrenia
6
Q
Hyperactive dopamine in the mesolimbic pathway theory
A
Dopamine theory
7
Q
NMDA receptor hypofunction
A
NMDA theory
8
Q
5 HT2A receptor hyperfunction in the cortex
A
Serotonin theory
9
Q
what were were the first drugs found to be useful to reduce psychotic symptoms in schizophrenia
A
Reserpine and chlorpromazine
10
Q
a neuroleptic agent; that is, it produces catalepsy in rodents and EPS in humans
A
Chlorpromazine
11
Q
In the dopamine hypothesis of psychosis Increasing evidence implicates both ________ and ________ networks
A
serotonin and glutamate
12
Q
antipsychotic drug with high incidence of EPS
A
Neuroleptic
13
Q
D2»_space; 5-HT 2 receptors
A
Typical / Classic Drugs
14
Q
Phenothiazine
Thioxanthine
Butyrophenone
A
Typical / Classic Drugs
15
Q
5-HT 2»_space; D2 receptors
A
Atypical / Newer Agents
16
Q
Clozapine
Olanzapine
Risperidone
Quetiapine
Ziprasidone
Aripiprazole
A
Atypical / Newer Agents
17
Q
antipsychotic drugs are well absorbed _____
A
orally
18
Q
True or False: antipsychotic drugs are
A
true
19
Q
True or False: antipsychotic drugs are
A
true
20
Q
True or False: antipsychotic drugs have short half lives
A
false, long
21
Q
in this theory, Schizophrenia is due to excess of functional DA in mesocortical tracts in the brain
A
Dopamine hypothesis
22
Q
Dopamine receptors
A
GPCR, D1- D5
23
Q
Dopamine receptors in the caudate, putamen, cortex, hypothalamus negatively
coupled to adenylyl cyclase
A
D2
24
Q
Blockade of D2
A
EPS (tremor, slurred speech, akathisia, dystonia)
25
has affinity for other receptors, Less EPS than first generation drugs
Atypical antipsychotics
26
All antipsychotic drugs block H1 receptor to some degree except:
- Haloperidol
- Iloperidone
- Lurasidone
27
First generation drugs:
dopamine receptor blockade
28
____________ path underlies its antipsychotic effect
Mesocortical-mesolimbic
29
this effect is due to the blockade of the chemoreceptor trigger zone
Antiemetic effect
30
Common adverse effects of Antipsychotics
Extrapyramidal symptoms, hyperprolactinemia (1st Generation)
31
Antipsychotics works by blocking
dopamine
32
histamine works as a
sedative
33
1st gen or 2nd gen: lower cost, EPS
1st
34
1st gen or 2nd gen: improves negative symptoms (emotional blunting,
social withdrawal, lack of motivation)
2nd
35
antipsychotic drugs are used together with ______ and _________ to treat mania
lithium, benzodiazapine
36
benzodiazepine works as a
sedative
37
Prevention of manic phase of bipolar disorder:
Aripiprazole, olanzapine, asenapine
38
Prevention of bipolar depression:
Quetiapine, lurasidone, olanzapine, carizapine
39
Meds for Tourette syndrome
Molindone
40
antipsychotics can be also used for
Alzheimer and Parkinsonism
41
Common with Haloperidol and more potent piperazine derivatives (Fluphenazine, trifluoperazine)
Dose dependent EPS : Parkinson like symptoms
42
how to manage Dose dependent EPS : Parkinson like symptoms
Mx: reduce dose, use of antimuscarinic agents
43
Also respond to antimuscarinic agents, or diphenhydramine
Movement problems akathisia, dystonia
44
autonomic effects are due to
blockade of peripheral muscarinic and alpha receptors
45
autonomic effects are seen more in:
Thioridazine>>clozapine and atypicals >>haloperidol
46
this is due to alpha blockade common in elderly esp with phenothiazines
Postural hypotension
47
Hyperprolactinemia, gynecomastia, infertility is the effect of
D2 blockade in pituitary, prominent with Risperidone
48
Treat with dantrolene, diazepam, dopamine agonists
Neuroleptic malignant syndrome hyperthermia
49
chlorpromazine work as
sedative
50
Visual: retinal deposits with
thioridazine
51
Cardiac rhythm abnormalities:
thioridazine, quetiapine, ziprasidone
52
heals Agranulocytosis
Clozapine
53
Commonly used for manic phase of bipolar disorder
Lithium
54
Used in bipolar disorder to decrease manic behavior and reduces frequency and magnitude of mood swings
Lithium
55
Toxicity
̶ Tremor, sedation, ataxia, aphasia
̶ Thyroid enlargement
̶ Cardiac abnormalities in the fetus
Lithium
56
Prolongs inactivation of voltage gated Na channels, GABA A agonist
Valproic acid
57
antimanic effects when failed to respond to lithium
Valproic acid
58
Prolongs inactivation of voltage gated Na channels
Carbamazepine and lamotrigine
59
drugs for for mania and prophylaxis of depressive phase
Carbamazepine and lamotrigine
60
Feelings of sadness and or loss of interest in normally pleasurable activities, leading to emotional and physical problems, with resulting impairment in social, occupational and other areas of functioning for 2 weeks
Depression
61
Monoamine Hypothesis:
- compulsion
- sleep
- memory
- impulse
- repetitive and stereotypical behavior
Serotonin
62
Monoamine Hypothesis:
- pleasure
- reward seeking
- drive
Dopamine
63
Monoamine Hypothesis:
- energy
- alertness
- concentration
- vigilance
noradrenaline
64
Monoamine Hypothesis:
- anxiety
- irritability
serotonin + noradrenaline
65
Monoamine Hypothesis:
- sex
- appetite
- aggression
serotonin + dopamine
66
Monoamine Hypothesis:
- attention
- motivation
dopamine + noradrenaline
67
drug that depletes monoamines
reserpine
68
this drug was used as an antituberculosis drug, was found to reverse reserpine induced depression
iproniazid
69
Depression is associated with loss of neurotrophic support
Neurotrophic hypothesis
70
for neural plasticity, resilience, and neurogenesis
Brain derived neurotrophic factor (BDNF)
71
Phenelzine
Selegiline
Tranylcypromine
Monoamine Oxidase Inhibitors
72
Amitryiptyline
Clomipramine
imipramine
Tricyclic antidepressants
73
Amoxapine
Bupropion
mirtazapine
Heterocyclic
antidepressants
74
Duloxetine
venlafaxine
5-HT NE reuptake inhibitors
75
Nefazodone
Trazodone
5-HT antagonists
76
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Selective Serotonin reuptake inhibitors
77
- Related to phenothiazine antipsychotics
- Well absorbed orally, but undergo first pass effect
- Excessive hepatic metabolism required
- Forms active metabolites
- Long half life (OD dosing)
Tricyclic antidepressants
78
- Require hepatic metabolism
- Fluoxetine half life of several days once a week dosing
Selective serotonin reuptake inhibitors
79
Pharmacokinetics similar to TCA
Heterocyclics
80
- Related to amphetamines and orally active
- Inhibitors of hepatic drug metabolizing enzymes
Monoamine oxidase inhibitor
81
NMDA antagonist
Ketamine
82
anesthetic agent that has antidepressant action as long as 1 wk.
Ketamine
83
modulator of GABA A receptors
Brexanolone
84
for postpartum depression
Brexanolone
85
- Inhibit the reuptake transporters that terminate the actions of NE and 5 HT
- Blocks H receptors and α adrenoceptors
Tricyclic antidepressants
86
* Highly selective on Serotonin Transporter (SERT) allosterically inhibit the transporter
* Minimal inhibitory effects on NE
SSRI
87
Bind to transporters for both serotonin and NE
SNRI
88
- Increase brain amine levels, interfering with metabolism
- increase in vesicular stores of NE and 5 HT
MAO Inhibitor
89
increase amine release by antagonism of α 2 receptors
Mirtazapine
90
no effect on 5 HT or NE amine transporters
Bupropion
91
increase NE in nerve endings; inhibit
reuptake of NE in nerve endings
Amine uptake blockade (Sympathomimetic effects)
92
Common in TCA and heterocyclic (mirtazapine) and 5 HT2 blockers
(nefazodone and trazodone)
Sedation
93
Occurs with all TCA esp. amitriptyline and doxepine ; also with nefazodone , amoxapine, amprotiline
Muscarinic blockade
94
Atropine like effects minimal with SSRI and bupropion
Muscarinic blockade
95
for patients withdrawing from nicotine dependence
Bupropion
96
Stress incontinence and vasomotor menopausal symptoms
SNRI
97
OCD
Clomipramine and SSRI
98
Neuropathic pain
Duloxetine, venlafaxine
99
interaction of fluoxetine and MAOI
Serotonin syndrome
100
Severe muscle rigidity, myoclonus, hyperthermia, cardiac instability,
seizures
Serotonin syndrome
