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pcol > Psychopharmacology: Antipsychotic and Antidepressant Drugs > Flashcards

Psychopharmacology: Antipsychotic and Antidepressant Drugs Flashcards

1
Q

Study of the drugs that affect cognition, affect, and behavior of an individual

A

Psychopharmacology

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2
Q

Inability to distinguish between what is real and what is not real

A

psychosis

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3
Q

most common psychotic disorder

A

Schizophrenia

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4
Q

Structural and functional changes in the brain

A

Schizophrenia

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5
Q

Dysregulated neurotransmitters

A

Schizophrenia

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6
Q

Hyperactive dopamine in the mesolimbic pathway theory

A

Dopamine theory

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7
Q

NMDA receptor hypofunction

A

NMDA theory

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8
Q

5 HT2A receptor hyperfunction in the cortex

A

Serotonin theory

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9
Q

what were were the first drugs found to be useful to reduce psychotic symptoms in schizophrenia

A

Reserpine and chlorpromazine

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10
Q

a neuroleptic agent; that is, it produces catalepsy in rodents and EPS in humans

A

Chlorpromazine

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11
Q

In the dopamine hypothesis of psychosis Increasing evidence implicates both ________ and ________ networks

A

serotonin and glutamate

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12
Q

antipsychotic drug with high incidence of EPS

A

Neuroleptic

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13
Q

D2&raquo_space; 5-HT 2 receptors

A

Typical / Classic Drugs

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14
Q

Phenothiazine
Thioxanthine
Butyrophenone

A

Typical / Classic Drugs

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15
Q

5-HT 2&raquo_space; D2 receptors

A

Atypical / Newer Agents

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16
Q

Clozapine
Olanzapine
Risperidone
Quetiapine
Ziprasidone
Aripiprazole

A

Atypical / Newer Agents

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17
Q

antipsychotic drugs are well absorbed _____

A

orally

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18
Q

True or False: antipsychotic drugs are

A

true

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19
Q

True or False: antipsychotic drugs are

A

true

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20
Q

True or False: antipsychotic drugs have short half lives

A

false, long

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21
Q

in this theory, Schizophrenia is due to excess of functional DA in mesocortical tracts in the brain

A

Dopamine hypothesis

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22
Q

Dopamine receptors

A

GPCR, D1- D5

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23
Q

Dopamine receptors in the caudate, putamen, cortex, hypothalamus negatively
coupled to adenylyl cyclase

A

D2

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24
Q

Blockade of D2

A

EPS (tremor, slurred speech, akathisia, dystonia)

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25
Q

has affinity for other receptors, Less EPS than first generation drugs

A

Atypical antipsychotics

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26
Q

All antipsychotic drugs block H1 receptor to some degree except:

A
  • Haloperidol
  • Iloperidone
  • Lurasidone
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27
Q

First generation drugs:

A

dopamine receptor blockade

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28
Q

____________ path underlies its antipsychotic effect

A

Mesocortical-mesolimbic

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29
Q

this effect is due to the blockade of the chemoreceptor trigger zone

A

Antiemetic effect

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30
Q

Common adverse effects of Antipsychotics

A

Extrapyramidal symptoms, hyperprolactinemia (1st Generation)

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31
Q

Antipsychotics works by blocking

A

dopamine

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32
Q

histamine works as a

A

sedative

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33
Q

1st gen or 2nd gen: lower cost, EPS

A

1st

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34
Q

1st gen or 2nd gen: improves negative symptoms (emotional blunting,
social withdrawal, lack of motivation)

A

2nd

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35
Q

antipsychotic drugs are used together with ______ and _________ to treat mania

A

lithium, benzodiazapine

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36
Q

benzodiazepine works as a

A

sedative

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37
Q

Prevention of manic phase of bipolar disorder:

A

Aripiprazole, olanzapine, asenapine

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38
Q

Prevention of bipolar depression:

A

Quetiapine, lurasidone, olanzapine, carizapine

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39
Q

Meds for Tourette syndrome

A

Molindone

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40
Q

antipsychotics can be also used for

A

Alzheimer and Parkinsonism

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41
Q

Common with Haloperidol and more potent piperazine derivatives (Fluphenazine, trifluoperazine)

A

Dose dependent EPS : Parkinson like symptoms

42
Q

how to manage Dose dependent EPS : Parkinson like symptoms

A

Mx: reduce dose, use of antimuscarinic agents

43
Q

Also respond to antimuscarinic agents, or diphenhydramine

A

Movement problems akathisia, dystonia

44
Q

autonomic effects are due to

A

blockade of peripheral muscarinic and alpha receptors

45
Q

autonomic effects are seen more in:

A

Thioridazine»clozapine and atypicals&raquo_space;haloperidol

46
Q

this is due to alpha blockade common in elderly esp with phenothiazines

A

Postural hypotension

47
Q

Hyperprolactinemia, gynecomastia, infertility is the effect of

A

D2 blockade in pituitary, prominent with Risperidone

48
Q

Treat with dantrolene, diazepam, dopamine agonists

A

Neuroleptic malignant syndrome hyperthermia

49
Q

chlorpromazine work as

A

sedative

50
Q

Visual: retinal deposits with

A

thioridazine

51
Q

Cardiac rhythm abnormalities:

A

thioridazine, quetiapine, ziprasidone

52
Q

heals Agranulocytosis

A

Clozapine

53
Q

Commonly used for manic phase of bipolar disorder

A

Lithium

54
Q

Used in bipolar disorder to decrease manic behavior and reduces frequency and magnitude of mood swings

A

Lithium

55
Q

Toxicity
̶ Tremor, sedation, ataxia, aphasia
̶ Thyroid enlargement
̶ Cardiac abnormalities in the fetus

A

Lithium

56
Q

Prolongs inactivation of voltage gated Na channels, GABA A agonist

A

Valproic acid

57
Q

antimanic effects when failed to respond to lithium

A

Valproic acid

58
Q

Prolongs inactivation of voltage gated Na channels

A

Carbamazepine and lamotrigine

59
Q

drugs for for mania and prophylaxis of depressive phase

A

Carbamazepine and lamotrigine

60
Q

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

A

Depression

61
Q

Monoamine Hypothesis:
- compulsion
- sleep
- memory
- impulse
- repetitive and stereotypical behavior

A

Serotonin

62
Q

Monoamine Hypothesis:
- pleasure
- reward seeking
- drive

A

Dopamine

63
Q

Monoamine Hypothesis:
- energy
- alertness
- concentration
- vigilance

A

noradrenaline

64
Q

Monoamine Hypothesis:
- anxiety
- irritability

A

serotonin + noradrenaline

65
Q

Monoamine Hypothesis:
- sex
- appetite
- aggression

A

serotonin + dopamine

66
Q

Monoamine Hypothesis:
- attention
- motivation

A

dopamine + noradrenaline

67
Q

drug that depletes monoamines

A

reserpine

68
Q

this drug was used as an antituberculosis drug, was found to reverse reserpine induced depression

A

iproniazid

69
Q

Depression is associated with loss of neurotrophic support

A

Neurotrophic hypothesis

70
Q

for neural plasticity, resilience, and neurogenesis

A

Brain derived neurotrophic factor (BDNF)

71
Q

Phenelzine
Selegiline
Tranylcypromine

A

Monoamine Oxidase Inhibitors

72
Q

Amitryiptyline
Clomipramine
imipramine

A

Tricyclic antidepressants

73
Q

Amoxapine
Bupropion
mirtazapine

A

Heterocyclic
antidepressants

74
Q

Duloxetine
venlafaxine

A

5-HT NE reuptake inhibitors

75
Q

Nefazodone
Trazodone

A

5-HT antagonists

76
Q

Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline

A

Selective Serotonin reuptake inhibitors

77
Q
  • Related to phenothiazine antipsychotics
  • Well absorbed orally, but undergo first pass effect
  • Excessive hepatic metabolism required
  • Forms active metabolites
  • Long half life (OD dosing)
A

Tricyclic antidepressants

78
Q
  • Require hepatic metabolism
  • Fluoxetine half life of several days once a week dosing
A

Selective serotonin reuptake inhibitors

79
Q

Pharmacokinetics similar to TCA

A

Heterocyclics

80
Q
  • Related to amphetamines and orally active
  • Inhibitors of hepatic drug metabolizing enzymes
A

Monoamine oxidase inhibitor

81
Q

NMDA antagonist

A

Ketamine

82
Q

anesthetic agent that has antidepressant action as long as 1 wk.

A

Ketamine

83
Q

modulator of GABA A receptors

A

Brexanolone

84
Q

for postpartum depression

A

Brexanolone

85
Q
  • Inhibit the reuptake transporters that terminate the actions of NE and 5 HT
  • Blocks H receptors and α adrenoceptors
A

Tricyclic antidepressants

86
Q
  • Highly selective on Serotonin Transporter (SERT) allosterically inhibit the transporter
  • Minimal inhibitory effects on NE
A

SSRI

87
Q

Bind to transporters for both serotonin and NE

A

SNRI

88
Q
  • Increase brain amine levels, interfering with metabolism
  • increase in vesicular stores of NE and 5 HT
A

MAO Inhibitor

89
Q

increase amine release by antagonism of α 2 receptors

A

Mirtazapine

90
Q

no effect on 5 HT or NE amine transporters

A

Bupropion

91
Q

increase NE in nerve endings; inhibit
reuptake of NE in nerve endings

A

Amine uptake blockade (Sympathomimetic effects)

92
Q

Common in TCA and heterocyclic (mirtazapine) and 5 HT2 blockers
(nefazodone and trazodone)

A

Sedation

93
Q

Occurs with all TCA esp. amitriptyline and doxepine ; also with nefazodone , amoxapine, amprotiline

A

Muscarinic blockade

94
Q

Atropine like effects minimal with SSRI and bupropion

A

Muscarinic blockade

95
Q

for patients withdrawing from nicotine dependence

A

Bupropion

96
Q

Stress incontinence and vasomotor menopausal symptoms

A

SNRI

97
Q

OCD

A

Clomipramine and SSRI

98
Q

Neuropathic pain

A

Duloxetine, venlafaxine

99
Q

interaction of fluoxetine and MAOI

A

Serotonin syndrome

100
Q

Severe muscle rigidity, myoclonus, hyperthermia, cardiac instability,
seizures

A

Serotonin syndrome

pcol (8 decks)

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