psychopharmacology for psychiatry

Question 1

what are the 4 types of treatments in medicine

Answer 1

chemical - drugs, medicine
electrical stimulation e.g ect for depression
structural rearrangement e.g surgery and orthopaedics
talking therapies e.g cbt

Question 2

how to classify psychiatric drugs

Answer 2

1. based on chemical structures
2. based on illness they treat
3. based on their pharmacology - neuroscience based nomenclature

Question 3

what are some examples of drugs which block enzyme activity

Answer 3

monoamine oxidase inhibitors - for anxiety and depression (block breakdown of 5ht and noradrenaline)
acetylcholinesterase inhibitors - for dementias
lithium - blocks glycogen synthase kinase for mood stability

Question 4

what are some receptor targeting medicines

Answer 4

antagonists:
- dopamine receptors blockers for schizophrenia
- serotonin receptor subtype antagonists for depression
- histamine receptor antagonist for sleep
agonists:
- benzodiazepines enhance GABA - help with sleep
- guanfacine enhance noradrenaline in adhd

Question 5

what are some examples of reuptake site targeting medicines

Answer 5

citalopram - enhances serotonin, ssri for depression and anxiety
desipramine - noradrenaline reuptake inhibitor, nri - for depression
methylphenidate - dopamine reuptake inhibitor - for adhd

• some can switch reuptake site direction to enhance release
  e.g amfetamine for adhd
  increases release of dopamine

Question 6

what are some drugs that block channels so reduce neuronal excitability

Answer 6

sodium channels:
(block transmission of info down axon)
sodium valproate and carbamazepine- used in epilepsy and mood stabilisation

calcium channels:
e.g gabapentin and pregabalin - epilepsy and anxiety

Question 7

fast acting excitatory neurotransmitter

Answer 7

glutamate
- present in 80% of neurones
in pyramidal cells - neurons which regulate brain function

Question 8

fast acting inhibitory neurotransmitter

Answer 8

gaba - make up 15% of neurones
= interneurones
involved in memory, movement, vision

Question 9

what are the slow acting (modulators)

Answer 9

make up about 5% of all
- dopamine, serotonin, noradrenaline, acetylcholine
- endorphins and other peptides
involved in emotions,drives valence of memory

Question 10

what is a partial agonist

Answer 10

lower max efficacy than full agonists
- improved safety - esp in overdose
in states of high neurotransmitter/ excess agonist med can act as an agonist

Question 11

what are some examples of partial agonists

Answer 11

buprenorphine
aripiprazole
varenicline