Psychopharmacology For Psychiatry Flashcards
What are the four main types of treatments for psychological issues?
Chemical - drugs
Electrical stimulation e.g ECT for depression
Structural arrangement e.g. psychosurgery/ deep brain stimulation for severe depression
Talking therapies e.g. cognitive behaviour therapy
What are the pros of classifying a drug based on what illnesses they treat?
Easy for doctors to choose a drug as they make the diagnosis
What are the 2 main cons of classifying a drug based on what illnesses they treat?
Many psychiatric medicines work in several disorders e.g. antidepressants can also treat anxiety
Most psychiatric disorders have multiple symptoms and a single medicine might not treat them all
What are the three methods of classification of drug for psychiatry?
- As the WHO classification does
- Based on what illnesses they treat
- Based on their pharmacology e.g. not antipsychotic but dopamine blocker
What are the four different systems medicines work on?
Receptors
Neurotransmitter reuptake sites
Ion channels
Enzymes
All neurotransmitters except for ________ are taken back into the pre-synaptic terminal via uptake sites
All NTs except for acetylcholine
What enzyme is blocked to treat anxiety and depression?
Monoamine oxidase inhibitors (MAOIs)
Lithium blocks which enzyme in order to provide mood stability?
Glycogen synthase
In receptor targeting medicines: Antagonists block the ___________
Endogenous agonist binding to the receptor
In receptor targeting medicines: agonists mimic _______
The endogenous agonist and stimulate the receptor
How does citalopram work to enhance serotonin?
Blocks the serotonin reuptake site
What is the most common drug target?
Blocking enzyme activity
What is a neurone auto receptor?
- usually inhibitory
- activated by neurotransmitter
- inhibit calcium influx
- switch off firing of terminal
- reduce neurotransmitter release
What enzymes are targeted for dementias?
Acetylcholinesterase inhibitors
In receptor targeting medicines, most treatments are _______
Receptor blockers (antagonists)
What receptors are blocker for schizophrenia?
Dopamine receptors
What receptor subtype is blocked for depression?
Serotonin receptor subtype antagonists
What are two examples of receptor agonists used in psychiatry and what are they used for?
> benzodiazepines enhance GABA for sleep
guanfacine enhance noradrenaline for ADHD
What are the two categorisations for neurotransmitters?
FAST acting (on-off switch)
Slow acting (modulators) - around 5% of NTs
Why are partial agonists sometimes used?
Improved safety
Which neurotransmitter system is in excess in epilepsy and alcoholism?
Glutamate
Glutamate is in Excess/Deficient in epilepsy and alcoholism
Excess
What is the treatment given for excess glutamate in epilepsy?
Perampanel - blocker
What are the two treatments given for excess glutamate in alcoholism?
Acamprosate - blocker
Ketamine - blocker
What NT system is deficient in anxiety?
GABA
GABA is in excess/deficient in anxiety?
Deficient
What treatment is used for the deficiency in GABA in anxiety?
Benzodiazepines - GABA enhancers
5-HT is in excess/deficient in depression and anxiety?
Deficient
Which neurotransmitter system is deficient in depression and anxiety?
5-HT
What treatment is given for 5-HT deficiency seen in depression and anxiety?
SRIs and MAOIs - serotonin enhancers
Which neurotransmitter system is in excess in psychosis?
Dopamine
Dopamine is in excess/deficient in psychosis?
In excess
What treatment is given to treat excess dopamine in psychosis?
Dopamine receptor blockers
Which neurotransmitter system is in excess in nightmares?
Noradrenaline
What treatment is given for excess noradrenaline seen in nightmares?
Prazosin - blocker
Which Neurotransmitter system is deficient in dementia?
Acetylcholine
What is allosteric modulation?
Some drugs act on the same site as the natural (endogenous) neurotransmitter
Others work ondifferent siteson the target proteins
