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Psychopharmacology - Other Psychoactive Drugs Flashcards

1
Q

3 types of drugs included in the “sedatives, hypnotics, and anxiolytics” class

A
  1. Benzodiazepines
  2. Barbiturates
  3. Azapirones
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2
Q

3 benzodiazepines

A

PAMs:
1. Diazepam (Valium)
2. Alprazolam (Xanax)
3. Lorazepam (Ativan)

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3
Q

Benzodiazepine uses

A
  1. Anxiety
  2. Insomnia
  3. Seizures
  4. Alcohol withdrawal
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4
Q

Benzodiazepine mechanism

A

Increases GABA activity

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5
Q

Benzodiazepine typical side effects

A

Most common:
1. Drowsiness
2. Sedation

Others:
3. Weakness
4. Unsteadiness
5. Poor memory/concentration
6. Anticholinergic effects
7. Sexual dysfunction
8. Disorientation/confusion (older adults)

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6
Q

Benzodiazepine paradoxical side effects

A
  1. Excitability
  2. Anxiety

Chronic use:
3. Tolerance, dependence, withdrawals
4. Rebound anxiety
5. Depression
6. Anorexia
7. Delirium
8. Seizures

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7
Q

Benzodiazepine discontinuation

A
  1. Gradual tapering based on dose, half-life, length of time on medication
  2. Longer taper required for short half-life (Xanax, Ativan)
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8
Q

Benzodiazepine interactions

A
  1. Alcohol - depressant combo that can be lethal
  2. Blood pressure medication - excessive drop in blood pressure
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9
Q

3 barbiturates

A

TALs:
1. Thiopental (Pentothal)
2. Amobarbital (Amytal)
3. Secobarbital (Seconal)

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10
Q

Barbiturate uses

A
  1. Anxiety
  2. Insomnia
  3. Seizures
  4. General anesthesia
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11
Q

Barbiturate mechanism

A

Enhances GABA activity

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12
Q

Barbiturate side effects

A
  1. Drowsiness
  2. Dizziness
  3. Confusion
  4. Ataxia
  5. Cognitive impairment
  6. Paradoxical excitement
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13
Q

Barbiturate sudden withdrawal risks

A
  1. Seizures
  2. Delirium
  3. Death
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14
Q

Barbiturate interactions

A
  1. Alcohol - can be lethal
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15
Q

Azapirone example

A
  1. Buspirone (BuSpar)
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16
Q

Azapirone uses

A
  1. Generalized anxiety disorder
  2. Other anxiety disorders
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17
Q

Azapirone side effects

A
  1. Dizziness
  2. Dry mouth
  3. Sweating
  4. Nausea
  5. Headache
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18
Q

Buspirone (BuSpar) advantage

A

Does not lead to sedation, dependence, or tolerance

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19
Q

2 types of narcotic-analgesics (opioids)

A
  1. Natural
  2. Semi-synthetic/synthetic
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20
Q

4 examples of natural narcotic-analgesics (opioids)

A

INEs:
1. Opium
2. Morphine
3. Heroin
4. Codeine

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21
Q

4 examples of synthetic narcotic-analgesics (opioids)

A

DONEs:
1. Methadone
2. Oxycodone
3. Hydrocodone
4. Fentanyl

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22
Q

Narcotic-analgesic (opioid) mechanism

A

Mimic effects of body’s natural analgesics (endorphins, enkephalins)

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23
Q

Narcotic-analgesic (opioid) uses

A
  1. Pre-surgery anesthetic
  2. Pain treatment
  3. Heroin detox (methadone)
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24
Q

Methadone to treat heroin use

A
  1. Does not produce same pleasurable effects as heroin
  2. Reduces heroin cravings
  3. Reduces heroin withdrawal symptoms
25
Q

Narcotic-analgesic (opioid) side effects

A
  1. Dry mouth
  2. Nausea
  3. Pupil constriction
  4. Postural hypotension
  5. Drowsiness
  6. Dizziness
  7. Constipation
  8. Respiratory depression

Chronic use:
1. Dependence
2. Tolerance
3. Withdrawal

27
Q

Narcotic-analgesic (opioid) overdose symptoms

A
  1. Convulsions
  2. Coma
  3. Death
28
Q

Narcotic-analgesic (opioid) withdrawal symptoms

A

Initial:
1. Flu-like symptoms (runny nose, watery eyes, nausea, fever, muscle aches)

Later:
1. Insomnia
2. Abdominal cramps
3. Vomiting
4. Diarrhea
5. Rapid heart rate
6. Elevated blood pressure

29
Q

Beta-blocker mechanism

A

Inhibit activity of SNS

30
Q

Beta-blocker uses

A
  1. Hypertension
  2. Cardiac arrhythmia
  3. Migraines
  4. Essential tremors
31
Q

Beta-blocker example

A
  1. Propranolol (Inderol)
32
Q

Beta-blocker Propranolol (Inderol) to treat anxiety

A

More effective for somatic symptoms than psychological symptoms of anxiety

33
Q

Beta-blocker Propranolol (Inderol) side effects

A
  1. Hypotension
  2. Decreased sex drive
  3. Insomnia
  4. Nausea/vomiting
  5. Dry eyes
  6. Dizziness
  7. Depression
34
Q

Beta-blocker Propranolol (Inderol) sudden withdrawal effects

A
  1. Rebound hypertension
  2. Tremors
  3. Headaches
  4. Confusion
  5. Cardiac arrhythmia
35
Q

2 types of mood stabilizers

A
  1. Lithium
  2. Anticonvulsants
36
Q

Lithium (Eskalith, Lithobid) uses

A

First-line
1. Acute mania
2. Classic bipolar disorder

37
Q

Lithium (Eskalith, Lithobid) side effects

A
  1. Nausea
  2. Vomiting
  3. Diarrhea
  4. Metal taste
  5. Increased thirst
  6. Weight gain
  7. Hand tremors
  8. Fatigue
  9. Poor memory/concentration
38
Q

Lithium (Eskalith, Lithobid) risks

A

Lithium toxicity - can lead to seizures, coma, death

39
Q

2 examples of anticonvulsant drugs

A
  1. Carbamazepine (Tegretol)
  2. Valproic acid (Depakene)
40
Q

Anticonvulsant side effects

A
  1. Nausea
  2. Dizziness
  3. Sleepiness
  4. Lethargy
  5. Ataxia
  6. Tremors
  7. Visual disturbances
  8. Impaired concentration
41
Q

Anticonvulsant risks

A
  1. Liver failure
  2. Agranulocytosis
  3. Aplastic anemia
42
Q

2 types of drugs to slow progression of Alzheimer’s disease

A
  1. Cholinesterase inhibitors
  2. NMDA receptor agonist
43
Q

Cholinesterase inhibitors (for Alzheimer’s) mechanism

A

Delay breakdown of acetylcholine

44
Q

4 examples of cholinesterase inhibitors (for Alzheimer’s)

A
  1. Tacrine (Cognex)
  2. Donepezil (Aricept)
  3. Rivastigmine (Exelon)
  4. Galantamine (Razadyne)

All approved for mild and moderate Alzheimer’s

Donepezil (Aricept) approved for severe Alzheimer’s

Tacrine (Cognex) uncommon due to risk for liver failure and serious side effects

45
Q

Example of NMDA receptor antagonist (for Alzheimer’s)

A
  1. Memantine (Namenda)

Approved for moderate to severe Alzheimer’s

46
Q

NMDA receptor antagonist (for Alzheimer’s) mechanism

A

Regulates activity of glutamate

47
Q

3 types of stimulants

A
  1. Methylphenidate (Ritalin, Concerta)
  2. Pemoline (Cylert)
  3. Amphetamine-dextroamphetamine (Adderall)
48
Q

Stimulant uses

A
  1. ADHD (attention and hyperactivity, not necessarily academic achievement)
49
Q

Stimulant mechanism

A

Increases dopamine and norepinephrine in prefrontal cortex

50
Q

Stimulant side effects

A
  1. Insomnia
  2. Nervousness
  3. Decreased appetite
  4. Weight loss
  5. Abdominal pain
51
Q

Drug holidays (stimulants)

A

Taking breaks from stimulants during school holidays so growth does not continue to be stunted by the medication

52
Q

Stimulant use in college students without ADHD

A
  1. Increase attention and positive mood
  2. No improvement in reading comprehension and fluency
  3. Possible negative effects on working memory and academic performance
53
Q

When to use second- or third-line medications for ADHD

A
  1. Stimulants did not work
  2. Too many side effects with stimulants
  3. Comorbidities interfere with stimulants
  4. High risk for stimulant misuse
54
Q

3 second-line medications for ADHD

A
  1. Atomoxetine (Strattera)
  2. Guanfacine (Intuniv)
  3. Clonidine (Kapvay)

Strattera is most common non-stimulant for ADHD

55
Q

Atomoxetine (Strattera) mechanism

A

Norepinephrine reuptake inhibitor

56
Q

Atomoxetine (Strattera) effectiveness

A
  1. Improves core ADHD symptoms
  2. Better than stimulants for people with tics, sleep disorders, anxiety, depression
57
Q

Guanfacine (Intuniv) and Clonidine (Kapvay) mechanism

A

Alpha-2-adrenergic agonists

58
Q

Guanfacine (Intuniv) and Clonidine (Kapvay) effectiveness

A
  1. Originally meant for high blood pressure
  2. Improves core ADHD symptoms
  3. Typically only prescribed when person has a comorbid tic disorder
59
Q

Third-line

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