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HBHD > Psychopharmacology/Stimulants > Flashcards

Psychopharmacology/Stimulants Flashcards

1
Q

When Cl- (exits/enters), cells are less likely to fire

A

enters

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2
Q

When K+ (exits/enters), cells are less likely to fire

A

exits

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3
Q

Neurotransmitters, like Ach, NE, Serotonin, Dopamine, etc., are STIMULATORY by what mechanism (what ion and which direction)

A

Stimulate Na+ influx

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4
Q

Neurotransmitters, like GABA and Glycine, are INHIBITORY by what mechanism (what ion and which direction)

A

Stimulate Cl- influx

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5
Q

Examples of Inhibitory neurotransmitters (2 total)

A

GABA

Glycine

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6
Q

Which serotonin receptors inhibit the signaling pathway (2 total)

A

5-HT1

5-HT5

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7
Q

Which neurotransmitters are “Monoamines” and thus key to all anti-depressant drugs

A

NE
Serotonin
Dopamine

*thus reuptake inhibitors for these are essential treatments (SSRIs, DNRIs, etc.)

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8
Q

Monoamines are NTs that are key to treating…

A

depression (so monoamine oxidase inhibitors are crucial for treatment)

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9
Q

Serotonin Receptor Antagonists (5HT2 & a1/2 antagonists)

A

Trazodone

Mirtazapine

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10
Q

How do serotonin antagonists (Trazodone and Mirtazapine) cause anti-depressant effects?

A

Not clear how. They also antagonize NE receptors, which may play a role

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11
Q

Examples of Tricyclic Anti-Depressants (SSRIs/SNRIs) (2 total)

A

Amitriptyline

Imipramine

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12
Q

All Tricyclic Anti-depresants (Amitriptyline, Impiramine) are what class?

A

SSRIs/SNRIs

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13
Q

Toxicities of anti-cholinergic effects (especially Tricyclics) (7 total)

A 
"Red as a beet" (flushing)
"Hot as hades" (fever)
"Mad as a hatter" (delerium)
"Blind as a bat" (blurred vision)
"Dry as a bone" (xerostomia)
"Heart runs alone" (tachycardia)
"Bowel and bladder lose their tone" (constipation and urinary retention)
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14
Q

Why are BOTH depression and anxiety treated with SSRIs and SNRIs (would think anxiety would be worsened with more serotonin and NE)?

A

Those with anxiety typically have underlying depression because they are closely linked (fear, panic, worry, agitation, etc.) (treating one can treat the other)

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15
Q

Classes of drugs to treat anxiety

A

SSRIs/SNRIs (counter-intuitive)
Buspirone (5-HT1 agonist)
Benzodiazepines (GABA)

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16
Q

_______________ is a 5-HT1 agonist (serotonin) that inhibits signaling at serotonergic synapses, thus helping to relieve anxiety

A

Buspirone

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17
Q

Inhibitory receptor that acts as a Cl- channel in order to hyperpolarize the post-synaptic neuron; acted on by benzodiazepines to be anxiolytics

A

GABA receptor

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18
Q

_____________________________ are GABA-a receptor positive modulators (NOT agonists, don’t open), increasing the potency of GABA receptors; cause anxiolysis but can also produce sedation/hypnosis

A

Benzodiazepines

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19
Q

Benzodiazepines increase the (potency/effectiveness) of GABA

A

Potency; does NOT increase effectiveness, so BZs can NEVER have more of an effect than GABA itself (difficult to overdose on BY THEMSELVES)

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20
Q

Examples of Benzodiazepines (anxiolytics) (5 total)

A 
Diazepam
Lorazepam
Midazolam
Alprazolam
Chlordiazepoxide

(-pams, -lams)

21
Q

2 Benzodiazepines that are best known for their sedative effects via “active metabolites”

A

Diazepam

Chlorodiazepoxide

22
Q

The “active metabolites” of BZ metabolism act on (a1/a2) containing GABA receptors to produce sedation

A

a2

23
Q

Anxiety is typically treated with what two categories of drugs?

A

BZ (anxiolytic via hyperpolarization)

SSRIs and SNRIs (treat underlying depression)

24
Q

“Schizo-“ meaning

A

“split from”

Schizophrenia= split from “mind” (-phrenia)

25
Q

What are the two main “positive” symptoms of Schizophrenia

A

Delusions (false beliefs)

Hallucinations (false perceptions)

26
Q

Treatments for Schizophrenia by the action of what NT antagonism

A

D2 receptor antagonists (Dopamine)

5-HT2A receptor antagonists (Serotonin)

27
Q

(1st/2nd) Generation drugs have VERY potent D2 receptor antagonists and thus have more extrapyramidal symptoms and hormonal changes because of inhibition of the Nigrostriatal pathway (EP) and Tuberoinfundibular pathway (hormones)

A

1st Generation

28
Q

(1st/2nd) Generation drugs have VERY potent 5-HT receptor antagonists and thus have more prominent side effects, like weight gain

A

2nd Generation

29
Q

The EXTRAPYRAMIDAL symptoms from D2 receptor antagonism are due to the inhibition of what portion of the brain

A

Nigrostriatal pathway (motor control of skeletal muscles) (Parkinsonism)

30
Q

The HORMONAL effects from D2 receptor antagonism (breast tissue and lactation) are due to the inhibition of what portion of the brain

A

Tuberoinfundibular pathway

31
Q

Hormonal effects of D2 receptor antagonism in psychotic treatments

A

Prolactin–> breast tissue and lactation (dopamine normally inhibits)

32
Q

Side effects of serotonin receptor antagonism in psychotic treatments

A

weight gain

33
Q

The psychotic treatment that blocks a1 receptors (ex: ________________________) can result in orthostatic hypotention with low potency and 2nd Generation drugs

A

Norepinephrine

34
Q

(low/high) potency and 2nd Generation a1 receptor antagonists like NE more commonly cause Orthostatic Hypotension

A

Low

35
Q

Antipsychotic treatment that can cause prolonged QT intervals

A

K+ channel blockers (Haloperidol)

36
Q

Why are 1st generation Antihistamines more likely to cause sedation than 2nd generation

A

Cross the BBB moreso, allowing for direct effects

37
Q

Atypical antipsychotic medication; mainly used when psychosis does not improve following the use of other antipsychotic medications; can cause agranulocytosis/neutropenia (potentially fatal)

A

Clozapine

38
Q

What percent of occupancy of D2 receptors is required for therapeutic effects on “positive” symptoms (can titrate to reduce side effects while maintaining efficacy)

A

60%

39
Q

ADHD is caused by deficiencies in what NTs

A

Dopamine
NE

  • is actually a loss of stimulants, go figure
  • thus reuptake inhibitors and agonists for each should treat
40
Q

Examples of stimulants used in ADHD treatment (3 total)

A

Methylphenidate (MPH)
Dextroamphetamine
Amphetamine salts

41
Q

Stimulant used for ADHD; blocks the reuptake of NE and Dopamine, inc. concentrations in synaptic space

A

Methylphenidate

42
Q

Stimulant used for ADHD; acts to BOTH block the reuptake and to release additional NE and Dopamine into synaptic space

A

Amphetamines

43
Q

Side effects of stimulant use (Methylphenidate, Amphetamines)

A 
Tachycardia
Arrhythmias
Diaphroesis
Insomnia
Euphoria
Agitation
Paranoia
44
Q

Simulants, like Amphetamines, are contraindicated with _________________ __________________

A

Monoamine Oxidase Inhibitors (would make too much) (main mech is already to inc. levels of monoamines)

45
Q

Non-stimulant used for ADHD; inhibits reuptake of NE; can initially cause sedation and fatigue because it takes time to become effective; can inc. suicidal ideations

A

Atomoxetine

46
Q

Alpha-2 agonists used for ADHD; modulate noradrenergic tone; can result in hypotension and sedation

A

Clonidine and Guanfacine

47
Q

Anti-depressants inc. neuronal firing by what two mechanisms

A

1) Inc. synaptic levels (reuptake inhibitors)

2) inhibit enzymatic breakdown (monoamine oxidase)

48
Q

Anxiolytics decrease neuronal firing by what mechanism

A

Cl- influx (Benzodiazepines)

SSRIs/SNRIs (treat underlying depression)

49
Q

NT receptors located on PRE-synaptic neuron that INHIBIT NT release, thus reducing signaling through that particular pathway

A

Autoreceptors

HBHD (21 decks)

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