Psychopharmocology Flashcards
What does pharmacodynamics refer to
THe means by which a psychotropic agent has an impact on receptors, enzymes, ion channels and chemical transporter systems
What does pharmacokinetics refer to
The way in which a psychotropic agent is passed thruogh the body
What is absoprtion
The transfer of psychotropic agents into the bloodstreem
What is distribution
How th psycotoropic drug crosses into the central nervous system from the bloodstream
What does metabolism mean
THe process of a drug’s molecular structure changing and its pharmacological properties
Where does metabolism generally happen
In the liver
What does elimination refer to
The removal of psychotropic agents from the body usually through urination or sometimes respiration
What characteristics impact pharmacokinetics
- Age
- Physiological function
- Gender
- Disesase
- Nutrition
WHat is half-life
The average time it takes to eliminate one-half o the drug’s concentration from one’s system
What is the therapeutic dose
THe drug concentration that gives a desired response
What is the toxic dose
When the drug concentration causes mild or severe side effects
What is the therapeutic index
The ratio of the toxic to therapeutic dose - a higher therapeutic index is more desirable
What is a loading dose
Starting on a high does to botain a desired response faster
What is potentiation
When one drug enhances the effect of a second drug
What is synergism
When one drug enhances the second drug significantly more than expected
What are some examples of depressant drugs
Alcohol, sedatives, hypnotics, anxiolytics, inhalants
What are some examples of cannabinoids
Marijuana
What are some examples of opioids
heroin, morphine, codeine
WHat are some examples of hallucinogens
LSD, mescaline, psilocybin, PCP
What are some examples of stimulants
Ampheamines, cocaine, caffiene
What category do antidepressants, antipsychotics and mood stabilisers come under
Psychotropic medications
What are the two parts of the nervous system
- Central Nervous system
2. The peripheral nervous system
What nervous system do psychotropic drugs impact
The Central nervous system
What is included in the central nervous system and what is it responsible for
The brain, spinal cord and network of neurons and is responsible for sending, receiving and interpreting information from all parts of the body
How do Neurons work
They use neurotransmitters to communicate with one another
WHat are neurotransmitters
The chemicals that communicate information through our brain and body by relaying signals betweeen neurons
What is pharmacodynaics
How psychotropics impact the way information is transmitted through neurotransmitters
What is acetylcholine associated with
- Memory
- Learning
- Attention
What is Epiinephrine associated with
- Fight flight or freeze
2. Anxiety
Where does epinephrine get produced
It is secreted by endocrine glands above the kidneys and adrenal glands
What is norepinephrine associated with
- Wakefulness
2. Alertness
What is dopamine associated with
- Reward
- Behavioural regulation
- Movement
- Learning
- Mood
- Attention
What neurotransmitters are associated with Schizophrenia and also activated by amphetamines and cocaine
Dopamine
What is serotonin associated with
- Inhibition of activity and behaviour
- Mood regulation
- Appetite
- SLeep
What does GABA do
It inhibits action and decreases neural transmission preventing over excitation
What drugs increase GABA
Barbiturates and benzodiazepine
What 3 personality disorders are in cluster A of the DSM and what drugs can be used to treat these disorders
- Paranoid
- Schizoid
- Schizotypal
Atypical antipsychotic medication at a low dose
What are some examples of antipsychotic medication
Clozapine,Risperidon Olanzapine
What personality disorder are included in cluster B of the DSM and what drugs can be used to treat them
- Antisocial
- BOrderline
- Histrionic
- Narcissistic
Can be treated with duloxetine and SSRI antidepressants
What personality disorders are included in cluster C of the DSM and what drugs can be used to treat them
- Avoidant
- Dependent
- Obsessive comuplsive
These can be treated wtih SSRIs or sometimes a long acting benzodiazepine
What are some examples of benzodiazepines
- Klonopin
2. Buspar
What medication can be used for anxiety/sedation and self harming
Neurontin - anxiety
Revia - self-harming
What is used to treat ADHD
Ritalin which is a dexamphetamine of mephinidate
What is an issue with Ritalin and how is it managed
It only lasts a few hours so is taken twice daily
What are some side effects of Ritalin
Hyperactivity and severe insomnia
What are some longer acting forms of medication for ADHD
VYnvase and Ritaline LA
What can be used to treat ADHD if the client is also abusing a substance
Atomoxetine or Strattera
What medication is used to manage mania
In order to control elevated mood sedating drugs are used as well as a mood stabilising drug like Lithium
What are some of the downsides of Lithium
It needs to be monitored very closely because it can become toxic resulting dyhydration, a tremor, impact cognition and lead to death
What is an alternative to lithium
Valproate Eiplim which is mildly sedating and can address insomnia and aggressiveness
What is the risk of Valporate
there can be liver inflamation although this is rare
What is Tegretol and what are its side effects
It is a mood stabiliser and can lead to lack of coordianation, dizziness and stomach upset
When is aricept used for demention
When the mini mental state is greater than 10
What are some side effects of aricept and what does it do
Slows cognitive decline but can lead to diarrhoea, muscle cramps, fatigue and nausea
What antipsychotic medication is used in dementia
Risperdal
What has previously been used to treat anxiety and what are the issues with its use
Valium- Diazepam and benzodiazepines. The issue with their use is depnedency and tolerance to the drugs as well as mild cogntiive decline and decreased problem-solving capacity
What is an alternative to diazepam and benzodiazepines to treat anxiety
antidepressants however they do not work as fast as diazepam and benzodiazepines
What population are likely to consum benzodiazepines and what is the significance of this
Drug abusers in the jsutice system do and this tends to lead to disinhibited behaviorus that may result in reoffending
What is the purpose of beta blockers and what patients should not use these
They reduce sympathetic nervous system actvity but can not be used when a patient has asthma
What do modern antidepressnats mostly target
Serotonin
Name 3 antidepressants and their brand name
- Sertraline - Zoloft
- Citalopram - Cipramil
- Fluoxetin - Prozac
What can you use if SSRI’s are not effective
Agents that target the noradrenaline system such a mirtazpine alson known as Avanza
What new antidepressant targets the melatonin system and how does it help
Agomelatine or Valdoxan and it improves circadian rhythms
What are some side effects of antidepressants
anxiety, agitation, non-specific gastric side effects, constriction of mood, sexual side effects
HOw long does it take the side effects of antidepressants to subside
10 days
What makes initiation of treatment difficult with antidepressants and how is it sometimes managed
People with depression are often sensitive anxious symptoms and agitation so worsening of symptoms can put them off. Sometimes benzodiazepines are administerd at the same time to counterac these effects.
WHat age group have an increase risk of suicide when first initiating antidepressants and why
young adults perhaps due to the agitating effects in the early treatment phase
What type of antidepressants are safe in pregnancy
SSRIs
How can treatment resistant depression be address throuh medication
Through the use of multiple antideprssants, a mood stabilser or antipsychotic as well as hormonal treatments like thyroxine
What treatment is used for OCD
Antidepressants in particular clomipramine or Anafranil
What is used to treat the delusions and hallucinations in schizophrenia
Antipsychotics
What can be used for treatment resistant schizophrenia
Clozaril but this is only dispensed if the white cell coutn is satisfactory as well as mood stabilisers
What is an issue when treating schizophrenia and how is overcome
Non-adherence due to poor insight, this can be coutneracted by long acting injectable forms of antipsychotics like Haldol
How is persisten aggression in schizophrenia treated
Longacting clopixol injections each fortnight
What is a side effect of long term antipsychotic use
involuntary movement disorder, tardive dyskinesia
What are the consequences of obstructive sleep apnoea and how is treated
Significant cognitive slowing and depression of mood it is treated through continuous positive airway pressure treatment and can also be treated modafanil
What are some short term treatments fo insomnia and what are the problems associated with it
Benzodiazepines such as temaze or serepax. The issue is that tolerance builds quickly and it leads to daytime sedaiton which reduces motivation to implement lifestyle cahnges that could help with insomnia
What is the issue with Stilnox
It has been associated with dissociative amnesia and impulsive disinhibited behaviour at night. It has been used as defence in assault cases and can be associated with suicide due to increase of impulsive actions
What treatment is used for alcohol dependence and barriers exist when using it
Campral or acamprosate it is take 3 times a day which can not be adhered to because of the high frequency
What drug of abuse is Naltrexone or ReVIa used to treat and how does it work
Opiods and it reverse the subjective effects of opioids
