Psychotropic Flashcards

1
Q

Phenelzine

A

Monoamine oxidase inhibitor

SAS product

Nonselective MAOIs irreversibly inhibit monoamine oxidases A and B (MAO‑A and MAO‑B), increasing the synaptic concentrations of adrenaline, noradrenaline, dopamine and serotonin.

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2
Q

Tranylcypromine

A

Monoamine oxidase inhibitor

Nonselective MAOIs irreversibly inhibit monoamine oxidases A and B (MAO‑A and MAO‑B), increasing the synaptic concentrations of adrenaline, noradrenaline, dopamine and serotonin.

More likely to interact with tyramine-containing food and is less sedating compared to phenelzine

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3
Q

Citalopram

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

least potential for drug interactions mediated by inhibition of CYP enzymes.

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4
Q

Escitalopram

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

least potential for drug interactions mediated by inhibition of CYP enzymes.

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5
Q

Fluvoxamine

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

Has an active metabolite, norfluoxetine, that contributes significantly to its effects, and has a long half-life (up to 16 days).

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6
Q

Fluoxetine

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

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7
Q

Paroxetine

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

Shortest half-life of the SSRIs and as increased risk of withdrawal symptoms.

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8
Q

Sertraline

A

SSRI

SSRIs selectively inhibit the presynaptic reuptake of serotonin (5‑hydroxytryptamine, 5HT).

least potential for drug interactions mediated by inhibition of CYP enzymes.

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9
Q

Amitriptyline

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors.

Greatest Anticholinergic effect.
Greatest sedative effect.
Highest risk of orthostatic hypotension - equal to Doxepin.

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10
Q

Clomipramine

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors. Clomipramine has a greater effect on serotonin transport than other TCAs.

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11
Q

Dosulepin/dothiepin

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors.

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12
Q

Doxepin

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors.

Greatest sedative effect.
Highest risk of orthostatic hypotension - equal to amitriptyline.

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13
Q

Impramine

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors.

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14
Q

Nortriptyline

A

Tricyclic antidepressant

TCAs inhibit reuptake of noradrenaline and serotonin into presynaptic terminals. Although unrelated to the therapeutic effects of the TCAs, they also block cholinergic, histaminergic, alpha1-adrenergic and serotonergic receptors.

Lowest risk of anticholinergic effects/orthostatic hypotension

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15
Q

Desvenlafaxine

A

SNRI

Inhibit serotonin and noradrenaline reuptake.

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16
Q

Duloxetine

A

SNRI

Inhibit serotonin and noradrenaline reuptake.

Lower risk with hypertension

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17
Q

Venlafaxine

A

SNRI

Inhibit serotonin and noradrenaline reuptake.

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18
Q

Agomelatine

A

Mode of action unclear; it is a melatonin receptor (MT1 and MT2) agonist and 5HT2C receptor antagonist.

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19
Q

Miansserin

A

Tetracyclic antidepressant; increases central noradrenergic neurotransmission by blocking presynaptic alpha2-adrenergic receptors. It also antagonises some postsynaptic serotonin receptors.

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20
Q

Mirtazapine

A

Tetracyclic antidepressant; acts by postsynaptic blockade of serotonin 5HT2 and 5HT3 receptors and presynaptic blockade of central alpha2-adrenergic inhibitory autoreceptors. It is also a potent H1 antagonist which accounts for its sedative effects.

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21
Q

Moclbemide

A

Moclobemide competitively and reversibly inhibits monoamine oxidase (MAO); it is relatively selective for type A (MAO‑A). Synaptic concentrations of serotonin, noradrenaline and dopamine are increased.

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22
Q

Reboxetine

A

Inhibits noradrenaline reuptake; weakly inhibits serotonin reuptake.

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23
Q

Vortioxetine

A

In vitro, vortioxetine inhibits the serotonin transporter, and acts as an antagonist at some 5HT receptor subtypes and as an agonist at others. It is thought to increase serotonin activity in the CNS

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24
Q

Amisulpride

A

Atypical Antipsychotic

High increase in prolactin

May prolong QT

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25
Q

Aripiprazole

A

Atypical Antipsychotic

Little effect on QT

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26
Q

Asenapine

A

Atypical Antipsychotic

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27
Q

Brexpiprazole

A

Atypical Antipsychotic

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28
Q

Cariprazine

A

Atypical Antipsychotic

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29
Q

Chlorpromazine

A

Typical Antipsychotic

Low potency but increased effects in sedation, anticholinergic, orthostatic hypotension, and cardiometabolic effects.

Photosensitivity

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30
Q

Clozapine

A

Atypical Antipsychotic

High cardiometabolic effects, risk with neutropenia, Sedation and anticholinergic effects.

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31
Q

Droperidol

A

Typical Antipsychotic

32
Q

Flupentixol

A

Typical Antipsychotic

33
Q

Haloperdol

A

Typical Antipsychotic

High potency

Increased EPSE
May prolong QT

34
Q

Lurasidone

A

Atypical Antipsychotic
moderate EPSE
Little effect on QT

35
Q

Olanzapine

A

Atypical Antipsychotic

High increase in cardiometabolic effects

36
Q

Paliperidone

A

Atypical Antipsychotic

high increase in prolactin
sexual/ejaculatory issue

37
Q

Periciazine

A

Typical Antipsychotic

38
Q

Quetiapine

A

Atypical Antipsychotic

Moderate increase in cardiometabolic effects. sedation and orthostatic hypotension.

39
Q

Risperidone

A

Atypical Antipsychotic

Moderate cardiometabolic effects.
High increase in Prolactin

Sexual/ejaculatory problems.

40
Q

Ziprasidone

A

Atypical Antipsychotic

May prolong QT.

41
Q

Zuclopenthixol

A

Typical Antipsychotic

42
Q

Antipsychotics

A

Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain (in particular the limbic system). Evidence suggests:

all effective antipsychotics block D2 receptors
differential blockade of other dopamine receptors (eg D1) may influence therapeutic and adverse effects
antagonism of other receptors may influence antipsychotic activity, eg 5HT2 antagonism with some agents.

43
Q

Alprazolam

A

Benzodiazepine - Short length of action (6-12 hours)

rapid onset (<1 hour after oral administration)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

44
Q

Bromazepam

A

Benzodiazepine- Medium length of action (12-24 hours)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

45
Q

Clobazam

A

Benzodiazepine- Long length of action (>24 hours)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

46
Q

Diazepam

A

Benzodiazepine- Long length of action (>24 hours)

rapid onset (<1 hour after oral administration)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

47
Q

Flunitrazepam

A

Benzodiazepine- Long length of action (>24 hours)

rapid onset (<1 hour after oral administration)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

48
Q

Lorazepam

A

Benzodiazepine- Medium length of action (12-24 hours)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

49
Q

Nitrazepam

A

Benzodiazepine- Short length of action (>24 hours)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

50
Q

Oxazepam

A

Benzodiazepine- Short length of action (6-12 hours)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

51
Q

Temazepam

A

Benzodiazepine- Short length of action (6-12 hours)

rapid onset (<1 hour after oral administration)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

52
Q

Midazolam

A

Benzodiazepine - Short length of action (6-12 hours)

rapid onset (<1 hour after oral administration)

Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

53
Q

Armodafinil

A

Non-amphetamine psychostimulant

Exact mode of action is unknown

54
Q

Modafinil

A

Non-amphetamine psychostimulant

Exact mode of action is unknown

55
Q

Lemborexant

A

Orexin receptor antagonist

Block the binding of wake-promoting orexin A and B neuropeptides.

56
Q

Suvorexant

A

Orexin receptor antagonist

Block the binding of wake-promoting orexin A and B neuropeptides.

57
Q

Buspirone

A

SAS product

Partial agonist at serotonin 5HT1A receptor

58
Q

Melatonin

A

Endogenous melatonin is associated with control of circadian rhythms and sleep regulation; it acts at MT1 and MT2 receptors in the anterior hypothalamus.

59
Q

Zolpidem

A

Potentiation of inhibitory effects of GABA.

60
Q

Zopiclone

A

Potentiates inhibitory effects of GABA.

61
Q

Dexamfetamine

A

Amphetamine

Active metabolite of Lisdexampamine

Psychostimulants are thought to enhance dopaminergic and noradrenergic neurotransmission.

62
Q

Lisdexamfetamine

A

Amphetamine

Psychostimulants are thought to enhance dopaminergic and noradrenergic neurotransmission.

63
Q

Methylphenidate

A

CNS stimulant

Psychostimulants are thought to enhance dopaminergic and noradrenergic neurotransmission.

64
Q

Atomoxetine

A

Selectively inhibits presynaptic noradrenaline reuptake in the CNS.

65
Q

Guamfacine

A

Selective alpha2a adrenoreceptor agonist; action in ADHD is unclear, but its effects in the prefrontal cortex are thought to improve ADHD symptoms.

66
Q

Acamprosate

A

Chemical structure is similar to that of GABA and taurine. Mechanism of action is unclear, possibly involves restoration of normal activity in glutamate and GABA-ergic systems.

67
Q

Disulfram

A

Deters alcohol use. Disulfiram prevents the usual metabolism of alcohol (irreversibly inhibits aldehyde dehydrogenase), blocking acetaldehyde breakdown, which causes unpleasant, potentially serious effects if alcohol is consumed, eg flushing, sweating, nausea, vomiting, palpitations, headache, dyspnoea, chest pain, hypotension, cardiovascular collapse, seizures, arrhythmias.

68
Q

Naltrexone

A

Opioid antagonist.

In alcohol dependence, naltrexone reduces craving for alcohol and possibly reduces some of the pleasurable effects, by blocking the effects of endogenous opioids.

In maintenance of opioid abstinence, it reversibly blocks opioid receptors (for 24–72 hours), preventing opioid effects, eg euphoria.

69
Q

Bupropion

A

Unknown; its effects in nicotine dependence may be due to inhibition of neuronal reuptake of dopamine and noradrenaline.

70
Q

Nicotine

A

Nicotine replacement reduces the severity of tobacco withdrawal symptoms and increases the likelihood of smoking cessation.

71
Q

Varenicilne

A

Partial agonist at a subtype of neuronal nicotinic acetylcholine receptors. It blocks nicotine binding to these receptors, preventing the pleasurable effects of smoking, while its partial agonist activity reduces symptoms of nicotine withdrawal.

72
Q

Buprenorphine

A

Buprenorphine is a partial opioid receptor agonist. Reduces withdrawal symptoms and craving for opioids in opioid dependence.

73
Q

Naltrexone with bupropion

A

Not fully understood; may be due to effects on the appetite regulatory centre in the hypothalamus and mesolimbic dopaminergic reward system.

74
Q

Phentermine

A

Sympathomimetic with CNS stimulatory effects, increasing energy expenditure.

75
Q

Guanfacine

A

Selective alpha2a adrenoreceptor agonist; action in ADHD is unclear, but its effects in the prefrontal cortex are thought to improve ADHD symptoms.