Psychotropic drugs Flashcards
Define full agonist
the drug mimics the effects of a neurotransmitter
Define partial agonists
the drug mimics a neurotransmitter but only to a lower point
Define antagonists
the drug blocks the effects of a neurotransmitter
Define inverse agonists
the drug produces the opposite effect of the neurotransmitter
What mnemonic is used for describing serotonin and what does it stand for?
DOMAINS
Depression
Obsession
Migraines
Anxiety
Intestines (90% of all serotonin is in the GI tract and it drives motility)
Nausea ( meds cause nausea)
Sexual (meds cause sexual dysfunction)
What is the mnemonic for Dopamine and what does it stand for?
DOPAMINE
Drugs (strong roll in addiction)
psychOsis
Prolactin inhibition
Attention (decreased)
Motivation (decreased)
Involuntary movements (SE)
Nausea (SE)
Energy (SE)
Describe Norephinephrine
-sympathetic nervous system
-fight or flight response (increased concentration, focus, energy, HR and BP and decreased GI and urinary function)
What is the trick to remembering what GABA is?
“think of falling asleep when your instructor is gabbing on and on…”
–> helps decrease insomnia, anxiety and agitation
What are GABAergic meds?
-meds that promote GABA
-barbiturates
-benzodiazepines
-ETOH (modulates GABA)
Describe Glutamate
-excitatory
-amplifies learning, memory, processing thoughts and sensory input
Describe Acetylcholine and what mnemonic is used for Acetylcholine?
-PSNS (rest and digest, feed and breed)
SLUDGEM
Salivation
Lacrimation (the flow of tears)
Urination
Diaphoresis
GI effect
Emesis
Miosis (pupil constriction)
Define Miosis
pupil constriction
Define Lacrimation
the flow of tears
What is the mnemonic for histamine and what does it stand for?
hISTAmine
Insomnia
STomach acid
Allergies
How do opioids work?
they bind to the opioid receptors in the brain
What is the mnemomic for opioids?
ARMED C
Analgesia
Respiratory depression
Miosis
Euphoria
Drowsiness
Constipation
What are the three main parts of the brain?
-brain stem
-cerebellum
-cerebrum
What does the brain stem control?
all of the most primitive parts, such as vitals signs and other things that we do not have conscious control of
What is the limbic system responsible for?
-fight or flight response when confronted with a stressor
-emotional part of the brain
What is the cerebrum responsible for?
-highest level of the brain
-executive functioning
-highest evolutionary aspect of the brain
-when the limbic system takes over (ex. during anxiety) executive functioning goes offline and the emotions take over– so we are not able to make decisions, think logically and rationally
What causes disturbances of mental function?
a combination of many factors, including:
-environment
-genes
-altered neurons (norepinephrine, serotonin, dopamine, glutamate, GABA)
What variables cause variation in drug effects?
-age (both very young and old)
-ethnicity
-polypharmacy
What cultural considerations must be considered for medication administration?
Asian descent: require 1/2 to 1/3 dose antipsychotics and have more severe side effects
Cardiovascular effects of propranolol
Asian descent– more sensitive
African descent– less sensitive
NOTE: not a blanket statement, it is individualized based on the person
What are the phases of drug treatment?
Initiation
Stabilization
Maintenance
Discontinuation
Describe the initiation phase of drug treatment
requires close monitoring for side effects (especially if naive), checking vital signs, etc. clients need a lot of support and teaching to promote adherence
Describe the stabilization phase of drug treatment
titrating of doses, frustrating for clients
-continue to monitor for side effects and teach about coping mechanisms
Describe the maintenance phase of drug treatment
seen in community setting, ongoing monitoring for adherence and side effects
-usually seen in the community
Describe the discontinuation phase of drug treatment
can take place in the community or hospital setting, medications are tapered slowly and patient is monitored
What drugs are used to treat anxiety and insomnia?
Barbiturates (-barbital’s)
Benzodiazepines (-azepam’s and -azolam’s)
Define tolerance
when the patient requires more and more of the med to achieve the same benefits
What Benzo’s are short-acting?
triazolam, oxazepam and midazolam
What are the long-acting benzo’s?
diazepam, chlordiazepoxide
What are the intermediate-acting benzo’s?
lorazepam, clonazepam, alprazolam and temazepam
What short-acting sedative is used for insomnia?
-zopiclone (hypnotic sleep agent)
causes: anterograde amnesia and somnambulism (sleep walking)
Define somnambulism
sleep walking
Describe Buspirone Hydrochloride (Bustab)
-for GAD
-melatonin receptor agnoist, GABA is not involved
-counters sexual side-effects of SSRIs
Describe Serotonin Reuptake Inhibitors (SSRIs)
-for GAD and anxiety related to depression
-can cause sexual dysfuntion
What mental illness can beta blockers be used for?
-Propranolol
-useful for performance anxiety as it works on the cardiovascular symptoms (racing heart, sweaty palms, diaphoresis)
-helps calm things down
What is Gabapentin used for?
-the treatment of anxiety when it is comorbid to another MH illness
What is melatonin used for?
-insomnia and anxiety
-it is a naturally occurring hormone that increases at nightfall
-may not consider that this is still a hormone we are increasing and could have it’s own SEs
What is Trazadone used for?
-anxiety and insomnia
-is an antidepressant
-causes very severe sedation effects so should be taken at bedtime
What is Prazosin used for?
-anxiety and insomnia related to nightmares from PTSD
What is Baclofen used for?
-muscle relaxant for treatment of anxiety and insomnia
What is Hydroxyzine used for?
-antihistamine with intense sedating effect that is good for insomnia
-helps with getting to sleep, but not staying asleep
-can interfere with sleep cycle, so do es not actually provide good quality sleep
(using Gravol to help them sleep)
What are the drug treatment types for depression?
Tricyclic Antidepressants (TCAs)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Monoamine Oxidase Inhibitors (MAOIs)
What is the gold standard drug treatment for depression?
SSRIs
What is Clomipramine used for?
-is is a Tricyclic Antidepressant (TCA) that is the gold standard treatment for OCD
What is the rule of thirds?
1/3 of patients will improve completely
1/3 will improve somewhat
1/3 will not improve
Applies to patients with antidepressants
What 2 medications for Bipolar Disorder decrease the rates of suicide?
lithium carbonate and clozapine
