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Psychopharmacology > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What type of treatment approach is recommended for anxiety disorders?

A

-psychotherapy; CBT, stress management, meditation, aerobic level exercise

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2
Q

What are first generation antipsychotic medication?

A
  • conventional antipsychotics
  • low potency and high potency
  • thorazine
  • chlorpromazine
  • stelazine
  • haldol
  • mellaril
  • prolixin
  • trilafon
  • navane
  • loxitane
  • moban
  • block dopamine receptors
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3
Q

what is second generation antipsychotic medication?

A
  • -they have a wider spectrum of action
  • improve/reduce negative symptoms: affects both dopamine and serotonin receptors
  • effective for manic episodes and agitation
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4
Q

Which anti-anxiety medication is not habit forming?

A
  • antihistamines (vistaril, Benadryl)

- beta blockers (inderal, tenormin)

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5
Q

What is the first line of defense for panic disorder?

A

–high potency benzodiazepines, combination of medication and psychological treatment.

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6
Q

what is catapres primarily used for

A
  • hypertension

secondary: anxiety and opiate withdrawal

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7
Q

What are some treatment considerations for anxiety disorders?

A

-try other measures 1st unless anxiety is severe
-short term: safe and effective
- long term: tolerance and dependence
abuse potential: valium, xanax, and halcion
-withdrawal

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8
Q

What are the two dopamine pathways and what are they responsible for?

A
  • Mesolimbic: reward pathway, causes positive symptoms
  • mesocroritcal: motivation and emotion; causes negative symptoms
  • ventral regimental área to the nucleares, accumben, amygdala, hippocampus, prefrontal cortex
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9
Q

What is the treatment effectiveness of antipsychotics

A
  • moderate affective ness 20-50% symptom reduction,

- FDA requires a 20-30% symptom improvement

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10
Q

What are the pros & cons of first generation antipsychotics

A
  • pros: improve/reduce positive symptoms, around for several years lots of research experience, inexpensive, some available in depot long term formulation
  • cons: don’t improve/reduce negative symptoms, only about 30% of patients, extrapyramidal side effects, relapse common,risk of neuroleptic malignant syndrome
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11
Q

What are the pros and cons of second generation antipsychotics

A
  • pros: may reduce/eliminate neurodegenerative, wider spectrum of action, improve/reduce negative symptoms, more tolerable, few extrapyramidal and anticholinergic side effects, less risk of TD, clorzail has antisuicidial effects
  • cons: increased risk of agranulocytosis, troublesome side effects, increased rates of extrapyramidal side effects
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12
Q

what are the side effects of first gen antipsychotics

A
  • extrapyramidal: Parkinsonisn, dystonic, akathisia
  • anticholinergic: blurred vision, dry mouth, constipation, urinary retention, sexual dysfunction, sedation
  • weight gain, blood pressure drop
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13
Q

What are the side effects of second gen antipsychotics

A
  • drowsiness/sedation
  • orthostatic hypotension
  • hypersalivation
  • dizziness & vertigo
  • seizures increased heart rate
  • marked weight gain and metabolic side effects
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14
Q

What are some treatment considerations for antipsychotics?

A
  • patients 20-50% reduction in symptom severity
  • fill results from antipsychotics therapy take considerable time
  • side effect management (sedation, extrapyramidal, akathisia
  • goal is to reduce symptoms to increase functioning
  • patient education is extremely important
  • monitor metabolic issues
  • relapse prevention (70% will relapse within a year)
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15
Q

What is the stress response syndrome?

A
  • stressful event happens
  • outcry: eruption of intense emotions and denial, state of shock, can last minutes, hours, or days
  • *intrusion: waves of intense emotions, relive event
  • *denial: can come right after outcry or can bounce from denialto intrusion
  • working through: can have repeated periods of intrusion and denial
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16
Q

What is good sleep hygiene?

A
  • 3 hrs prior prepare the body and mind for sleep
  • routine getting up and going to bed
  • limit bed use: sleep and sex
  • avoid: bright light, intense exercise, loud music, intense discussions
  • meditation
  • progressive muscle relaxation
  • watch a peaceful tv show
  • warm bath
  • eat carbs, veggies or milk
  • listen to peaceful music
  • sleeping cool
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17
Q

What are contributors/variables that are linked to insomnia?

A
  • situational stress
  • emotional disorders
  • medication, drugs, alcohol
  • medical illness
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18
Q

What is the first line of medication choice for self harm?

A
  • should be based on associated features
  • depression: SSRI
  • atypical depression: MAOI
  • psychotic features: antipsychotic
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19
Q

What is the first line of medication choice for eating disorders?

A

-naltrexone takes away the high or reward of starving in anorexia or bulimia nervosa

20
Q

What are antianxiety medication

A
  • Barbiturates
  • benzodiazepines
  • atypical benzodiazepines
  • buspirone
  • antihistamines
  • beta blockers
  • catapres
  • minipress (prazosin)
21
Q

How do benzodiazepines work?

A

-They bind to the receptors to inhibit neurotransmitter release

22
Q

What are the pros and cons of Benzodiazepines? (anti-anxiety medication)

A
  • cons: highly addictive, withdrawal, overdose, longer half life, affects sleep, abused
  • pros: fast acting (20-30 min), sedative, anti-anxiety, seizure prevention, less lethal and barbiturates,
23
Q

what are some atypical and non benzodiazepine anti-anxiety medication?

A
  • hypnotics: prosom, doral, ambien, kunesta, sonata

- they have less cognitive impairment and little effect on sleep

24
Q

What are some advantages and disadvantages to Buspar (anti-anxiety medication)

A
  • pros: no tolerance or dependence, no interaction with CNS depressants, no impaired psychomotor function
  • cons: delayed onset of action, 1-2 weeks symptoms reductions, less effective than benzos, side effects include nausea, dizziness, anxiety
25
Q

What are some of the pros and cons of antihistamines? ( benedryl, visitril/atrax) (anti-anxiety medication)

A
  • pros: work in 20-30 min, last 4-6 hs, non habit forming

- cons: side effects in sedation, drowsiness, impaired performance, anxiolytic tolerance, narrow therapeutic window

26
Q

What are the side effects for antihistamines? (benedryl, visitril/atrax (anti-anxiety medication)

A

-sedation, drowsiness, impaired performance.

27
Q

What are the side effects of buspar?

A
  • nausea, dizziness, anxiety
28
Q

Which anti-anxiety agents are non habit forming?

A
  • Antihistamines (benedryl, visitril/atrax)

- Beta blockers (inderal, tenormin)

29
Q

which anti-anxiety medications are fast acting?

A
  • antihistamines (20-30) min

- hypnotics (prosom, doral, ambien, kunesta, sonata)

30
Q

What are the pros and cons of beta blockers? (inderal, tenormin)

A
  • pros: peripheral manifestations, performance anxiety, antihypertensive, adjunctive for PD, non habit forming
    cons: internal experience, rebound blood, pressure elevation, side effects: dizziness, lowered blood pressure, depression.
31
Q

ted talk Schizophrenia

A

-atrusive hallucinations when its something that can happen in real life
-she would hallucinate spiders and the IT clown
-

32
Q

What does increased dopamine in the mesolimbic system create

A

-positive symptoms

33
Q

What does decreased dopamine in the mesocortical create

A

-negative symptoms

34
Q

What are some first generation antipsychotics?

A
  • Thorazine
  • haldol
  • mellaril
  • stelazine
  • proxil
  • trilafon
  • navane
  • loxitane
  • moban
35
Q

What are some second generation antipsychotics?

A
  • clozaril
  • risperdal
  • zyprexa
  • seroquel
  • geodon
  • fanapt
  • invega
  • saphris
  • abilify
36
Q

Which medication is most used for binge eating?

A
  • SSRI, depressants, Wellbutrin
37
Q

what are minipress (prazosin) used for

A

primary hypertension, secondat nightmares PTSD

38
Q

What are the length of treatment for antipsychotics

A
  • 1st acute episode: treatment is at least one year,
  • 2nd episode, 5 years
  • 3rd episode, lifetime
  • other psychoses, at least 6 months
39
Q

What is the best treatment option for PTSD

A
  • exposure based cognitive therapy, EMDR

- medication is used to treat certain aspects of PTSD but not the primary treatment

40
Q

What medication is used to treat hyperarousal in PTSD

A

-NEUROEPHINEPHREINS
-ANTIDEPRESSANTS
-benzodiazepines
minipress/prazosin,
-anticonvulsants

41
Q

What medication is used for intrusive symptoms? i.e. flashbacks

A
  • SSRIS, prozac, fluoxetine, 2ND gen antipsychotics
42
Q

What medication is used for kindling in PTSD?

A
  • Eskalith/Lithium Carbonate; Depakote/Divaloprex; Tegretol, Equetro/Carbamazepine
43
Q

What medication is used for nightmares in PTSD?

A
  • MINIPRESS

- PRAZOSIN

44
Q

what are some hypnotics

A
  • ProSom (Estazolam): rapid action, intermediate half-life, no active metabolites
  • Doral (Quazepam): active metabolites
  • Ambien and Ambien CR (Zolpidem): short-acting
  • Lunesta (Eszopiclone): short-acting
  • Sonata (Zaleplon): shortest-acting, half-life of one hour
45
Q

What medication do you use to treat seep wake disorders?

A

-hypnotics (prosom, doral, ambien, kunesta, sonata)

46
Q

What are some non habit forming sleep drusg/

A
  • rozerem
  • desyrel/trazodone
  • seroquel/quetiapine
  • remeron/mirtzepine
  • benedryl/diphenhydramine
47
Q

What are some common benzodiazepines

A
  • xanax
  • librium
  • valium
  • ativan

Psychopharmacology (3 decks)

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