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Psychopharmacology > Test #2 > Flashcards

Test #2 Flashcards

1
Q

Primary approach for treatment of Anxiety D/O

A

Psychotherapy

If it gets too severe try out meds.

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2
Q

What do benzodiazepines ends in? What are other names they are referred to as?

A

LAM and PAM

Also referred to as tranquilizer, sedative

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3
Q

Pros of Benzos

A
  • Very Effective
  • Fast Acting 20-30 min.
  • Well Tolerated
  • Better anti-anxiety specificity than barbiturates
  • Less lethal in overdoes than barbiturates
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4
Q

Cons of Benzos

A
  • Dependence Potential
  • Can cause Sedation
  • Longer half-life drug accumulation
  • Short half-life anterograde amnesia
  • Abused
  • Affect Sleep Architecture - Can prevent you from having a good night sleep
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5
Q

Advantages of BuSpar

A
  • No tolerance or dependence
  • No interaction w/CNS depressants
  • No interaction with Alcohol
  • No impaired psychomotor function
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6
Q

Disadvantages of BuSpar

A
  • Delayed onset of action
  • 1-2 weeks symptom reduction
  • Less effective than benzos
  • SE: nausea, dizziness, anxiety(?)
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7
Q

ADVANTAGES OF . . .

  • No tolerance or dependence
  • No interaction w/CNS depressants
  • No interaction with Alcohol
  • No impaired psychomotor function
A

Advantages of BuSpar

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8
Q

DISADVANTAGES OF . . .

  • Delayed onset of action
  • 1-2 weeks symptom reduction
  • Less effective than benzos
  • SE: nausea, dizziness, anxiety(?)
A

Disadvantages of BuSpar

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9
Q

Block histamine receptors in CNS

  • Vistaril/Atratax (hydroxyzine)
  • Benadryl (diphenhydramine)
A

Antihistamines

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10
Q

Advantages of Antihistamines

A
  • Work in 20-30 minutes
  • Last 4-6 hours
  • Non-habit-forming
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11
Q

Disadvantages of Antihistamines

A
  • SE: sedation, drowsiness, impaired performance
  • Anxiolytic tolerance
  • Anti-anxiety; overtime you keep taking it and you’ll develop a tolerance
  • Narrow therapeutic window (sedation)
  • Fine line between managing anxiety and falling asleep
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12
Q

Beta Blockers end in . . .

A

LOL
Inderal (propranolol)
Tenormin (atenolol)

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13
Q

Advantages of . . .

  • Work in 20-30 minutes
  • Last 4-6 hours
  • Non-habit-forming
A

Advantages of Antihistamines

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14
Q

Disadvantages of . . .

  • SE: sedation, drowsiness, impaired performance
  • Anxiolytic tolerance
  • Anti-anxiety; overtime you keep taking it and you’ll develop a tolerance
  • Narrow therapeutic window (sedation)
  • Fine line between managing anxiety and falling asleep
A

Disadvantages of Antihistamines

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15
Q

Advantaged of Beta Blockers

A
  • Peripheral manifestations
  • Removing symptoms tacicardia
  • Performance anxiety
  • Antihypertensive
  • Adjunctive for PD
  • Non-habit-forming
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16
Q

Disadvantages of Beta Blockers

A
  • Internal experience
  • Doesn’t do much for the cognitive or worry
  • Reduce physiological sxs not cognitive
  • SE: dizziness, lowered blood pressure, depression - long term use
  • Rebound blood pressure elevation
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17
Q

Advantaged of . . .

  • Peripheral manifestations
  • Removing symptoms tacicardia
  • Performance anxiety
  • Antihypertensive
  • Adjunctive for PD
  • Non-habit-forming
A

Beta Blockers

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18
Q

Disadvantages of . . .

  • Internal experience
  • Doesn’t do much for the cognitive or worry
  • Reduce physiological sxs not cognitive
  • SE: dizziness, lowered blood pressure, depression - long term use
  • Rebound blood pressure elevation
A

Beta Blockers

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19
Q

Primary use and Secondary use of the Minipress and Catapres

A

Primary: Hypertension
Secondary: nightmares (PTSD) and ANXIETY

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20
Q

Treatment of Panic D/O

A

Combination of Medication and Psychological Treatment

Panic D/O is CHRONIC, medication treatment should be >1 year

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21
Q

How soon does Benzo withdrawal start?

A

1-4 days

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22
Q

How long does the acute phase of Benzo withdawl last

A

10-14 days

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23
Q

Short Term Symptoms of Acute Withdrawl

A 
Insomnia
Palpitations
Sweating
Headache
Weight loss
Tinnitus
Anxiety/panic attacks
naseau 
muscle aches
abnormal body sensations
perceptual changes
hallucinations
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24
Q

4 dopaminergic pathways

M* M* N T

A
  • Mesolimbic
  • Mesocortical
  • Nigrostriatal
  • Tuberoinfundibular
25
Q

Increased dopamine drive in _______ system -> POSITIVE symptoms

A

Mesolimbic

26
Q

Decreased dopamine in drive_____ system -> NEGATIVE symptoms

A

Mesocortical

27
Q

extrapyramidal (facial movements, tremors) symptoms

Motor control, death in these can result in Parkinson’s

A

Nigrostriatal

28
Q

prolactin elevation symptoms

  • Hormonal regulation, maternal behavior, pregnancy, and other sensory processors
  • Gynecomastia - develop breasts, lactate
A

Tuberoinfundibular

29
Q

First gen anti-psychotics improve ______ symptoms

A

Positive

30
Q

Second gen anti-psychotics improve/reduce _____ symptoms

A

Negative

31
Q

A con of first gen anti-psychotics: you experience ____ symptoms

A

Extrapyramidal

32
Q

Type of symptom:
Motor functioning symptoms, Parkinsonian; (2) Dystonic; - sustained muscle spasm contraction (3) Akathisia - constant state of restlessness

A

Extrapyramidal

33
Q

Overall effectiveness of med

A

20-30%

34
Q

First Gen Antipsychotics end in . . .

A 
-ZINES
Throazine
o	Haldol (Haloperidol)
o	Mellaril (Thioridazine)
o	Stelazine (Trifluoperazine)
o	Prolixin (Fluphenazine)*
o	Trilafon (Perphenazine)
o	Navane (Thiothixene)
o	Loxitane (Loxapine)
o	Moban (Molindone)
35
Q

First even First Gen Anti-psychotic

A

Thorazine

36
Q

Second Generation Anti-psychotics end in . . .

A 
-PINE, -DONEo	Clozaril (Clozapine) - first one developed
o	Risperdal (Risperidone)*
o	Zyprexa (Olanzapine)*
o	Seroquel (Quetiapine)
o	Geodon (Ziprasidone)
o	Fanapt (Iloperidone)
o	Invega, Invega Sustenna (Paliperidone)*
o	Saphris (Asenapine)
o	Abilify (Aripriprazole)
37
Q

o PROS
Wider spectrum of action

Improve/reduce negative symptoms

More tolerable

Fewer extrapyramidal and anticholinergic side effects and less risk of TD

Clorzaril (Clozapine) has antisuicidal effects and is effective for those unresponsive to antipsychotics

o CONS

  • Increased risk of agranulocytosis (requires weekly blood tests for first 6 mos.)
  • Troublesome side effects (esp. WIEGHT GAIN and metabolic side effects)
  • Increased rates of extrapyramidal side effects at higher than usual doses; if you take high doses only
  • Prolactin elevations
  • Electrocardiogram changes
A

Pros/cons of second gen antipsychotics

38
Q

Goal of Anti-psychotics

A

Goal = reduce symptoms to increase functioning so the patient can benefit more from other forms of treatment: symptoms under control in order for patient to benefit from therapy and be stable enough to learn skills.
- Adhere to treatment

39
Q

Steps in Stress Response Cycle

S O I D W C

A
  1. Stressful Event
  2. Outcry
  3. Intrusion
    DENIAL
  4. Working through
  5. Completion
40
Q

simultaneously an eruption of intense, unpleasant emotion AND denial (I can’t believe it. It cant be true). Stake of shock, engulfed by very strong emotions. May last minutes, hours, or days. Move quickly to phase 2

A

Outcry

41
Q
  • waves of intense emotion and a strong impulse to think about, imagine, remember, or mentally relive the stressful event - not brought on willfully, emotions feel very raw, people feel very vulnerable, easily overwhelmed.
  • Startle easily, don’t sleep well, often have nightmares - can lose reality testing and have psychotic-like symptoms (hall & del)
A

Intrusion

42
Q

may come right after outcry or on the heels of intrusion - state of emotional numbness - feel nothing - disassociation, avoidance, social withdrawal

A

Denial

43
Q

_____ is prolonged with periodic emotional upheaval

- periods of intrusion and denial

A

Working Through

44
Q

Medications used to treat hyperarousal

A B A A M

A 
o	Antidepressants
o	Benzodiazepines
o	Alpha-2 
 AdrenergicAgonists
o	Anticonvulsants
o	Minipress/Pazosin
45
Q

Treatment of PTSD

A

o Psychotherapy is primary; medications target specific symptoms as they arise
o Solid/safe patient-therapist relationship
o Restoration to some sense of control over turbulent emotions

46
Q

PTSD PRESENTATION

Acute

A

< 3 months

47
Q

PTSD PRESENTATION

Chronic

A

> 3 months

48
Q

Acute onset of PTSD

A

immediately following traumatic event

49
Q

Delayed onset of PTSD

A

6+ months after the traumatic event

50
Q

Factors that contribute to PTSD Presentation

A

o Single instance vs. recurring traumas
o Age at which the trauma occurs
o Stage of stress syndrome response

51
Q

o Repeated episodes of trauma -> changed brain functioning/morphology -> increases the likelihood that subsequent stresses are responded to w/even more intense affective symptoms

o Eskalith/Lithium Carbonate; Depakote/Divaloprex; Tegretol, Equetro/Carbamazepine

A

kindling Effect Associated with PTSD

52
Q

(opiate antagonist)
o Reduces relief of release endorphins
o Endorphins are kind of like opiates?

A

Naltrexone

53
Q

Agression is well treated with ____

A

Antidepressants

54
Q

Non habit forming hypnotic

A

Rozerem

55
Q

Symptom Clusters

A

Positive
negative
mood
cognitive

56
Q

Type of Sxs, takes days to treat

hallucinations, delusions, conceptual disorganization, disorganized speech, excitement, grandiosity

A

Positive Sxs

57
Q

Type of SXS takes weeks to months to treat
THINGS IT TAKES AWAY
Alogia, flat affect, anhedonia, avolition,

A

Negative Sxs

58
Q

Type of sxs, takes weeks to months to treat

attention impairment, memory dysfunction, impaired executive functioning, behavioral disorganization

A

Mood SXS

59
Q

Type of sxs, takes weeks to months to treat

depression, excitement aggression, anxiety, hostility poor social skills.

A

cognitive sxs

Psychopharmacology (3 decks)

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