Unit 2 Instructors Notes Flashcards
1
Q
Which of the following is a type of methylxanthine:
A. Theobromine B. Theophylline C. Caffeine D. All of these E. A and C, but not B
A
D) All of these
2
Q
Caffeine - Pharmocokinetics
1) Administration
2) Distribution
3) Biotransformation
4) Excretion
A
*Commonly Administered:
-Orally
Primary site of Action:
-Brain
Biotransformation from liver enzymes Excreted primarily through Kidneys/Urine
3
Q
Which of the following is true of caffeine?
A. Effects include vasodilation
B. Half life is approximately 2-4 hours
C. Cannot cross the blood-brain barrier
D. Biotransformation occurs primarily in the lungs
A
B. Half life is approximately 2-4 hours
4
Q
Caffeine-Neuropharmocology
A
- The neurotransmitter that caffeine impacts & results in increased alertness is Adenosine
- By acting as an Antagonist
5
Q
Caffeine Effects Vs. Withdrawal Effects
A
- Increased heart rate Vs. Decreased heart rate
- Decreased Sleep Vs. Increased sleep
- Increased alertness Vs. Decreased alertness
- Increased Endurance Vs. Decreased athletic performance
- Vasoconstriction Vs. Vasodilation
6
Q
The mechanism of caffeine tolerance Dr. Blakely describes is called:
A.Upregulation-Cell creates additional adenosine receptors
B. Depot binding
C. Reuptake inhibition D.Compensatory reaction
A
A.Upregulation-Cell creates additional adenosine receptors
7
Q
Schizophrenia-Symptoms & Theory
Theories:
- Too much Dopamine (oldest theory)
- Too much Dopamine in some areas; too little in others
A
- Positive Symptoms:
- Hallucinations
- Delusions
- Negative Symptoms:
- Flat effect
- Anhedonia (loss pf pleasure from preferred activities)
- Avolition (Lack of goal-directed Bx)
8
Q
Antipsychotic Classification
1st) Typical
A
1st) Generation/Typical
Typically dopamine antagonist E.g.Thorazine, Mellaril. Haldol, Prolixin
9
Q
Antipsychotic Classification
2nd Atypical
A
2nd Gen/Atypical
E.g. Risperdal, Zyprexa, Clozaril
10
Q
Antipsychotic Classification
3rd Atypical
A
3rd Generation/Atypical
May Function as a dopamine partial agonist E.g. Abilify
11
Q
Another common route of administration for antipsychotics is:
A. iv
B.im-Stands for?
C. inh
D. supp.
A
B.im-Stands for?
Intramuscular
12
Q
The kinetics of antipsychotics can be characterized as:
A. Having a consistent half-life of 6 hours regardless of type of antipsychotic
B. Having a wide range of half-life lengths dependent on prescription
C. Neither of these, antipsychotics have 0-order kinetics
A
B. Having a wide range of half-life lengths dependent on prescription
13
Q
Akathisia is characterized by:
A. High fever-NMS B. Inability to stay still C. Tongue-rolling and lip-smacking- Tardive dyskinesia D. Involuntary clinching of the muscles- Dystonia
A
B. Inability to stay still
14
Q
Difference Between:
- Antianxiety
- Sedative-Hypnotics
- Generic Types:
A
- Antianxiety: Typically Longer acting e.g. Valium, Librium, Xanax (Benzos)
- Sedative-Hypnotics: Typically Shorter acting e.g. Halcion, Restoril (Also Benzos) Ambien (Z-drugs)
- Generic Types: Barbiturates, Benzos, Z-drugs
15
Q
The effects of antianxiety medications are often due to the drugs:
A. Acting as a serotonin agonist
B. Increasing GABA reuptake
C. Facilitating dopamine
D. Facilitating GABA
A
D) Facilitating GABA
16
Q
Antianxiety Effects Vs. Withdrawal Effects
- Withdrawal symptoms can Vary based on: Specific drug, immediacy of drug reduction, dose
- Tolerance is: Likely; Part of abuse potential -Acute (first dose) or Chronic (from long-term use)
A
- Decreased anxiety symptoms - Increased anxiety symptoms
- Decreased muscle tension - Increased muscle tension
- Decreased seizure activity - Increased seizure activity
17
Q
The lethality risk of benzodiazepines is:
A. Typically high
B. Typically low
A
B.Typically low-However if taken in combination with high doses of alcohol or barbiturates more likely to be fatal
18
Q
Besides lethality, antianxiety/sedative-hypnotics carry risks to newborns as they:
A. Cross the placental barrier
B. Decrease lactation in women
C. Are overly prescribed to infants
D. Should not be mixed with alcohol
A
A. Cross the placental barrier
19
Q
Geller & Seifter Procedure
A
This is a screening procedure for antianxiety properties
*Tests for punishment-abolishing
effects
Multiple schedule arrangement
20
Q
What are some characteristics of depression that Dr. Blakely lists?
A
- Depressed mood through most/large portions of day
- Increase or decrease in appetite
- Increase or decrease in weight
- Increase or decrease in sleep (perhaps fatigue)
- Increase in negative self-statements
- Decreased activity enjoyment
- Feelings of worthlessness
- Inappropriate guilt
21
Q
Kinds of Antidepressants
1st Generation-Tricyclic/MOAI
A
1) Gen-Tricyclic/MOAI
Monoamine (e.g. dopamine, seratonin, norepinephrine) Ocidase inhibitor e.g. Euphozid, Parnate, Marplan
22
Q
Kinds of Antidepressants
2nd Generation-SSRI
A
Selective serotonin reuptake inhibitors e.g. Prozac, Zoloft
23
Q
Kinds of Antidepressants
3rd Generation - SNRI
A
-Selective norepinephrine reuptake inhibitors e.g. Effexor, Wellbutrin
24
Q
Serotonin syndrome symptoms may include which of the following:
A. Extrapyramidal signs and symptoms B. Agitation C. Delirium D. B and C, but not A E. All of these
A
E. All of these-Serotonin syndrome is more likely when: Someone is on multiple antidepressants or switches to higher dose
25
One reason why antidepressants don’t tend to have effects that function as reinforcing for drug taking is:
A. Effects are delayed
B. Acute tolerance occurs to effects
C. Drugs are highly likely to produce movement disorders
D. All of these
A) Effects are delayed
26
Which of the 7 Dimensions of ABA is most relevant to the measurement of depression?
A. Analytic
B. Effective
C. Behavioral
D. Has generality
C. Behavioral-e.g., calories consumed, hours slept, negative self-statements, attendance at work/school
27
Types of Seizures
1) Generalized: Both hemispheres involved & loss of consciousness
-Tonic Phase: Stiffening
-Clonic Phase: Convulsing
-Atonic: Loss of muscle control
May fall down
-Absent: "Zone out" for several moments
28
Types of Seizures
2) Partial: One part of Brain involved
- Simple: No loss of consciousness Sensory events may occur
| - Complex: Consciousness impaired May also include sensory events above May engage in automatisms
29
Type of seizure that is sometimes called a “grand mal” seizure (loss of consciousness; involves convulsing)
A. Atonic
B. Absent
C. Tonic/clonic
D. Partial complex
C. Tonic/clonic
30
Types of Anticonvulsant
1st Generation
1st Generation: Some unpleasant side effects E.g. Phenobarbital, Dilantin, Tegretol, Depakote
31
Types of Anticonvulsant
2nd Generation
May have fewer side effects E.g. Lyrica, Trileptal, Topamax
*Neuropharmocology: Enhancing GABA or Reduce neuronal activity
32
Anticonvulsant Effects
-Side Effects Vs Withdrawal Effects
- Tired Vs. Alert (maybe anxiety)
- Increase in Sleep Vs. Decrease in sleep
- Decreased Seizure activity Vs. Increased seizure activity
- Speech Prob/Memory Issues Vs. Likely improvement in these as well
33
If a drug with anticonvulsant properties is given for a different therapeutic use then withdrawal effects will not include increases in seizure activity
A. True
B. False
B) False
34
ADHD characteristics
-Symptomatic Categories: Inattentive
- Frequent task Changes
- Poor direction/instruction following
- Easily distracted
35
ADHD characteristics
-Symptomatic Categories: Hyperactive
- Restlessness
| - Lots of movement
36
ADHD characteristics
-Symptomatic Categories:
Impulsive
- Poor decision-making
| - Less sensitive to delay contingencies of SR or SP
37
Which of the following is a characteristic effect of non- stimulant ADHD medication:
A. Increase in sleep
B. Increase in activity
C. Decreased in appetite
D. All of these
A. Increase in sleep
38
```
The primary neurotransmitters involved in the neuropharmacology of stimulants are:
A. Dopamine and Norepinephrine
B. Serotonin and Epinephrine
C. GABA and Epinephrine
D. None of these
```
A. Dopamine and Norepinephrine
39
The behavioral effects of stimulants may include which of the following:
A. AO for food
B. EO for sleep
C. Punishment
D. All of these
A) AO for food
40
Correlation and experimental studies are equally likely to have systematic bias.
A. True
B. False
B) False
41
The difference between a placebo effect and a nocebo effect is:
A. The experimental design
B. The effects being measured
C. Placebo effects are seen in drugs of abuse, nocebo effects are not
D. A and B, but not C
E. All of these
B. The effects being measured
42
```
Theobromine can be found in:
A. Tea
B. Coffee
C. Cocoa beans
D. Poppy seeds
```
c) Cocoa Beans
43
Which of the following is a side effect of caffeine withdrawal?
A. Seizures
B. Sleepiness
C. Increased appetite D. Increased heart rate
B) Sleepiness
44
The two general categories of seizures are:
A. Typical and atypical
B. Dystonia and akathisia
C. Generalized and partial
C) Generalized & Partial
45
If no lose of consciousness occurs this is a _____ partial seizure.
A. Simple
B. Absent
C. Complex
D. Tonic/Clonic
A) Simple
46
Stimulants may pose a health risk if an individual has:
A. A heart condition
B. Hearing problems
C. A learning disability D. A diagnosis of ADHD
A) A heart condition
47
Caffeine: Stimulant
* Behavioral Functions
- EP for engaging in physical activity
- AO for sleep (more alert)
- SR+ for certain Bxs
* Withdrawal symptoms: Headaches, Lack of focus, tiredness, increased sleep, decrease heart rate
48
Symptoms of Schizophrenia
* Positive:
- Hallucinations
- Bizarre speech
- Delusions
* Negative:
- Anhedonia (lack of pleasure)
- Flat affect (Lack of emotion)
- Avolition (Lack of goal directness)
49
What Causes Schizophrenia?
* Theories:
- Too much dopamine activity - drugs that decreased dopamine seem to help
- Too much dopamine in some parts of the brain & too little in other parts of the brain
50
Classification of Anti-Psychotic
| 1st generation AKA: Typical (Phenothiazines)
- Older antipsychotic, more side effects, typically blocks dopamine
ex: Thorazine (Chlorpromazine) & Haldol (Haloperidol), Mellaril (Thioridazine)
- 2nd Generation AKA: Atypical: Fewer side effects or not as prevalent
- 3rd Gen: A-typical with respect to side effects
51
Akathesia:
-Restless movement, Pacing
52
Dystonia
-Clenching of muscles
53
Parkinsonisms
-Flat affect, shuffling of feet, tremors, mask like face, Uncontrolled mouth movements, etc
54
Neuroleptic
-Mallignant Syndrome: Looks like flu, fever w/ rigidity & fatal if untreated
55
Tardive dyskinesia:
-Tics, rolling tongue, abnormal movement. Can be irreversible increasing risk over time
56
Withdrawal from & Other uses for Antipsychotics
- Usually stored in fat cells & released slowly, withdrawal effects are typically mild
* Other uses:
- As anti-emetics: stops vomiting
- Tourette's syndrome (tics)
- Bx problems with ASD
- Use during alcohol detoxification
57
ANXIOLYTICS: ANTI-ANXIETY
* Phenobarbital: was used as an anxiolytic prior to the development of the benzodiazepines (can still be used for that purpose, although less freq)
* Phenobarbital: has a relatively high lethality risk
* Benzodiazepines: have a low lethality risk e.g. Valium, Ativan, Xanax, Librium
58
Anxiolytics: Anti-Anxiety
* Benzodiazepines: Some are long acting & some are short acting
- They generally have anticonvulsant properties
- Tolerance can develop very rapidly
- Can require a long fade down of the drug over months
- A high potential for Abuse!
- Withdrawal effects can be dose dependent
- Cross the placental barrier; newborns are at risk for withdrawal symptoms!
59
Antianxiety:
Gaba Receptors
- Admin -> Oral & absorbed in GI tract (IV)
- Distribution -> Brain & fat cells
- Biotransformation -> Liver
- Excretion -> Kidney
60
The Geller and Seifter Procedure
* Purpose: Screen potential anxiolytics
* Multiple schedule arrangement:
- VI food = moderate/steady responding )no drug)
- FR food + shock = Low rate responding (no drug)
- FR food + shock = elevated responding (with drug)
* Conclusion: benzodiazepines have an AO for punishment
61
CAN WE HELP TX ANXIETY?
- Bx Functions:
- Escape & Avoidance
- Respondent conditioning (Phobias) = Anxiety attacks
* Measurements:
- Self report, track: Pacing, refusals, running away, hyperventilating biting nails, hair twirling etc
* Treatments:
- Drugs, systematic desensitization (graduated exposure), relaxation techniques (mediation, yoga, etc.)
62
Symptoms of Depression
- Change in appetite
- Sleeping Less/More
- Neg Statements
- Loss of Pleasure
- Inappropriate guilt
- Feelings of Worthlessness
- Crying, Suicidal
- Fatigue
- Altered mood: sad, not engages, not joking, staying in bed
63
How can we help TX Depression?
- Can we see it? Define it? Measure it?
- % of time intervals of sleep per day
- Rate & duration of episodes of crying
- Weight data as permanent product
- Social withdraw
64
Classifications of Antidepressants
1st Gen: Tricyclics/MAOIs (Monoamine Oxidase inhibitor) e.g. Euphozid, Parnate, Marplan
*2nd Gen: SSRIs (Selective Serotonin Reuptake inhibitors) E.g. Prozac, Zoloft
(Note: Takes the longest to show a clinical effect, even @ high doses)
3rd Gen: SNRI (Selective Norepinephrine Reuptake inhibitors) E.g. Effexor, Wellbutrin
65
Antidepressants 1/2 life 3-24 hrs
- Admin -> Oral (absorbed in GI tract)
- Distribution -> Brain & liver, breast milk
- Biotransformation -> Liver & GI Track)
- Excretion -> Kidneys
66
List Side Effects of Anti-Depressants
-Side Effects:
-Dry mouth, Nausea, Headaches, Vomiting, Dizziness, Weight gain, Insomnia, Decreased Libido
67
List Side Effects of Anti-depressants
Withdrawal Effects:
-Anxiety, General Malaise
68
Side effects of Anti-Depressants
-Lethality
- Hypertension (TCA) &
| - Serotonin syndrome
69
Serotonin Syndrome
- Confusion, agitation, lethargy, coma, hyperthermia, tachycardia, nausea, vomiting, diarrhea, hyperthermia, tachycardia, nausea, vomiting, diarrhea, hyperkinesia, hyperflexia, cogging rigidity
* Causes of SS: SSRt, Lithium, Meperidine, MAOI, Triptans, Cocaine
70
Antidepressants
- Wellbutrin (Active ingredient) main effect is antidepressant & side - effect is Reduction od addictive urges
* Zyban main effect is reduction of addiction urges side effect is that it may relieve depression
* Alsl used to help individuals Quit Smoking
71
Health Concerns
- Heart issues (esp with Tricyclics)
- Serotonin syndrome: Abundance of serotonin = agitation, delirium & EPS (disorientation, confusion, anxiety)
- Bx Function: EO & AOs for food
72
Characteristics of Types of Seizures
1) Partial-Simple
* No loss of consciousness
* Involves 1 part of brain/hemisphere
* Sensory disturbances
73
Characteristics of Types of Seizures
*Partial - Complex
- Consciousness is effected or impaired
- Sensory disturbances
- Automatisms
74
Characteristics of Types of Seizures
-Generalized
- Loss of consciousness
- Both sides of brain involved
- E.g: Tonic/Clonic (granmal), atonic, absence
75
*Anticonvulsants
1/2 life: varies widely with these drugs 4-24 hrs
-Can cause harm to fetus!
- Admin -> Oral or IV
- Distribution -> Brain (passes placenta barrier)
- Biotrans-formation -> Liver
- Excretion -> Kidneys
76
Anticonvulsants: Increase GABA activity
Side effects Vs Withdrawal effects
-Terminate only under care of Doctor
- Increase Sleep Vs. Decrease sleep
- Increase Tiredness Vs. Increase alertness & energy
- Difficult to concentrate Vs. Increase anxiety
- Effects speech Vs. Improve speech
- Can harm fetus Vs. Increase Seizures
77
ADHD
- Admin -> Oral, patch
- Distribution -> Brain (release of dopamine & norepinephrine)
- Biotransformation -> Liver
- Excretion -> Kidneys
78
Chemical Treatment for ADHD
1) Amphetamine (Stimulant)
2) Non-Amphetamine (stimulant)-Less sleep, increase alertness, increase in task completion, decrease sleep
3) Non-stimulants: Increase in sleep, decrease in activity & alertness
79
Theories And Effects of Stimulants
- Behavioral fxs: AO for food, AO for Sleep, EO for physical activity
- Theories: Some stimulus more salient?
- Some stimulus less salient?
- EO to complete tasks?
80
Drug Evaluation
- Placebo
- Nocebo
* Placebo: Positive Effects, No active ingredient, Bx change in direct of drug effect
* Nocebo: Negative Effects, Reports side effects, No drug
81
Possible withdrawal effects of caffeine may include:
a. Increased headaches, lack of focus, tiredness, increased sleep,
decrease heart rate
b. Decreased headaches, alertness, decreased sleep, increased
heart rate
c. EO for engaging in physical activity, AO for sleep and SR+ for
certain behaviors
d. I could go for a coffee.
A.Increased headaches, lack of focus, tiredness, increased sleep, decrease heart rate
82
Some of the positive effects of schizophrenia may include:
a. Anhedonia (lack of pleasure), Flat affect (lack of emotion), Avolition
(lack of goal directedness)
b. Hallucinations, Bizarre speech, Delusions
c. Akathesia, Dystonia, Tardive dyskinesia
d. EPS (Parkinsonisms), Neuroleptic Malignant
e. Elvis told me not to answer this question
b. Hallucinations, Bizarre speech, Delusions
83
Anhedonia is the:
a. lack of emotion
b. lack of pleasure
c. Flat affect
d. lack of goal directedness
b. lack of pleasure
84
Antipsychotics are excreted from the body via the:
a. Liver
b. Fat cells
c. Kidneys
d. Both A & C but not B
c) Kidneys
85
Typical Anti-psychotics have ___ side-effects compared Atypical antipsychotics.
a. more
b. less
c. equal
d. no
a) More
86
The Geller and Seifter procedure is a test to screen potential ______.
a. side effects
b. anxiolytics
c. antidepressants
d. anti-psychotics
b. anxiolytics
87
Anxiety is considered:
a. A cause/explanation for behavior
b. An explanatory fiction
c. category of behaviors
d. All of the above
e. B & C only
e. B & C only: but don’t call it an explanatory fiction toothers!
88
Some antidepressant may also used:
a. to help individuals quit smoking
b. as an AO for some drugs of abuse c. as an EO for sleep
d. All of the above
e. A & B only
e) A & B only
89
Match each numbered term with the corresponding letter (definition):
1. Atonic
2. Absence
3. Tonic/clonic
A. Stiffening & convulsions
B. Loss of muscle control
C. zones out/spaces out D. Automatisms
1) Atonic: B) Loss of muscle control
2) Absence: C) Zones out/spaces out
3) Tonin/clonic: A) Stiffening & convulsions
90
What is an aura?
a. the perception of a strange light, an unpleasant smell, or confusing
thoughts or experiences
b. human energy field
c. signs that a seizure episode may be about to begin
d. A and C
e. A Dark wizard and witch catcher (auror)
d) A and C
91
An important dimension of seizures that staff & caregivers should measures are:
a. Onset and offset of auras.
b. number of seizures
c. Type of seizures
d. Duration of seizures
e. B & D.
e) B & D
92
What does impulsiveness mean from a behavior analytic perspective?
a. The person is inattentive
b. Considers delayed consequences
c. Sensitive to immediate contingencies
d. lack of rule governed behavior
c. Sensitive to immediate contingencies
93
The ____ effect is when everything is the same as the drug condition, but there is ______.
a. Placebo, no active ingredient
b. Placebo, no side effects
c. Nocebo, no active ingredient
d. Nocebo, no side effects
a. Placebo, no active ingredient
94
Antipsychotics decrease the activity of
a. Norepinephrine
b. Serotonin
c. Dopamine
d. Monoamine Oxidase
c) Dopamine
95
Benzodiazepines (Valium, Ativan, Xanax, Librium, Klonopin) often develop tolerance very rapidly leading to a high potential for abuse.
a. True
b. True only for patients with seizures
c. False
a) True
96
What might patients try if medications don’t work to decrease seizures?
a. Charlette's Web (oil derived from marijuana)
b. Ketagentic diet (high in fat)
c. Surgery
d. Vagus nerve stimulator
e. All of the above.
e) All of the above
97
When evaluating drugs the nocebo is when the patient reports ______ when they actually did not receive the drug.
a. positive effects
b. no effects
c. side effects
d. behavior change in direct of drug effect
c) Side effects
98
In general, there are less side effects as we move up the generations of anti-depressants.
A. True
B. False
a) True
99
Side effects of anti-depressants such as nausea, headaches, dizziness, insomnia, may decrease with time.
a. True
b. False
c. I’m sleepy.
a) True
100
When seizures occur there is an ___ supply of electricity in the brain. These drugs ____GABA.
a. Under, increase
b. Over, increase
c. Under, decrease
d. Over, decrease
b) Over, increase
