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Pharm35

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robbypowell's version from 2016-12-02 12:30

Psychopharmacology

Question Answer
what is the major class of drugs to treat schizophrenia?Antipsychotics (formerly neuroleptics or major tranquilizers)
what is the major class of drugs for affective disorders (depression, mania, bipolar disorders)?antidepressants (and lithium)
CNS disorder that impairs processes and ability to function... loss of contact with reality (psychoses)Schizophrenia (the worst description of schizophrenia i've ever read, Moz)
Do patients with positive or negative symptoms have better success with pharmacotherapy?Positive
T/F: Schizophrenia has a significant genetic componentTrue (according to this... so just go with it. but don't believe it in your own life)
According to one hypothesis of schizophrenia's etiology... it is cause by hyperactivity of what neurotransmitter pathway?Dopamine
according to the Monoamine hypothesis of depression, the cause is a deficiency of ______, ________, or both at central synaptic sitesNorepinephrine; Serotonin (5HT)
depletors of Neurotransmitters such as ______ produce depressionReserpine
Antipsychotics mainly act as _____ receptor antagonistsDopamine (block effects of dopa)
T/F: Benzodiazepines can be used in conjunction with antipsychotics for greater effectiveness of antipsychotic therapyTrue
What is the prototype drug for Classic Antipsychotics?Chlorpromazine
What is the prototype drug for Atypical Antipsychotics?Clozapine
T/F: Classic Antipsychotics, such as Chlorpromazine, block nearly ALL dopa receptors widelyTrue (can induce Dystonia, Parkinson-like syndrome, akathisia, and tardive dyskinesia)
T/F: Atypical Antipsychotics, such as Clozapine, block nearly ALL dopa receptors widelyFalse (Classical such as Chlorpromazine do this)
Atypical Antipsychotics such as Clozapine more selectively block ______ and _____ pathways; Clozapine specifically is more selective for blocking ___ & ___ receptors (also serotonin)Mesolimbic; Mesocortical;; D1 & D4
Rank these phenothiazine substitution groups based on effectiveness: Piperazines, Piperidines, Aliphatics; Rank them based on anticholinergic effectsPiperAZINES > Aliphatics > PiperIDINES; reverse order for anticholinergic effects
T/F: Most antipsychotics decrease the threshold for seizuresTrue (so must use caution with epileptic patients)
T/F: Most antipsychotics increase the threshold for seizuresFalse (decrease, making it easier to have seizures... so must use caution with epileptic patients)
Which 3 antipsychotic is also an effective anti-emetic (stop throwing up) via inhibition of the CRTZ in the brain?Chlorpromazine, Prochlorperazine and Droperidol
T/F: Most antipsychotic drugs disrupt thermoregulation at high doses via hypothalamic effectsTrue
T/F: Antipsychotic agents can be useful for epinephrine reversalTrue (due to anti-adrenergic effects)
What Dopa Agonist is used for treating Hyperprolactinemia induced by antipsychotics?Bromocriptin
What endocrine hormone level is affected by Antipsychotics... ---> ______-emiaProlactin ---> Hyperprolactinemia
Antipsychotics affect thermoregulation by their effects on the ______Hypothalamus
What are the cardiovascular side effects of antipsychotics?Orthostatic Hypotension
T/F: Antipsychotics can be produce (rarely) the fatal neuroleptic malignant syndrome or hyperthermiaTrue
Rank these antipsychotics from most to least potent; rank them from most to least sedativeHaloperidol > Fluphenazine > Thiothixene > Trifluoperazine > Thioridazine > Chlorpromazine; reverse order for sedative effects of drugs
T/F: Antipsychotics is used in the control of manic phase of bipolar disorder, hallucinations associated with alcohol withdrawal and hiccupsTrue
T/F: Antidepressants is used in the control of manic phase of bipolar disorder, hallucinations associated with alcohol withdrawal and hiccupsFalse
What drug is used to treat Tourette's syndrome?Pimozide
What antipsychotic drug can cause agranulocytosis?Clozapine
Prolonged use of what psychopharmacotherapeutic type of drug causes a decrease in leukocyte count?Antipsychotics
Most antidepressants increase the concentration of what 2 neurotransmitters in the brain?Norepinephrine & Serotonin (5HT) (this is consistent with Monoamine Hypothesis)
T/F: Antidepressant drugs can cause dec number or sensitivity of alpha2 and 5HT presynaptic receptors and beta postsynaptic recep with very little change in other postsynaptic receptor mechanismsTrue
T/F: Antipsychotic drugs can cause dec number or sensitivity of alpha2 and 5HT presynaptic receptors and beta postsynaptic recep with very little change in other postsynaptic receptor mechanismsFalse
What 2 classes of antidepressants are considered 1st generation antidepressants?• Tricyclic antidepressants (TCA) and monoamine oxidase inhibitors (MAOI)
The structure of TCA (Tricyclic Antidepressants) is a modified ______ (antipsychotic)Phenothiazine
What is the "prototype" TCA?imipramine
What type of drugs are: imipramine, amitriptyline, doxepin, & desipramine?Tricyclic Antidepressants (TCA)
What generation of antidepressants raise serotonin levels in synaptic sites by either inhibiting their re-uptake or breakdown?1st gen (TCA's and MAOI's)
memorize
T/F: Acute Overdosage CNS
Question Answer
How long does it take for TCA's to have an antidepressant effect?2-3 weeks
How long does it take for TCA's to increase the synaptic concentration of serotonin and norepi?Immediate (though antidepressant effect takes 2-3 weeks)
What are the ANS side effects caused by TCA's?Anticholinergic effects of Increased Sweating & Sexual Dysfunction
T/F: TCA's initially cause insomnia, restlessness & fatigueTrue (but then tolerance develops and these initial side effects subside)
T/F: TCA's have diverse unrelated structures of many different compounds with no unifying structure (chemically unrelated to each other)False (MAOI's are the antidepressants that this is true for)
T/F: MAOI's structure is a modified phenothiazineFalse (this is true of TCA's which are all modified Phenothiazine) (MAOI's are structurally diverse and chemically unrelated to each other)
T/F: MAOI's have diverse unrelated structures of many different compounds with no unifying structure (chemically unrelated to each other)True
List 4 drugs that TCA's have drug interactions with?MAOI's, Guanathedine, Amphetamine, & Clonidine
T/F: most MAOI's are non-specific in terms of which MonoAmine Oxidases that they inhibit (affect them all globally)True
T/F: most MAOI's are specific to Monoamine Oxidase in the CNSFalse (most are non-specific)
Class of drugs that can have lethal interaction with Foods containing Tyramine (chocolate, alcoholic beverages and cultured/fermented products like cheese, soy sauce, kim chi)MAOI's
T/F: TCA's are less effective and have more side effects than MAOI'sFalse (vice-versa, benefit of MAOI's is they can work for depression that is not successfully treated by TCA's)
T/F: MAOI's are less effective and have more side effects than TCA'sTrue (benefit of MAOI's is that they can work for atypical depression... i.e. depression that is non-responsive to TCA's)
T/F: MAOI's cause Serotionin Syndrome when given with SSRI'sTrue
T/F: TCA's cause Serotonin syndrome when given with SSRI'sFalse (true for MAOI's)
What class of drugs causes Serotonin Syndrome when given with SSRI's?MAOI's
MAOI's and what opioid analgesic can produce a fatal reaction?Meperidine
What antidepressant class induces hypotension when general anesthesia is administered?MAOI's
What is the only 2nd and 3rd gen anti-depressant that causes weight loss rather than weight gain?Bupropion***
Buproprion's adverse effects differs from all other 2nd and 3rd gen antidepressants in what 2 ways?minimal CV effects; cause weight loss (rather than gain)
Caution should be used when prescribing 2nd or 3rd gen antidepressants to CVD patients... except for which drug because it has minimal CV effects?Bupropion
Fluoxetine, Fluvoxamine, Sertraline & Paroxetine are what class of drugs?Selective Serotonin Reuptake Inhibitor
this class of antidepressants can increase bleeding when given with warfarinSSRI (selective serotonin repute inhibitor)
Lithium Salts (antimaniac) is a mood stabilizer and has a (high/low) Therapeutic IndexLow
memorize

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