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66 Cards in this Set
- Front
- Back
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What is psychopharmacology?
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The study pf drug induced changes in mood, sensation, thinking, and behavior
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What are 3 characteristics of all psychiatric medications?
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1. Alter neuron function
2. Lipophilic 3. Cross the BBB |
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What are the 3 main types of psychiatric agents?
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1. Monoamines
2. Excitatory Amino Acids 3. Inhibitory Amino Acids |
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The monoamine hypothesis is based on what?
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Theory that depression is a result of depletion of monoamines specifically serotonin, NE, and dopamine
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What are the 3 main monoamines?
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1. Serotonin
2. Dopamine 3. NE |
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What do all 3 monoamines affect?
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Mood
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Serotonin exclusively affects what?
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Obsessions and compulsions
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NE exclusively affects what?
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Alertness
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Dopamine exclusively affects what?
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Attention and pleasure/reward motivation
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Where do the neurons that create serotonin originate?
Where do they innervate? |
Dorsal Raphe nuclei
Innervate the whole brain |
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What are 6 behaviors mediated by serotonin?
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1. Mood
2. Anxiety 3. Fear 4. Memory 5. Impulsivity 6. Sleep |
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What are 4 psychiatric conditions associated with serotonin?
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1. Mood Disorders
2. Anxiety Disorders 3. OCD 4. Eating Disorders |
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Where do the neurons for NE originate?
Where does NE not innervate? |
Locus cereleus
Does NOT innervate nucleus accumbens |
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What are 4 behaviors modulated by NE?
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1. Mood
2. Attention 3. Cognition 4. Sexual Function |
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What are 4 psychiatric conditions related to NE?
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1. Mood disorders
2. Anxiety Disorders 3. ADHD 4. Pain Disorders |
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Where are the 2 locations that domaminergic neurons originate from?
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Ventral Tegmental area and substantia nigra
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What 7 behaviors are mediated by dopamine?
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1. Mood
2. attention 3. Movement 4. Reward 5. Pleasure 6. Cognition 7. Psychosis |
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What are 4 psychiatric conditions related to dopamine?
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1. Schizophrenia
2. ADHD 3. Mood Disorders 4. Addictions |
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What is the most comon excitatory NT?
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Glutamate
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What 2 receptors does Glutamate activate?
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1. Metabotropic
2. NMDA receptors |
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What is the MOA of phencyclidine and ketamine?
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Block NMDA receptors resulting in effects mimicking schizophrenia
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In what 3 pathways do glutamate neurons originate from?
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1. Cortico-cortical pathways
2. Thalamo-cortical pathways 3. Extrapyramidal pathways |
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What 4 behaviors does glutamate mediate?
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1. Mood
2. Psychosis 3. Seizures 4. Learning and Memory |
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What are 3 psychiatric conditions that are related to glutamate?
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1. Schizophrenia
2. Mood Disorders 3. Alzheimers Disease |
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What is the most common inhibitory NT?
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GABA
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Aprat from GABA, what is another common inhibitory AA?
Through what receptor does it act? |
Glycine - modulation of NMDA receptor
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Where do GABA neurons originate from?
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Ubiquitous throughout CNS
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What 4 behaviors are mediated by GABA?
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1. Anxiety
2. memory 3. Sleep/consciousness 4. Seizures |
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What are 4 psychiatric conditions associated with GABA?
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1. Anxiety Disorders
2. Insomnia 3. Alcohol Withdrawl 4. Pain Disorders |
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What "Other" NT is implicated in Alzheimers Disease?
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Ach
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What receptors are altered by certain psychiatric medications and can make patients sleepy and gain weight?
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Histamine (H1) receptors
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What are the 5 therapeutic agent classes?
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1. Antipsychotics
2. Antidepressants 3. Lithium and Mood Stabilizers 4. Benzodiazepines 5. anti-Dementia Drugs |
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Are the therapeutic classes very strict?
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NO, they often overlap
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All antipsychotics share what pharmological property?
This fact led to what? |
Dopamine (D2) receptor antagonism
Led to Dopamine hypothesis of schizophrenia |
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Agents that increase synaptic dopamine can do what?
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Result in psychosis
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Mesocortical dopaminergic dysregulation causes what?
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Negative Symptoms - social isolation, poor hygiene
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Mesolimbic dopaminergic dysregulation causes what?
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Positive symptoms - delusions, perceptual disturbances
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Nigrostriatal and Tuberinfundibular dopaminergic dysregulation cause what?
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Side Effects
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Usually, side effects are what?
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Dose dependent and REVERSIBLE
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Nigrostriatal dopaminergic dysregulation can give what?
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Parkinson like symptoms
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Tuberinfundibilar side effects are what?
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Prolactin Effects
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What side effect is NOT reversible?
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Tardive Dyskinesia
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What negative heart side effect can antipsychotics cause?
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QTc prolongation - can cause fatal arrythmias
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Antipsychotics are classified into what 2 categories?
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1. First Generation (typical)
2. Second Generation (atypical) |
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How do high potency first gen drugs compare to low potency?
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High Potency - low side effects bc less antihistamine, antiadrenergic, and antocholinergic effects
Low Potency - more side effects because more of the above effects |
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What are 2 common antihistaminic side effects?
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Weight gain
Sedation |
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What are 2 antiadrenergic side effects?
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1. Orthostasis - head rush / dizziness
2. Arrythmias |
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Second generation drugs also have effects on what pathway?
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Serotonin
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The newer atypical (2nd gen) antipsychotics are derivatives of what drug?
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Clozapine
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What makes Atypicals "better" than typicals?
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They are NOT more effective but they ARE better tolerated
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Atypicals are usually associated with what side effect profile?
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Weight gain, metabolic syndrome
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What is the main role of antodepressants?
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Increase monoamines
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What are the 4 main kinds of antidepressants?
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1. Monoamine oxydase inhibitors (MAOIs)
2. Tricyclic Antidepressants (TCA) 3. Serotonin reuptake Inhibitors (SSRIs) 4. serotonin Norepinephrine Reuptake inhibitors (SNRI) |
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What side effects / restrictions are seen with MAOI's?
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MOA breaks down tyramine so patients must avoid this (in aged, pure foods)
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Is there a difference in the effectiveness of different antidepressants in curing depression?
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NO
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What is the safest and best tolerated antidepressant?
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SSRIs
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What antidepressant can help to remove comorbid pain symtoms?
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SNRIs
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Do antidepressants actually cause increased suicidality?
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No, just brings emotions to the surface
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What is the primary treatment for bipolar affective disorder?
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Mood stabilizers
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Mood stabilizer medication includes what?
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Lithium and anti-convulsants
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Is the MOA known for lithium?
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NO
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Are mood stabilizers usually associated with side effects?
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Yes, significant side effects
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What is the MOA of benzodiazepines?
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Increase GABA by increasing the frequency of GABA mediated chloride channel ion opening and causing neuronal hyperpolarization
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What is the main use of Benzo's?
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Most common sedative used in psychiatry
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Where are benzodiazepines metabolized?
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In the liver - so beware in alcoholic patients
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What are the only 2 medications useful in treating dementia?
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1. Acetylcholinesteract inhibitors
2. NMDA receptors antagonist |
