Pharmacology - Exam 2E - Antidepressants And Antipsychotics

Front 1

What drug was historically used to treat hypertension and schizophrenia?

Back 1

Reserpine

Front 2

What is the method of action of reserpine?

Back 2

It inhibits the storage of amine neurotransmitters in the brain

Front 3

Levels of what neurotransmitters in the brain are thought to be the cause of depression?

Back 3

5-HT (Seratonin) and Norepinephrine

Front 4

What is depression ultimately caused by?

Back 4

Decreased amine-dependent synaptic transmission

Front 5

What is the prototypical agent for tricyclic antidepressents?

Back 5

Amitriptyline

Front 6

- What are the elimination half-lives?
- How many half lives does it take to reach a steady state?
- How long does it take to see any clinical significance?
- Why is this?

Back 6

- 12-76 hrs
- 5 half-lives
- Weeks to months
- Due to remodeling of neuronal networks

Front 7

What is the method of action for Amitriptyline?

Back 7

Non-specifically inhibit storage of serotonin and norepinephrine in the CNS
Accounts for therapeutic effects

Front 8

What other receptors does Amitriptyline bind too?

Back 8

Adrenergic
Histominergic
Cholinergic

Front 9

What are the adverse effects of using Amitriptyline?

Back 9

α-adrenergic - hypotension
Histaminergic - drowsiness
Cholinergic - SLUD (Salivation, Lacrimation, Urination, Defacation)

Front 10

What is Amitriptyline a secondary agent too?

Back 10

SSRI's (Selective Seratonin Reuptake Inhibitors)
SNRI's (Selective Norepinephrine Reuptake Inhibitors)

Front 11

What is the method of action for Trazodone?

Back 11

- serotonin antagonist and reuptake inhibitor (SARI)
- more specific for serotonin than Tricyclic antidepressents

Front 12

What is Trazodone used for?

Back 12

Depression and Insomnia

Front 13

What are the adverse reactions associated with using Trazodone?

Back 13

Less than Tricyclic antidepressents
Usually just drowsiness

Front 14

What are the specific drugs that are SSRI's (Selective Seratonin Reuptake Inhibitors)?

Back 14

Fluoxetine (Prozac)
Paroxetine (Paxil)
Citalopram (Celexa)
Escitalopram (Lexapro)
Sertraline (Zoloft)

Front 15

What is the prototypical SSRI drug on which all others are based chemically?

Back 15

fluoxetine (Prozac)

Front 16

What is the method of action of SSRI's (Selective Seratonin Reuptake inhibitors)?

Back 16

Decreases Seratonin reuptake which increases Seratonin levels in the CNS

Front 17

What are the drugs of choice for initial treatment of depression?

Back 17

SSRI's

Front 18

What are the adverse effects of the SSRI's?

Back 18

Similar to Tricyclic Antidepressents but to a much lesser severity and frequency

Front 19

What are the SNRI (Selective Norepinephrine Reuptake Inhibitor) drugs?
Which one is the prototypical agent on which the other drugs are based?

Back 19

bupropion (Wellbutrin) – prototypical agent
venlafaxine (Effexor)
duloxetine (Cymbalta)

Front 20

What is the Mode of action for the SNRI's?

Back 20

Decreases the reuptake of both Seratonin and Norepinephrine at the synapse

Front 21

What is the greatest use of SNRI's?

Back 21

Most effective in treating antidepression along with anxiety

Front 22

What is the drug of choice for treating bipolar disorder?

Back 22

Lithium

Front 23

What are the ions that Lithium competes with?

Back 23

Mg++, K+, Na+, Ca++

Front 24

What is the Mode of action of Lithium in the CNS?

Back 24

Competes with overactivity of neurotransmitters thought to contribute to mania

Front 25

What are the adverse effects of Lithium in the CNS?
In the GI?
In the Muscular system?

Back 25

Dizziness, Lethargy, and Memory loss
Metalic Taste
Hand Tremors, Muscle Weakness

Front 26

What are the implications for use of Antidepressents in regards to dentistry?

Back 26

Decreased compliance with oral hygiene
Be careful placing the patient back in the chair for treatment or x-rays

Front 27

What are the positive symptoms of Schizophrenia?

Back 27

hallucinations
delusions
thought disorders
insomnia
bizarre behavior

Front 28

What are the negative symptoms of Schizophrenia?

Back 28

apathy
a motivation
anhedonia (lack of pleasure from normal pleasurable experiences), asocial behavior

Front 29

What is the prototypical antipsychotic agent?
What is its mode of action?

Back 29

chlorpromazine (Thorazine)
Non-specifically inhibit dopamine at the level of its D2 receptor

Front 30

Of the adverse reactions that stem from Antipsychotics where do the extrapyramidal symptoms come from?

Back 30

Due to dopamine effects on tracts other than mesocorticolimbic

Front 31

What are the early onset Extrapyramidal symptoms that are caused by antipsychotics?

Back 31

- Dystonia : muscle spasms - limbs and facial muscles
- Pseudoparkinsonism
More due to BLOCK of DA

Front 32

What are the intermediate onset Extrapyramidal symptoms associated with antipsychotic drugs?

Back 32

Akathisia or Restlessness

Front 33

What are the newer generation antipsychotics?

Back 33

risperidone (Risperdal)
quetiapine (Geodon)
olanzapine (Zyprexa)
aripiprazole (Abilify)

Front 34

What is the mode of action of the newer generation of antipsychotic drugs?

Back 34

- Inhibit serotonin at the level of its receptors (specifically)
- Also inhibit D2 receptors

Front 35

What is the use of the newer generation of antipsychotic drugs?

Back 35

First line agents for treatment of psychosis

Front 36

What are the adverse effects of the newer generation antipsychotics?

Back 36

Same as the typical antipsychotics but less severe and frequent

Front 37

What are the implications for using antipsychotic drugs in dentistry?

Back 37

- Neuroleptic facial movements
- ↑ sedation when given with opioids
- ↑ oral candidiasis (agranulocytosis, leukocytosis)
- ↓ salivation
- NSAIDs - interaction with lithium