Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
135 Cards in this Set
- Front
- Back
Drug |
A chemical that in relatively small amounts effects physiology |
|
Everything is a poison depending on its ____ |
Dose |
|
Psychopharmacology |
The study of how drugs effect the brain, interact with the brain, and how the body effects the drugs to interact with the brain |
|
The neural tube becomes ___ and ___ |
The brain and spinal column |
|
The neural tube "zips" together from ___ to ___ & ___ |
Middle, caudal and rostral |
|
Cell proliferation |
A process that increases the number of cells; most prominent in the 2nd trimester |
|
Cell migration |
A process in the development and maintenance of tissues during development, injury, and immune responses |
|
Synaptogenesis |
Formation of synapses between neurons in the NS. Occurs after growth cone reaches Target neuron |
|
Organization of the brain determines its ____ |
Function |
|
The 3 important parameters in brain organization |
1. Density of neurons, 2. pattern of axon and dendrite branching, and 3. pattern of synaptic contacts |
|
Parasympathetic preganglionic neurons use ____ as their main neurotransmitter |
Acetylcholine |
|
Preganglionic neurons are located in either the ___ or ____ |
Brain stem or spinal chord. |
|
Postganglionic sympathetic neurons are ____ receptors |
Adrenergic |
|
Postganglionic parasympathetic neurons are _____ |
Cholinergic |
|
Effects of norepinephrine and epinephrine vary among different target cells according to the types of ____ receptors they express |
Adrenergic |
|
Adrenergic receptors are ____ & ____ |
Alpha 1&2 and Beta 1&2 |
|
Two types of acetylcholine receptors |
Muscarinic and nicotinic |
|
Muscarinic and nicotinic receptors connect to ____ muscles and are responsible for voluntary movement |
Striatum |
|
Parasympathetic action = increased ____ activity |
Acetylcholine |
|
Which "gets your juices flowin'," cholinergic or anticholinergic? |
Cholinergic. Anticholinergic = constipation |
|
Pharmokinetics |
How the body effects the drug |
|
Pharmacodynamics |
How the drug effects the body |
|
ADMET |
The absorption, distribution, metabolism, elimination, and time (how fast and how long a drug will appear at the Target) |
|
Half life |
Time to eliminate 1/2 of the drug in the body |
|
Half life depends on both ____ and ____ |
Volume of distribution and clearance |
|
T1/2 = ____ |
0.7 x volume of distribution ÷ clearance (0.7 is an approximate #) |
|
The Blood Brain Barrier |
A layer of brain epithelial cells that allow water, some gasses, selective transport molecules, and lipid-soluble molecules to pass into the brain |
|
Aside from the BBB, ___ cells also serve as a barrier |
Glial cells |
|
___ and ___ are hydrophobic and pass the blood brain barrier |
H and C |
|
___ and ___ become polar and attract water due to hydrogen bonding and cannot pass the BBB |
O and N |
|
A ___ charge attracts more water and ____ lipid solubility |
Positive, lowers |
|
The change in charges in the BBB causes a change in ___ as well |
pH |
|
The ease at which a drug passes the ____ BBB impacts their psychoactive effectiveness |
Blood Brain Barrier |
|
____ is the primary energy source for the brain |
d-glucose |
|
Why does heroin feel more potent than morphine? |
Heroin is more lipid soluble and passes the BBB 2-3x more effectively |
|
Define Ligand |
An Ion molecule that binds to a channel (i.e. a neurotransmitter, component of a drug) |
|
Ligand gated ion channel |
A group of ion channel proteins which open to allow ions (Na, K, Ca, etc) to pass through the membrane in response to the chemical messenger |
|
The function of G-protein coupled receptors |
They detect molecules outside the cell and activate cellular responses. |
|
Define agonist |
A chemical that binds to a receptor and activates it to produce a biological response |
|
Define antagonist |
A type of receptor ligand or drug that blocks a biological response by binding and blocking a receptor rather than activating it |
|
Partial Agonist definition |
Drugs that bind to and activate a receptor but only have partial efficacy in relation to a full agonist |
|
Inverse agonist |
A drug that binds to the same receptor as an agonist but induces a response opposite to the agonist. |
|
Define partial inverse agonist |
A drug that binds to the same receptors as an agonist, but induces the opposite effect of an agonist, in a lesser effect than a full inverse agonist |
|
What % of people with depression receive treatment? |
Less than 25% |
|
Of those with depression that get treatment, ___ receive inadequate treatment |
1/3 |
|
Of those with depression, less than ___ receive adequate treatment |
10% |
|
Risk of depression is ____ in women |
Higher |
|
Risk of depression is ___ in first degree relatives |
Higher |
|
Of those with depression, ___ will respond and recover |
70% |
|
Of those with depression, ___ of non-responders will respond to ECS therapy |
20% |
|
Of those with depression, ___ will not respond to any treatment |
10% |
|
Norepinephrine is synthesized from amino acid ____ |
L-tyrosine |
|
Function of tyrosine hydroxylase |
Responsible for catalyzing the conversion of the amino acid l-tyrosine for dopamine production |
|
Function of DOPA decarboxylase |
Responsible for the synthesis of dopamine from L-DOPA |
|
Function of dopamine beta- hydroxylase |
The only enzyme involved in the synthesis of small-molecule neurotransmitters, i.e. norepinephrine |
|
Locus Coeruleus neurons project to the ____ |
Cerebral cortex |
|
Antidepressants elevate ___ and ___ levels |
Norepinephrine and serotonin |
|
Antidepressants have a ___ week lag time for clinical improvement |
2 week |
|
Changes in receptor levels in depression appear to correlate with changes in ____ |
Mood |
|
TCA stands for... |
Tricyclic Antidepressants |
|
TCA antimuscarinic effects include: |
Memory dysfunction, dry mouth, increased eye pressure in glaucoma patients, constipation, decreased sweating, and blurred vision |
|
TCA cardiovascular effects include: |
Tachycardia, elevated norepinephrine, hypotension |
|
TCA use should be limited in patients with: |
Congestive heart failure, orthostatic hypotension, and advanced cardiovascular disease |
|
TCA ____ vary widely, and may contribute to variability in effectiveness |
Half life |
|
Trazadone blocks ___ adrenergic receptors and ___ receptors |
A1, H1 |
|
Trazadone side effects include: |
Tachycardia, hypotension, may contribute to priapism, sedation |
|
Bupropion (Wellbutrin, Zyban) is a ___ and ___ reuptake inhibitor |
Dopamine and norepinephrine |
|
Bupropion is as effective as ___ and ___ in treatment of depression |
TCAs, SSRIs |
|
Bupropion is ineffective in treatment of ___ |
Panic disorder |
|
___ Reported to be effective in promoting smoking cessation |
Wellbutrin |
|
Adverse effects of bupropion (Wellbutrin, Zyban) |
Insomnia, agitation, tremors, sweating, weight loss, seizures, diarrhea, sexual dysfunction |
|
Dopamine activity can exacerbate psychosis in schizophrenia on this specific drug: |
Bupropion (Wellbutrin, Zyban) |
|
Bupropion is the generic name for: |
Wellbutrin, Zyban |
|
Due to their half lives, how many doses of SSRIs are needed per day? |
Once |
|
Long half life of norfluoxetine suggests a delay of ____ is required after stopping use before starting MAO inhibitor |
1-3 month |
|
Gastrointestinal side effects of SSRIs |
Nausea, diarrhea, abdominal pain |
|
CNS side effects of SSRIs |
Anxiety, akathisia and agitation, insomnia |
|
Endocrine effects in SSRIs |
Sexual dysfunction in men |
|
Symptoms of serotonergic syndrome |
Excitement, diaphoresis, rigidity, hyperthermia, tachycardia, hypotension, coma, even death |
|
____ have serious, even potentially fatal interaction with MAO inhibitors |
SSRIs |
|
Elderly metabolize ___ more slowly |
SSRIs |
|
Avoid use of this drug class during pregnancy |
SSRIs |
|
This class of drug has been known to activate mania |
SSRIs |
|
MAOI inhibits the activity of ___ |
Monoamine oxidase |
|
There are ___ isoforms of MAO |
2 |
|
MAOA metabolises ____ and ___ |
Norepinephrine and serotonin |
|
MAOB metabolizes ____ |
Dopamine |
|
Most MAO inhibitors are irreversible except ____ |
Moclobemide |
|
Tyramine is a naturally occurring amine found in: |
Cheeses, wines, certain foods (pickled fish, chocolate, coffee, yeast) |
|
Tyramine is oxidized by ___ |
MAO |
|
If tyramine is not metabolized, it can cause: |
Hypertension, headache, fever, intracranial bleeding, death |
|
Lithium may be less effective in treating patients with _____ |
Rapid cycling |
|
In patients with rapid cycling, ___ and ___ may be more effective than lithium |
Lamotrigine (Lamictal) and carbamazepine (tegretol) |
|
____ may act by blocking inositol 1-phosphate in neurons with subsequent interruption of the 2nd messenger system |
Lithium |
|
____ reduces neuron responsiveness to muscarinic, alpha adrenergic, cholinergic, etc stimuli |
Lithium |
|
It is postulated that ___ stabilizes catecholamine receptors and may increase GABA activity |
Lithium |
|
Li+ has a ____ therapeutic index |
Low |
|
____ levels should be monitored every 2-3 days at first, then weekly for 4 weeks, then monthly, then quarterly |
Lithium |
|
____ treatment should be interrupted if patients exhibit fever, vomiting, or diarrhea |
Lithium |
|
___ treatment should be discontinued if patients will undergo surgery, have heart failure, or receive diuretics |
Lithium |
|
Lithium is safe for pregnancy after the ___ trimester |
The 1st trimester |
|
Gastrointestinal side effects of lithium |
Nausea, vomiting, diarrhea |
|
CNS side effects of lithium |
General weakness, fine tremors |
|
Cardiovascular side effects of lithium |
EKG changes, arrhythmia |
|
Lithium impacts on kidneys: |
Polyurea due to reduced sodium reabsorption |
|
Lithium impacts on endocrine system |
Weight gain due to reduced thyroid function, diabetes |
|
Dermatological impacts from lithium |
Rash and acne, psoriasis, hair loss |
|
Hematologic impacts of lithium |
High white blood cell count |
|
What are lithium toxicity levels? |
Mild to moderate: 1.5-2.0mEq/L Severe: 2.5-4.0mEq/L |
|
What are symptoms of mild to moderate lithium toxicity? |
Nausea, headache, vomiting, diarrhea, coarse tremor, ataxia, slurred speech, and confusion |
|
Li overdose treatments: |
Fluids and electrolyte replacement, forced diuresis with mannitol, urinary alkalinization, hemodialysis |
|
Which anticonvulsants exhibit some utility in the treatment of bipolar disorder? |
Depakote, Tegretol, and Lamictal |
|
How does Tegretol work for bipolar? |
It increases the inhibitory control of GABA, making it harder for neurons to fire. |
|
Indications for Tegretol |
manic phase of BD, rapid cycling in BD, treating depressive phase with antidepressants (to prevent mania or rapid cycling), to augment Antidepressants in tx-resistant depression |
|
Mechanism of Tegretol |
Blocks voltage dependent Na channels and inhibits paroxysmal depolarization shifts |
|
Tegretol is not recommended in pregnancy due to risk of |
Neural tube defects |
|
Tegretol side effects are reduced by: |
Slowly increasing dose |
|
Gastrointestinal side effects of Tegretol |
Nausea, vomiting, constipation, loss of appetite, diarrhea |
|
CNS side effects of Tegretol |
Sedation, dizziness, ataxia, confusion |
|
You can use ___ either alone or with lithium to treat BD and schizoaffective |
Depakote |
|
Depakote is more effective than ___ in rapid cycling |
Li |
|
____ may be effective in treating depression compared to Tegretol or Li |
Depakote |
|
Pharmacodynamics of depakote |
Decreased GABA metabolism with secondary increase to GABA concentration. |
|
Dosing of Depakote |
TID due to 8-10.5 hr half life |
|
Pharmacokinetics of depakote |
Metabolized by liver via beta oxidation, glucuronidation, and P450 |
|
What's the word on depakote and pregnancy? |
Should not be used in pregnancy or breastfeeding, neural tube defects, fatal clotting abnormalities in infants |
|
Side effects of depakote |
Sedation, dizziness, nausea, vomiting, pancreatitis early in Tx |
|
Pharmacodynamics of Lamictal |
Unknown, but may effect sodium channels that modulate the release of excitatory transmitters |
|
____ has a weak inhibitory effect on 5HT3 receptors |
Lamictal |
|
Most common side effects of Lamictal |
Sedation, dizziness, diplopia, ataxia, decreased coordination, rash, steven-johnson syndrome, irritability, agitation, anxiety, depression, mania |
|
Indications of (gabapentin) neurontin |
Reports of effectiveness in mania may have been premature, although widely used in BD |
|
Gabapentin is chemically related to ____, but does not act as ____ receptors. In fact, it may inhibits the reuptake of ___ |
GABA |
|
Side effects of gabapentin |
Somnolence, fatigue, ataxia, dizziness, weight gain, appetite change, easy bruising, joint pain, tremor, blurred vision, hostility |
|
Mechanism of topamax |
Blocks voltage-sensitive sodium channels and augments GABA activity while inhibiting NMDA-glutamate receptors |
|
Adverse effects of Topamax |
Dizziness, drowsiness, ataxia, constipation, nausea, vomiting, kidney stones |