NSG552 Psychopharmacology Exam 1 91 questions and answers
What are the 6 general principles of psychopharmacological treatment? - answer Safety
Tolerability
Efficacy
Practicality
Treatment accessibility
Treatment compliance
Pharmacokinetics - answer How the drug moves in the body. (ex. Where is it absorbed? How and where is it metabolized? Where is it excreted?)
Pharmacodynamics - answer What the drug does to the body. (consider mechanism of action)
Define First-generation antipsychotics - answer Referred to as Typical Antipsychotics. Most have strong bond with D2 receptors only, cause EPS symptoms faster due to prolonged receptor dissociation, have more dangerous side effect profiles, have been around longer, more effective at treating positive symptoms, less expensive. (Ex. Haloperidol, Chlorpromazine, Thioridazine, Fluphenazine)
Define Second-generation antipsychotics - answer Referred to as Atypical Antipsychotics. Most have a weak bond with D2 receptors and block serotonin receptors leading to anti-depressive and anxiolytic effects. They cause less EPS due to rapid receptor disassociation which leads to rapid dopamine neurotransmission. Have less dangerous side effect profiles but can cause metabolic syndromes, have been around shorter time, more expensive, more effective at treating negative symptoms but can treat positive symptoms as well, long-acting injections available for several of these. (Ex. Risperidone, Clozapine, Quetiapine, Aripiprazole, Ziprasidone) Extra Pyramidal Symptoms (EPS) - answer Side effects caused by certain antipsychotic medications, which include: involuntary or uncontrollable movements. tremors. muscle contractions.
Tardive dyskinesia - answer A neurological disorder characterize by involuntary movement of the face and jaw.
Upregulation - answer Occurs through chronic use of antagonists which causes an increase in the number of receptors, externalization of receptors, and increased sensitivity of the receptors.
Prolonged use of antagonist -> Up-regulation of receptors -> Sudden withdrawal of antagonist ->
increased number of receptors and increased sensitivity of receptors *YOU MUST GRADUALLY TAPER A DRUG TO AVOID BINDING TO ALL NEW RECEPTORS FROM UPREGULATION
Down regulation - answer Occurs by chronic exposure of agonists which causes decreased number of receptors, internalization of receptors, and decreased sensitivity of the receptors. Prolonged use of agonist -> down-regulation of receptors -> decreased effectiveness of agonist mediated clinical response.
You have two options:
1 Increase the drug dose OR 2 Switch to another drug(BEST OPTION)
Receptor profile - answer The receptors that each drug binds to
(example, risperidone's receptor profile would like...
(a) Blockade of 5HT2A and D2 receptors
(b) High affinity for a1, a2, and H1 receptors)
Binding - answer Refers to a drug metabolite or neurotransmitter attaching to a receptor
Affinity - answer refers to the "preference" or likelihood of a drug to bind to a certain receptor. Linked to potency.
CYP450 - answer A group of enzymes in the liver that metabolize different drugs. There are six. List the 7 CYP450 Enzymes - answer (1) CYP1A2 (2) CYP2B6 (3) CYP2C9
(4) CYP2C19 (5) CYP2D6
(6) CYP3A4
(7) CYP2EI
CYP2B6 - answer Metabolizes arteminsin, bupropion, cyclophosphamide, efavirenz, ketamine, and methadone (2B6, there are two psych drugs (bupropion, methadone (ketamine...?) and six altogether.
CYP1A2 - answer metabolizes AcetAminophen (two As)
CYP2C9 - answer metabolizes Warfarin/Coumadin (think warfarin factors 2, C, 9)
CYP2C19 - answer metabolizes PPIs, antidepressants, antiplatelet, antifungals, and anticancer drugs (2C19, two see one, there is only one class of psych drugs that are metabolized, you ONLY SEE one! antidepressants)
CYP2D6 - answer Metabolizes Cardiovascular drugs (2-D echo, echo is a test for heart)
CYP3A4 - answer Most common and ambiguous (if not above, then it's this one, a lot of psych drugs are involved with this one)
CYP2EI - answer ETOH (You have to be 21 to drink)
CYP450 inhibitors - answer Decreases drug metabolism:
