1
Q
What do psychologists need to know about psychopharmalogical treatments? (4)
A
- Likely impact on disorder
- Side effects
- Common interactions
- Proprietary names
2
Q
Common street drugs psychologists need to know about? (7)
A
- Marijuana
- Heroin/opiods
- Cocaine
- Methamphetamine
- Hallucinogenics
- Alcohol
- Inhalants
3
Q
What is pharamcodynamics?
A
How an agent (drug) has an impact. (Inhibiting or activating receptors/enzymes etc).
4
Q
What is pharmacokinetics?
A
The way in which a psychotropic agent is passed through the body.
5
Q
What are the four processes of pharmacokinetics? HINT: DAME PHARMACO
A
- Absorption (into bloodstream)
- Distribution (into CNS)
- Metabolism (generally in liver)
- Elimination (urination/respiration)
D - A - M - E
6
Q
What does half-life mean?
A
Average time it takes to eliminate one half of the drugs concentration from the system.
7
Q
What is the “Therapeutic Index”?
A
Ratio of drug effectiveness (therapeutic dose) to drug toxicity.
8
Q
Should a Therapeutic Index be high or low ideally?
A
High. A high therapeutic index indicates risk of toxicity is lessened. E.g. safer drug 3000: versus morphine 70:1
9
Q
What does it mean for a prescribed drug to be antagonistic?
A
Counters the effect of other drugs.
10
Q
Name depressants (5). Hint: in a HAAIS
A
- Alcohol
- Inhalants
- Sedatives
- Anxiolytics
- Hypnotics
11
Q
Name opioids (3)
A
- Heroin
- Morphine
- Codeine
12
Q
Name hallucinogens (4)
A
- Mescaline
- PCP
- LSD
- Psilocybin
13
Q
Name stimulants (3)
A
- Cocaine
- Caffeine
- Amphetamines
14
Q
Name 3 largest classifications of psychotropic medications (3)
A
- Mood stabilisers
- Antipsychotics
- Antidepressants
15
Q
Bodily processes impacting pharmacokinetics?
A
- Liver impairment
- Renal impairment
- Gastro motility
16
Q
Personal characteristics impacting pharmacokinetics?
A
- Age
- Physiological functioning
- Gender
- Disease status
- Nutrition
17
Q
What is a psychotropic?
A
Substance affecting mood, perception, behaviour.
18
Q
What is acetylcholine involved in?
A
Memory, Learning and Attention
19
Q
What is epinephrine involved in?
A
Fight or flight - discussed in regards to anxiety.
20
Q
What is norepinephrine involved in?
A
Wakefulness and alertness.
21
Q
What is dopamine involved in?
A
Behaviour regulation, learning, movement, mood. Inhibitory or excitory.
22
Q
What is serotonin involved in?
A
Inhibits activity and behaviour. Relates to mood regulation, sleep, appetite.
23
Q
What is GABA involved in?
A
Inhibiting neurons to decrease over-excitement.
24
Q
What disorder implicates dopamine dysfunction?
A
Schizophrenia.
25
Barbituates and Benzo's increase which NT?
GABA - inhibits overexcitement.
26
Cluster A - what type of characteristics might require medication?
Paranoid or eccentric features.
27
Cluster A - what type of medications are given? Name 3.
Anti-psychotics at mild doses.
Risperidone - Risperdal
Olanzapine - Zyprexa
Quetiapine - Seroquel
28
Cluster B - what type of characteristics might require medication? (5) Hint: DAALI
- Impulsive
- Depressive
- Angry
- Anxiety
- Labile
29
Cluster B - what type of medications are given? Name 3.
- D, A, I: Duloextine (Cymbalta) or other SSRI's
- Anxiety, self harm: Gabapentin (Neurontin) or naltrexone (Revia)
30
Cluster C - what type of characteristics might require medication?
Anxious and Avoidant symptoms.
31
Cluster C - what type of medications are given? Name 3.
- SSRI's for anxiety
- Occasionally long acting benzo's - (clonazepam) Klonopin or buspirone (Buspar)
32
What medications are given in ADHD? (Main types and back up/longer lasting)
- Dexamphetamines
- Mephinidate (Ritalin)
- Vyvanse - longer acting
- Ritalin LA
33
Can you use Ritalin if there is substance abuse?
Generally no - recommend atomoxetine (Strattera) instead. It boosts levels of norepinephrine in your brain to help with attention, hyperactivity, and impulsive behaviour but it not a stimulant.
34
Name drug given in Ritalin if substance abuse is present?
Atomoxetine (Strattera)
35
What features of Bipolar Disorder generally require medication?
Mania - sedation
Mood stabilisation - mood stabilisers
36
Name medications generally used in Bipolar disorder (4)
Carbamazpeine (Tegretol) - mood stabiliser
Lithium - mood stabiliser
Valproate (Epilim) - sedation
Quietiapine (Seroquel) - antipsychotic
37
Common side effects of Lithium?
Tremor, excessive thirst, toxicity (death).
38
Side effects of Tegretol?
Ataxia (lack of voluntary co-rodination of muscles), dizziness, stomach upset.
39
What 2 drugs (at different phases) may help with Dementia?
Initial - Donepizil (Aricept) to help slow cog decline
Later - Risperdone (Risperdal) or antipsychotic to manage behaviour changes
40
What is Donepizil (Arciept) used for?
Slowing cog decline in dementia (inital phase)
41
What is side effect of antipsychotics on dementia?
Can risk temporary cognitive decline.
42
Why are diazepam and benzo's no longer used as first line medications in anxiety?
Addictive and can lead to mild cognitive decline and diminished problem solving skills. Negative impact on new learning - bad for phobia treatments.
43
Risk of benzos and heroin or opiods?
Increase risk of death due to repression of respiratory processes in the brain.
44
Common medications for anxiety?
- Antidepressants(SSRI's)
- Betablockers
45
Give two examples of Beta blockers used in anxiety treatment?
Propranol (Inderal)
Atenolol (Noten)
46
How do betablockers work in anxiety?
Block epinephrine (adrenaline).
47
Name historical type of antidepressant's not given frequently anymore?
Tricyclic antidepressants - effective but lots of side effects inc stomach upset and dizziness.
48
What is first line medication for depression? Name examples (3)
SSRI's first
- Setraline (Zoloft)
- Fluxoetine (Prozac)
- Citalopram (Cipramil)
49
What are alternatives to SSRI's for depression (3)?
Agomelatine (Valdoxan) targets melatonin system.
Mirtazapine (Avanza) targets norepinephrine.
Desvenlafaixine (Pristiq) targets norepinephrine and SSRI.
50
Agomelatine (Valdoxan) and Mirtazapine (Avanza) are alternative medications for which disorder?
Major Depression
51
What are common side effects of antidepressants? (5) HINT: GLAAM
- Loss of libido
- Gastric symptoms
- Anxiety
- Agitation
- Mood constriction
52
How long does it take for antidepressants to start working?
1-2 weeks
Full effects 4-8 weeks
53
What side effect of antidepressants is implicated in increased suicide risk?
Agitation
54
Is is safe to take SSRI's whilst pregnant?
Generally yes.
55
How is "treatment resistant" depression augemented with medication?
Addition of mood stabiliser or antipsychotic to medication mix.
56
What is clomipramine (Anafranil) used to treat?
Antidepressant for OCD
57
What medications are used for OCD?
Higher Dose antidepressants.
58
What are the following medications used to treat?
- Mirtazapine (Avanza)
- clomipramine (Anafranil)
- Atenolol (Noten)
1. Alt antidepressant targeting norephinephrine system in depression
2. OCD
3. Beta blocker for anxiety
59
What are the following medications used to treat?
- Valproate (Epilim)
- Agomelatine (Valdoxan)
- Setraline (Zoloft)
1. Sedation in bipolar
2. Melatonin system in depression
3. SSRI in depression
60
What class of drugs is used for delusions and hallucinations?
Antipsychotics
61
Name common antipsychotics used in schizophrenia? (3)
- Olanzapine (Zyprexa)
- Risperidone (Ripserdal)
- Quetiapine (Seroquel)
62
Common side effects of antipsychotics?
Weight gain.
63
What drug might be used in "treatment resistant" schizophrenia? What are the side effects? (SSS)
Clozapine (Clozaril). Sedation, seizures and salivation (drooling/night wetting).
64
Why are injections sometimes used in schizophrenia?
Low medication adherence due to poor insight.
65
What is haloperidol (Haldol) and zuclopenthixone (Clopixol) used for?
Long acting injectable antipsychotics used for schizophrenia in hospital settings.
66
Name long acting injectable antipsychotics used for schizophrenia in hospital settings?
haloperidol (Haldol) and zuclopenthixone (Clopixol)
67
What is significant side effect of some typical antipsychotics?
Tardive dyskinesia
68
What is Tardive dyskinesia?
A movement disorder characterized by uncontrollable, abnormal, and repetitive movements of the face, torso, and/or other body parts
69
How long does it take for delusions and hallucinations to improve with low dose antipsychotics?
Weeks to months.
70
What was the first antipsychotic medication used in the treatment of schizophrenia first in 1950?What drugs and conditions are these serious side effects of?
Ataxia
Tardive dyskinesia
1. Bipolar - linked to tegretol use. Lack of voluntary muscle use, dizziness and nausea.
2. Schizophrenia - linked to antipsychotics use. Involuntary, abnormal and repetitive movements of face/other body parts.
71
What was the first antipsychotic medication used in the treatment of schizophrenia first in 1950?
Chlorpromazine
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