NSG 552 PSYCHOPHARMACOLOGY EXAM 1,2 & 3 BUNDLE
LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
Pharmacokinetics - ANSWER: Studies how the body acts on the drug
Pharmacodynamics - ANSWER: Studies how the drug acts on the body
First-generation antipsychotic - ANSWER: - first developed in the 1950s, first
available treatment for psychosis
- aka typical antipsychotics
- increased risk for EPS, Tardive dyskinesia
- d2 blocker
- Currently 11 FDA-approved and commerically available FGAs
- Most common differences between individual FGAs are their potency and side
effects
- examples include Thorazine (chlorpromazine), Haldol (haloperidol), Prolixin
(fluphenazine), perphenazine (Trilafon
Second-generation antipsychotic - ANSWER: - examples include Abilify
(aripiprazole), Seroquel (quetiapine), Zyprexa (olanzapine), Risperdal (risperidone),
Clozaril (clozapine)
- lower risk of EPS symptoms compared to 1st gen
- higher risk of metabolic side effects
- serotonin-dopamine receptor antagonists
- AKA atypical antipsychotics
EPS - ANSWER: Involuntary movements that occur as a side effect to certina
medications. AKA drug induced movement disorder. May include tardive
dyskinesia, dystonic reactions, parkinsons-like symptoms, akathesia, NMD,
akinesia
- Can be acute or chronic
- related to suppression of D2 dopamine receptors in the nigrostriatal pathway
Tardive dyskinesia - ANSWER: - characterized by involuntary movments in the face
and body
- often induced by long-term use of anitpsychotic drugs
- can be associated with use of other medication types (antidepressants, lithium,
antihistamines)
- more common with 1st gen antipsychotics
- movements may include: writhing, mouth puckering, tongue rolling, lip smacking,
pill rolling, tongue protrusion
,Upregulation - ANSWER: Refers to the activiation of the nervous system. Is the
process by which a cell increases its response to a subtance or signal from outside
the cell to carry out a specific response
downregulation - ANSWER: Refers to state of calm/relation within nervous system.
Characterized by a decreased response by a cell to a molecule or neurotransmitter.
Receptor Profiles - ANSWER: FGA - Primarily D2 antagonism. Also antagonize M2,
H1, and a1 receptors
SGA - 5-HT2A & D2 antagonism. Rapid D2 dissociation. 5HT2A agonism. Also
antagonizes M2, H1, 5HT2C, and a1 receptors
Binding - ANSWER: When a neurotransmitter binds to a receptor on a receiving
cell, it causes ion channels to open or close.
Affinity - ANSWER: The property of a drug that describes its ability to bind to a
receptor
Constant
Unique for each drug-receptor pair as it is dependent on each of their structures
CYP450 - ANSWER: - membrane-bound hemoproteins that play a pivotal role in the
detoxification of xenobiotics, cellular metabolism, and homeostatis
-Inhibitition or induction of CYP enzymes is a major mechanism underlying drug-
drug interactions
- A CYP450 inhibitor prevents or reduces work by CYP450 enzymes = decreased
drug metabolism and increased risk for toxicity
- A CYP450 inducer increases rate of hepatic metabolism = decreased serum
concentation of other drugs metabolized by the same hepatic isoenzyme
Grapefruit juice is an inhibtior, which can increase serum levels of certain drugs
Dopamine Pathways - ANSWER: - mesolimbic (positive sx)
- mesocortical (negative sx)
- nigrostriatal (EPS)
- tuberoinfundibular (prolactin)
Metabolic Syndrome - ANSWER: cluster of conditions that incerase risk for T2DM
and cardiovascular disease (obesity, HTN, high triglycerides, low HDL, insulin
resistance)
-increased risk for metabolic syndrome found with some antipsychotic
medications, primarily SGA
High Potency vs Low Potency - ANSWER: High potency: higher risk for
EPS/hyperprolactinemia. Effective at lower doses. Haldol, risperdal, prolixin,
olanzapine
Low potency: more sedating with more anticholinergic symptoms. Thorazine,
seroquel, clozaril, geodon
, Neuroleptic malignant syndrome (NMS) - ANSWER: - Life threatening
- occur with use of dopamine receptor antagonists or when dopaminergic
medidcation are suddenly withdrawn
- sx usually begin within 2 wks of starting a new med or changing dose.
- Characterized by fever, AMS, muscle rigidity, autonomic dysfuncton
- Dantrolene sodium is FDA approved to treat. Muscle relaxant that reduces
hyperthermia/muscle stiffness
QTC interval - ANSWER: -measurement of the left ventricle's repolarization efficiency
on ECG.
- usually 350-450 (men), 360-460 (women)
-associated with life-threatening cardiac arrhythmias
-antipsychotic and antidepressant drugs can prolong QT intervals, some more than
others
The study of the use of psychotropic medications in the treatment of psychiatric
disorders: - ANSWER: Psychopharmacology
The study of what the body does to drugs: - ANSWER: Pharmacokinetics
The study of what drugs do to the body: - ANSWER: Pharmacodynamics
Involves the absorption, distribution, metabolism and excretion of meds: - ANSWER:
Pharmacokinetics
Increase serum levels of other drugs that are substrates of that enzyme: - ANSWER:
CYP450 inhibtor
Decrease serum levels of other drugs that are substrates of that enzyme: - ANSWER:
CYP inducer
Part of the brain that regulates powerful emotions such as fear, rage, sexual desires:
- ANSWER: amygdala
The relay station for sensory information: - ANSWER: thalamus
Essential for maintaining homeostasis, controls basic needs such as sleep-wake
cycles: - ANSWER: hypothalamus
This lobe is involved in executive functioning, high order planning, speech adn
motiviation: - ANSWER: frontal lobe
Derived from Trytophan and made in the Ralphe Nuclei: - ANSWER: serotonin
Made in the Locus Ceruleus and Involved in the noradrenergic pathway: - ANSWER:
norepinephrine
LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
Pharmacokinetics - ANSWER: Studies how the body acts on the drug
Pharmacodynamics - ANSWER: Studies how the drug acts on the body
First-generation antipsychotic - ANSWER: - first developed in the 1950s, first
available treatment for psychosis
- aka typical antipsychotics
- increased risk for EPS, Tardive dyskinesia
- d2 blocker
- Currently 11 FDA-approved and commerically available FGAs
- Most common differences between individual FGAs are their potency and side
effects
- examples include Thorazine (chlorpromazine), Haldol (haloperidol), Prolixin
(fluphenazine), perphenazine (Trilafon
Second-generation antipsychotic - ANSWER: - examples include Abilify
(aripiprazole), Seroquel (quetiapine), Zyprexa (olanzapine), Risperdal (risperidone),
Clozaril (clozapine)
- lower risk of EPS symptoms compared to 1st gen
- higher risk of metabolic side effects
- serotonin-dopamine receptor antagonists
- AKA atypical antipsychotics
EPS - ANSWER: Involuntary movements that occur as a side effect to certina
medications. AKA drug induced movement disorder. May include tardive
dyskinesia, dystonic reactions, parkinsons-like symptoms, akathesia, NMD,
akinesia
- Can be acute or chronic
- related to suppression of D2 dopamine receptors in the nigrostriatal pathway
Tardive dyskinesia - ANSWER: - characterized by involuntary movments in the face
and body
- often induced by long-term use of anitpsychotic drugs
- can be associated with use of other medication types (antidepressants, lithium,
antihistamines)
- more common with 1st gen antipsychotics
- movements may include: writhing, mouth puckering, tongue rolling, lip smacking,
pill rolling, tongue protrusion
,Upregulation - ANSWER: Refers to the activiation of the nervous system. Is the
process by which a cell increases its response to a subtance or signal from outside
the cell to carry out a specific response
downregulation - ANSWER: Refers to state of calm/relation within nervous system.
Characterized by a decreased response by a cell to a molecule or neurotransmitter.
Receptor Profiles - ANSWER: FGA - Primarily D2 antagonism. Also antagonize M2,
H1, and a1 receptors
SGA - 5-HT2A & D2 antagonism. Rapid D2 dissociation. 5HT2A agonism. Also
antagonizes M2, H1, 5HT2C, and a1 receptors
Binding - ANSWER: When a neurotransmitter binds to a receptor on a receiving
cell, it causes ion channels to open or close.
Affinity - ANSWER: The property of a drug that describes its ability to bind to a
receptor
Constant
Unique for each drug-receptor pair as it is dependent on each of their structures
CYP450 - ANSWER: - membrane-bound hemoproteins that play a pivotal role in the
detoxification of xenobiotics, cellular metabolism, and homeostatis
-Inhibitition or induction of CYP enzymes is a major mechanism underlying drug-
drug interactions
- A CYP450 inhibitor prevents or reduces work by CYP450 enzymes = decreased
drug metabolism and increased risk for toxicity
- A CYP450 inducer increases rate of hepatic metabolism = decreased serum
concentation of other drugs metabolized by the same hepatic isoenzyme
Grapefruit juice is an inhibtior, which can increase serum levels of certain drugs
Dopamine Pathways - ANSWER: - mesolimbic (positive sx)
- mesocortical (negative sx)
- nigrostriatal (EPS)
- tuberoinfundibular (prolactin)
Metabolic Syndrome - ANSWER: cluster of conditions that incerase risk for T2DM
and cardiovascular disease (obesity, HTN, high triglycerides, low HDL, insulin
resistance)
-increased risk for metabolic syndrome found with some antipsychotic
medications, primarily SGA
High Potency vs Low Potency - ANSWER: High potency: higher risk for
EPS/hyperprolactinemia. Effective at lower doses. Haldol, risperdal, prolixin,
olanzapine
Low potency: more sedating with more anticholinergic symptoms. Thorazine,
seroquel, clozaril, geodon
, Neuroleptic malignant syndrome (NMS) - ANSWER: - Life threatening
- occur with use of dopamine receptor antagonists or when dopaminergic
medidcation are suddenly withdrawn
- sx usually begin within 2 wks of starting a new med or changing dose.
- Characterized by fever, AMS, muscle rigidity, autonomic dysfuncton
- Dantrolene sodium is FDA approved to treat. Muscle relaxant that reduces
hyperthermia/muscle stiffness
QTC interval - ANSWER: -measurement of the left ventricle's repolarization efficiency
on ECG.
- usually 350-450 (men), 360-460 (women)
-associated with life-threatening cardiac arrhythmias
-antipsychotic and antidepressant drugs can prolong QT intervals, some more than
others
The study of the use of psychotropic medications in the treatment of psychiatric
disorders: - ANSWER: Psychopharmacology
The study of what the body does to drugs: - ANSWER: Pharmacokinetics
The study of what drugs do to the body: - ANSWER: Pharmacodynamics
Involves the absorption, distribution, metabolism and excretion of meds: - ANSWER:
Pharmacokinetics
Increase serum levels of other drugs that are substrates of that enzyme: - ANSWER:
CYP450 inhibtor
Decrease serum levels of other drugs that are substrates of that enzyme: - ANSWER:
CYP inducer
Part of the brain that regulates powerful emotions such as fear, rage, sexual desires:
- ANSWER: amygdala
The relay station for sensory information: - ANSWER: thalamus
Essential for maintaining homeostasis, controls basic needs such as sleep-wake
cycles: - ANSWER: hypothalamus
This lobe is involved in executive functioning, high order planning, speech adn
motiviation: - ANSWER: frontal lobe
Derived from Trytophan and made in the Ralphe Nuclei: - ANSWER: serotonin
Made in the Locus Ceruleus and Involved in the noradrenergic pathway: - ANSWER:
norepinephrine
