NSG552 Psychopharmacology Exam 1
1. What are the 6 general principles of psychopharmacological treatment?:
Safety
Tolerability
Efficacy
Practicality
Treatment accessibility
Treatment compliance
2. Pharmacokinetics: How the drug moves in the body. (ex. Where is it
absorbed?
How and where is it metabolized? Where is it excreted?)
3. Pharmacodynamics: What the drug does to the body. (consider mechanism of
action)
4. Define First-generation antipsychotics: 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)
5. Define Second-generation antipsychotics: 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)
6. Extra Pyramidal Symptoms (EPS): Side effects caused by certain
antipsychotic medications, which include: involuntary or uncontrollable
movements. tremors. muscle contractions.
7. Tardive dyskinesia: A neurological disorder characterize by involuntary
movement of the face and jaw.
8. Upregulation: 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
, NSG552 Psychopharmacology Exam 1
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
9. Down regulation: 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)
10. Receptor profile: 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)
11. Binding: Refers to a drug metabolite or neurotransmitter attaching to a receptor
12. Affinity: refers to the "preference" or likelihood of a drug to bind to a certain
receptor. Linked to potency.
13. CYP450: A group of enzymes in the liver that metabolize different drugs.
There are six.
14. List the 7 CYP450 Enzymes: (1) CYP1A2
(2) CYP2B6
(3) CYP2C9
(4) CYP2C19
(5) CYP2D6
(6) CYP3A4
(7) CYP2EI
15. CYP2B6: Metabolizes arteminsin, bupropion, cyclophosphamide, efavirenz,
ketamine, and methadone (2B6, there are two psych drugs (bupropion,
methadone (ketamine...?) and six altogether.
16. CYP1A2: metabolizes AcetAminophen (two As)
17. CYP2C9: metabolizes Warfarin/Coumadin (think warfarin factors 2, C, 9)
18. CYP2C19: 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)
1. What are the 6 general principles of psychopharmacological treatment?:
Safety
Tolerability
Efficacy
Practicality
Treatment accessibility
Treatment compliance
2. Pharmacokinetics: How the drug moves in the body. (ex. Where is it
absorbed?
How and where is it metabolized? Where is it excreted?)
3. Pharmacodynamics: What the drug does to the body. (consider mechanism of
action)
4. Define First-generation antipsychotics: 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)
5. Define Second-generation antipsychotics: 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)
6. Extra Pyramidal Symptoms (EPS): Side effects caused by certain
antipsychotic medications, which include: involuntary or uncontrollable
movements. tremors. muscle contractions.
7. Tardive dyskinesia: A neurological disorder characterize by involuntary
movement of the face and jaw.
8. Upregulation: 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
, NSG552 Psychopharmacology Exam 1
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
9. Down regulation: 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)
10. Receptor profile: 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)
11. Binding: Refers to a drug metabolite or neurotransmitter attaching to a receptor
12. Affinity: refers to the "preference" or likelihood of a drug to bind to a certain
receptor. Linked to potency.
13. CYP450: A group of enzymes in the liver that metabolize different drugs.
There are six.
14. List the 7 CYP450 Enzymes: (1) CYP1A2
(2) CYP2B6
(3) CYP2C9
(4) CYP2C19
(5) CYP2D6
(6) CYP3A4
(7) CYP2EI
15. CYP2B6: Metabolizes arteminsin, bupropion, cyclophosphamide, efavirenz,
ketamine, and methadone (2B6, there are two psych drugs (bupropion,
methadone (ketamine...?) and six altogether.
16. CYP1A2: metabolizes AcetAminophen (two As)
17. CYP2C9: metabolizes Warfarin/Coumadin (think warfarin factors 2, C, 9)
18. CYP2C19: 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)
