NSG552 PSYCHOPHARMACOLOGY EXAM 1
REVIEW EXAM Q&A NEWLY MODIFIED EXAM
TESTED AND APPROVED!!!
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)
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.
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,Tardive dyskinesia -- ANSWER--A neurological disorder characterized by
involuntary movement of the face and jaw.
General principles of psychopharmacological treatment -- ANSWER--Safety,
Tolerability, Efficacy, Practicality, Treatment accessibility, Treatment
compliance
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 ->
Upregulation 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 ->
downregulation 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).
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, 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)
SSRIs vs TCAs -- ANSWER--SSRIs have a more favorable safety profile than
TCAs in both acute and long-term treatment of major depression.
Antidepressants Classes used for chronic pain -- ANSWER--Include TCAs,
SNRIs, SSRIs.
Best Antidepressants for appetite loss -- ANSWER--Include TCAs and
tetracyclic antidepressants like Remeron.
Best Antidepressants to avoid sexual dysfunction -- ANSWER--Include
Bupropion and Nefazodone.
Antidepressants that lower seizure threshold -- ANSWER--Include Amoxapine,
Bupropion, Clomipramine, and Maprotiline.
Length of antidepressant treatment -- ANSWER--Continue regimen for 9 to 12
months after symptom remission.
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REVIEW EXAM Q&A NEWLY MODIFIED EXAM
TESTED AND APPROVED!!!
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)
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.
Page | 1
,Tardive dyskinesia -- ANSWER--A neurological disorder characterized by
involuntary movement of the face and jaw.
General principles of psychopharmacological treatment -- ANSWER--Safety,
Tolerability, Efficacy, Practicality, Treatment accessibility, Treatment
compliance
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 ->
Upregulation 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 ->
downregulation 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).
Page | 2
, 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)
SSRIs vs TCAs -- ANSWER--SSRIs have a more favorable safety profile than
TCAs in both acute and long-term treatment of major depression.
Antidepressants Classes used for chronic pain -- ANSWER--Include TCAs,
SNRIs, SSRIs.
Best Antidepressants for appetite loss -- ANSWER--Include TCAs and
tetracyclic antidepressants like Remeron.
Best Antidepressants to avoid sexual dysfunction -- ANSWER--Include
Bupropion and Nefazodone.
Antidepressants that lower seizure threshold -- ANSWER--Include Amoxapine,
Bupropion, Clomipramine, and Maprotiline.
Length of antidepressant treatment -- ANSWER--Continue regimen for 9 to 12
months after symptom remission.
Page | 3
