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Psychotropic Drugs
Chapter 18
72
Pharmacology
Not Applicable
04/29/2013

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Term
What are organic disorders?
Definition
those caused by genetics, illness, or injury
Term
What are functional disorders?
Definition
those without an obvious cause or reason
Term
What are some examples of functional disorders? (3)
Definition
-psychoses
-affective disorder
-neuroses(anxiety disorders)
Term
Over BLANK% of american adults have some form of a mental disorder.
Definition
Over 20% of american adults have some form of a mental disorder.
Term
What are some examples of mental disorders?
Definition
-schizophrenia
-unipolar depression
-bipolar depression
-panic disorders
-phobias
-OCD
-personality disorders
Term
What are positive psychotic symptoms?
Definition
patients experience extra sensations that do not actually exist
Term
What are some examples of positive psychotic symptoms?
Definition
-auditory hallucinations
-delusions
-unwanted thoughts
-disorganized behavior
-agitation
-disordered speech and communication
Term
What are negative psychotic symptoms?
Definition
patient is failing to react to sensations that actually do exist
Term
What are some examples of negative symptoms?
Definition
-flat affect
-unemotional
-apathetic, passive
-difficulty with abstract thinking
-lack of spontaneity
-lack of ambition
-lack of pleasure
-social withdrawl
Term
Can a patient only experience positive or negative symptoms?
Definition
no they can experience some of both
Term
What are conventional antipsychotic agents used to treat?
Definition
treat positive symptoms, but there are higher risks with them, not used much anymore
Term
What are some examples of high potency conventional antipsychotic agents? (2)
Definition
-haloperidol(Haldol)
-loxapine(Loxitane)
Term
What are some examples of low potency conventional antipsychotic drugs? (2)
Definition
-chlorpromazine(Thorazine)
-promethazine(Phenergan)
Term
What do atypical antipsychotic drugs do?
Definition
work on positive and negative symptoms
Term
What are some examples of atypical antipsychotic agents? (6)
Definition
-ariprazole(Abilify)
-olanzapine(Zyprexa)
-quetiapine(Seroquel)
-risperidone(Risperdal-Consta)
-ziprasidone(Geodon)
-paliperidone(Invega)
Term
What kind of antivity are antipsychotics?
Definition
anticholinergic activity
Term
How do antipsychotics work?
Definition
work as CNS depressant
Term
How do antipsychotics work with other CNS depressants? (opioids)
Definition
additive or synergestic effects
Term
What else can antipsychotic drugs do?
Definition
antiemetic effects(anti-vomiting), Phenergan
Term
What are some adverse effects of antipsychotics?
Definition
-sedation
-extrapyramidal effects
-orthostatic hypotension
-cardiovascular effects
-seizures
-anticholinergic effects
-skin reactions
-agranulocytosis
Term
When is sedation seen with antipsychotic effects?
Definition
during the tolerance period
Term
What are some extrapyramidal effects of antipsychotics? (4)
Definition
-dystonia(muscles can't contract effectively)
-parkinson symptoms
-compulsive motor activities
-dyskinesia(can't perform voluntary actions)
Term
What is agranulocytosis?
Definition
decrease in WBC count, increases risk for infection
Term
What are some drug interactions of antipsychotic drugs? (3)
Definition
-CNS depressants
-epinephrine
-anticholinergics
Term
Wht are some dental implications of antipsychotics? (5)
Definition
1.communicate cautiously
2.emphasize oral hygiene
3.check TMJ for pain and extrapyramidal effects
4.be aware of drug interactions
5.slow rising following treatment
Term
What are some neurotransmitters associated with depression?
Definition
-serotinin(5-HT)
-norepinephrine(NE)
-dopamine
Term
What happens to these neurotransmitters in depression?
Definition
they decrease
Term
Do all antidepressants have the same mechanism of action?
Definition
no they are all different
Term
How do tricyclic antidepressants(TCAs) work?
Definition
block NE and 5-HT reuptake(keeps them in synapse longer to continue stimulation)
Term
What is the downside of TCAs?
Definition
they have a lot of side effects
Term
How do second generation antidepressants work?
Definition
antagonize 5-HT reuptake inhibitor
Term
How do selective-serotonin reuptake inhibitors (SSRIs) work?
Definition
SEROTONIN SPECIFIC- block 5-HT reuptake
Term
How do serotonin-norepinephrine reuptake inhibitors work?
Definition
block reuptake of 5-HT and NE, more specific, effective, less side effects
Term
How do monoamine oxidase inhibitors (MAOIs)?
Definition
last resort, blocks breakdown of NE, 5-HT, and doapmine
Term
How does buproprione work?
Definition
blocks reuptake of NE and dopamine
Term
What are some examples of TCAs?
Definition
-amytriptyline(Elavil)
-imipramine(Tofranil)
Term
What pharmacologic effect do TCAs have on depressed patients?
Definition
reduced depressive ideas, uplifted mood
Term
What pharmacologic effect do TCAs have on nondepressed patients?
Definition
sedation, fatigue
Term
Why would a nondepressed patient take TCAs?
Definition
taken offlabel for things like neuropathic pain
Term
What do TCAs have a lower therapeutic index than?
Definition
SNRIs
Term
What are TCAs used after and before?
Definition
after newer drugs but before MAOIs
Term
What are some adverse reactions of TCAs?
Definition
-CNS
-ANS
-cardiac toxicity
-dependence
-withdrawl symptoms
Term
What are some drug interactions of TCAs?
Definition
-synergestic with amphetamines and other CNS stimulants
-MAOIs
-barbiturates
-cigarette smoking
-antihypertensives
Term
What are some dental implications of TCAs?
Definition
xerostomia, exercise caution when useing vasoconstrictors
Term
What is an example of a second generation antidepressant?
Definition
trazodone(Desyrel)
Term
Are there a lot of adverse reactions seen with second generation antidepressaants?
Definition
fewer than TCAs
Term
Second generation antidepresants have BLANK sedative effects than TCAs.
Definition
Second generation antidepresants have stronger sedative effects than TCAs.
Term
What can second generation antidepressants lead to?
Definition
priapism(erection that won't go away) and impotence in men
Term
What are second generation antidepressants often given in comintation with? WHy?
Definition
SSRI because this will increase serotonin without effecting other neurotransmitters
Term
What are some examples of SSRIs? (3)
Definition
-fluoxetine(Prozac)
-sertraline(Zoloft)
-escitalopram(Lexapro)
Term
SSRIs have fewer adverse reactions than BLANK or BLANK.
Definition
SSRIs have fewer adverse reactions than TCAs or second generation antidepressants.
Term
What are some examples of SNRIs? (3)
Definition
-venlafaxine(Effexor)
-desvenlafaxine(Pristiq)
-duloxetine(Cymbalta)
Term
What are the side effects of SNRIs like?
Definition
similar to SSRIs
Term
Are SNRIs more or less effective than SSRIs?
Definition
more on most patients because this effects NE
Term
What is more likely to happen with SNRIs?
Definition
withdrawl symptoms
Term
What is the last resort antidepressant?
Definition
MAOIs
Term
What are some examples of MAOIs?
Definition
-phenelzine(Nardil)
-isocarboxazid(Marplan)
Term
Why are MAOIs a last resort med?
Definition
many drug interations to can lead to hypertensive crisis
Term
What are some examples of drug interations to can lead to hypertensive crisis with MAOIs?
Definition
-foods(cheese, wine)
-CNS stimulants
-other antidepressants
-dextromethorphan(anti-tussive, in mant OTC meds)
-biggest problem is with antihypertensive meds
Term
What are some brands of buproprion?
Definition
Wellbutrin, Zyban
Term
What is buproprion often used in combo with?
Definition
SSRIs
Term
What is a reduced side effect of buproprion compared to other antidepressants?
Definition
reduced sexual dysfunction (related to serotonin)
Term
What is buproprion also effective for?
Definition
-treatment of seasonal affective disorder (SAD)
-anti-smoking
Term
What is preffered, buproprion + SSRI OR MAOI?
Definition
buproprion + SSRI
Term
What are some drug treatments for bipolar disorder?
Definition
-lithium
-atypical antipsychotics
-anticonvulsants
Term
How does lithium help treat bipolar?
Definition
-may help regulate glutamate levels
-no psychotrophic effects at normal doses
Term
What is an examples of an atypical antipsychotic used to treat bipolar disorder?
Definition
olanzapine(Zyprexa)
Term
What is an example of an anticonvulsant used to treat bipolar?
Definition
valproate(VPA, Depakote)
Term
What is ADD now known as?
Definition
ADHD-PI (primarily unattentive)
Term
What are some stimulants used to treat ADD/ASHD?
Definition
-methylphenidate(Ritalin, Concerta)
derivatives- Adderall, Focalin
Term
How do stimulants help treat ADD/ADHD?
Definition
may help regulate dopamine levels int he brain
Term
What is an example of a nonstimulant used to treat ADD/ADHD? How does it work?
Definition
atomoxetine(Strattera), NE reuptake inhibitor
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