Chapter 3 Terms - Biological Basis for Understanding Psychotropic Drugs

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1.

Antagonists

Drugs that block or depress the normal response of a specific receptor by only partly fitting the receptor site. AKA anxiolytics. Many act by increasing the effectivness of GABA which modulates neural excitability. Drugs that prevent the destruction of acetylcholine. Slows heart, lowers blood pressure, increases secretions, and increases contraction of smooth muscles. Antipsychotics medications, AKA second-generation, which commonly interact with serotonin & dopamine receptors. They are considered the 1st line treatment for psychosis. Low extrapyramidal side effects. A 24-hour biological rhythm that influences specific regulatory functions such as the sleep/wake cycle, body temperature, the hormonal neurotransmitter secretions. The original classification of antipsychotic medications, also known as typical antipsychotics and first generation antipsychotics, which work by D2 receptor antagonism. They tend to cause more side effects. Drugs used to promote sleep. Parts of the frontal cortex, basal ganglia, and brainstem. Controles & regulates emotion. Love, joy, hope, and social behavior. Known as an antimanic drug because it can stabilize the manic phase of a bipolar disorder. When effective, it can modify future manic episodes and protect against future depressive episodes. Antidepressants that inhibit monoamine oxidase, an enzyme that breaks down amines such as serotonin and norephinephrine. Must be on a tyramine-free diet due to potentially fatal interactions. Classes of drugs used to treat mood disorders; include lithium and anticonvulasants.

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Neurons

2.

Antianxiety (anxiolytic) drugs act by? Anticholinesterase drugs

Specialized cells in the central nervous system. Each neuron has a soma or cell body, an axon, and dendrites. A chemical substance that functions as a neural messenger. Neurotransmitters are released from the axon terminal of the presynaptic neuron when stimulated by an electrical impulse Physiological actions and effects of drugs on the body; this includes mechinism of action and it's effects. The actions of the body on the drugs; this includes absorption, distribution, excretion, onset, duration, and transformation in the liver. Protein molecules located within or on the outer membrane of cells of various tissues, such has neurons. A receptor receives stimulation that causes a reaction resulting in stimulation or inhibition of the cell. The part of the brain stem that mediates alertness, arousal, and motivation; serves to filter out repetitive stimuli to prevent overload. The return of neurotransmitters to the presynaptic cell after communication with receptors on the postsynaptic cell. First-line antidepressants that block the reuptake of serotonin, permitting serotonin to act for an extended period at the synaptic binding sites in the brain. The gap between the membrane of one neuron and the membrane of another neuron. The synapse is the point at which the transmission of the nerve impulse occurs. The ratio of the therapeutic dose of a drug and the toxic dose of a drug. Drugs that inhibit the reuptake of norepinephrine and serotonin by the presynaptic neurons in the CNS, increasing the amount of time norepinephrine and serotonin are available to the postsynaptic receptors.

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Neurotransmitter

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Pharmacodynamics

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Atypical antipsychotics

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Pharmacokinetics

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Circadian rhythms

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Receptors

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Conventional antipsychotics

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Reticular activating system (RAS)

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Reuptake

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Hypnotic Limbic system

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Lithium

Selective serotonin reuptake inhibitors (SSRIs)

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Synapse

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Monoamine oxidase inhibitors (MAOIs)

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Therapeutic index Tricyclic antidepressants

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Mood stabilizer

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Anticholinergic

Same as sympathetic, adrenergic, & stimulating. Fight or flight response. "Drying". Reduces salivation, slows digestion, urinary retention, reduces kidney activity. Drugs predominately used to elevate mood in people who are depressed. Absence or diminution of voluntary motion. Akinesia is usually accompanied by a parallel reduction in mental activity. anti-anxiety medication. Series of xray images are taken of the brain, and computer analysis produces "slices" providing a precise 3D like reconstruction of each segment. It can detect lesions, abrasions, areas of infarct and aneurysms. An injection into body tissue, either muscular or subcutaneous, that keeps the medication in a concentrated space and releases it slowly into the bloodstream. Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuro-leptic, antipsychotic medication, in which it manifests as muscle spasms of the face, head, neck and back. A catecholamine secreted by the adrenal gland and by fibers of the sympathetic nervous system. It is responsible for many of the physical manifestations of fear and anxiety. Side effects of psychotropic drugs. 3 reversible exta-pyramidal side effects are acute dystonia, Akathisia, and pseudoparkinsonism. Tardive dyskinesia, is the most serious and is not reversible. The major inhibitory neurotransmitter in the central nervous system targeted by drugs that reduce anxiety. NMDA and AMPA receptors. An excitatory amino acid type receptor. Excitatory. AMPA plays a role in learning and memory. A rare fatal reaction to high-potency neuroleptic drugs. Symptoms include muscle rigidity, fever, and elevated white blood cell count. Thought to result from dopamine blockage at the basal ganglia and hypothalamus.

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Norephinephrine

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Antidepressant Akathisia

Type of monamine. 1,2, 1, 2 receptors. Level in brain affects mood, attention, arousal, stimulates sympathetic branch of autonomic nervous system for "fight or flight" in response to stress. Magnetic field is applied to the brain; nuclei of hydrogen atoms absorb and emit radio waves that are analyzed by computer, providing 3D visualization of the brain's structure in sectional images. Radioactive substance (tracer) injected, travels to the brain, and shows up as bright spots on the scan; data collected by detectors are relayed to a computer, which produces images of the activity and 3D img of CNS. A medication-induced temporary constellation of symptoms associated with Parkinson's disease: tremor, reduced accessory movements, impaired gait, and stiffening of muscle. Drugs that have an effect on psycho function, behavior or experience. Plays a role in sleep regulation, hunger, mood states, pain perception, aggression and sexual behavior. 3D image of brain by injecting substance into the body. The substance travels through the blood and allows the physician to see if there are any parts of the brain that are receiving less blood than others. A serious and irreversible side effect of the phenothiazines and related drugs; consists of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, truck or pelvis. Thought Processes. Formulation of goals, decision making, planning, insight, voluntary motor ability starts in the frontal lobe, motivation, social judgment.

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MRI

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Anxiolytic CT scan

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PET scan

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Depot injection

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Dystonia

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Pseudoparkinsonisms

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Epinephrine

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Psychotropic drugs

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Serotonin

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Extrapyrimidal symptoms

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Gammaaminobutyric acid (GABA) Glutamate

SPECT scan (singlephoton emission computerized tomography)

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Tardive dyskinesia

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Neuroleptic malignant syndrome (NSM)

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Frontal Lobe

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Parietal Lobe

Sensory and Motor. Receive and identify sensory information, concept formation and abstraction, body awareness, reading, math, right and left orientation. Vision. Visual memories, visual association. Auditory. Language comprehension, stores sounds into memory, connects with the limbic system (the emotional brain) to allow the expression of emotions.(Keep rapping your head above your ears and listen to the sound) Monitor world, Monitor body fluids, Constrict muscles, Regulate organs, Regulate basic drives, Mediate sensations, Store & retrieve memories, Regulate Mood, Intellectual functions, Sleep wake cycle, Language, visual & auditory data. parasympathetic activation: Hypermotility & diarrhea. Sympathetic activation: Vasoconstriction & hypertension. Hormones which act on the pituitary gland to stimulate or inhibit the secretion of pititury hormones Stimulates the pituitary to release corticotropin

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Norepinephrine or Noradrenaline NE

Monoamine. Alpha 1, alpha 2, beta 1, & beta 2 receptors. Effects mood, attention & arousal. Stimulates sympathetic or fight flight response. Monoamine. 5 HT 1, 5 HT 2, 5 HT 3, & 5 HT 4 receptors. Effects sleep regulatoin, hunger, mood, hormonal activity, & pain perception. Plays a role in aggression and sexual behavior. Monoamine. H 1 & H 2 receptors. Effects alertness, inflamitory response, stimulates gastric secretions. Amino Acid. GABA A & GABA B receptors. Reduces aggression, excitation, & anxiety. Effects inhibition, pain perception, anti convulsant, muscle relaxing. May impare cognition & psycomotor function. Amino Acid. NMDA & AMPA receptors. Excitiory. AMPA has role in learning & memory. Cholinergic. Stimulates parasympathetic nervous system. Nicotinic & muscarinic receptors M1, M2, M3. Effects learning, memory. Regulates mood, sexual and aggressive behavior. Peptide & Neuro Modulator. SP receptor. Promotes memory. enhances sensitivity to pain. Antagonist has anti depressant and anti anxiety effects. Peptide & Neuro Modulator. SRIF receptor. Altered levels are associated with congnitive disease. Peptide & Neuro Modulator. NT receptor. Anti psychotic properties. Enzyme that destroys acetylcholine. Destroys monoanines such as dopamine norepinephrine, and serotonin. Attachment of neuro transmitters to presynaptic receptors at the synapse which inhibit the further release of neuro transmitters.

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Occipital Lobe Temporal Lobe

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Serotonin 5 HT

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Histamine

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12 Functions of the Brain

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Gamma Aminobutyric Acid GABA

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Anxiety can cause

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Glutamate

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Releasing Factors The Hypothalamus Secretes CRH Corticotropin releasing hormone which does what? Word Salad Looseness of Association Memory dementia

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Acetycholine ACh

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Substance P, SP

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incoherent speech and thought patterns. A jumble of unrelated words unconnected phrases and topics
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Somatostatin SRIF

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the ability to retain & recall past experience a person has no recall of the events of the previous 8 minutes, but may have vivid recall of events which occured years earlier Make interpersonal relationships possible. Quality social skills are lacking in individuals with most mental illnesses Soma: Cell Body, presynaptic cell, post synaptic cell, axon, dendrite, receptor, synapse, neurotransmitters D1, D2, D3, D4, & D5 Receptors. effects fine muscle movmet, emotions, thoughts, decisioin making. Stimulates hypothalamus to secrete hormones for sex, thyroid, & adrenal.
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Neurotensin NT Acetylcholinesterase Monoamine Oxidase MOA Feedback Inhibiton

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Social Skills

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Parts of the Neuron Dopamine DA

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Neuro Peptides

Large molicules which are transmitted at the same time as neuro transmiters that initiate long term changes in the post synaptic cell which modify cell shape and responsiveness to stimuli. Protiens & gases released by the postsynaptic cells which influence the growth, shape, and activity of the presynaptic cells Estrogen, Testosterone, and cortisol can bind to neurons causing short and long term changes in neuron activity. Regulates the internal organs. Responsible for regulating blood gasses and blood pressure. Responsible for basic drives like hunger, thirst, and sex Ascending pathways which modulate the emotional value of sensory meterial Psychological reward and drug addiction

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Magnetic Resinance Imaging MRI

Magnetic field, hydrogen nuculi emit radio frequency analyzed by computer producing 3D image. Detects: Edema, ischemia, infection, neoplasm, and trauma Magnetic field without ionizing radiation, hydrogen nuculi emit radio frequency analyzed by computer producing 3D image. Detects: Edema, ischemia, infection, neoplasm, and trauma Radiation tracer injected, analyzed by computer producing 3D image of CNS. Detects: oxygen use, glucose metabolism, blood flow, neurotransmitter interaction. Identifies physiological & biochemical change as they occur. Uses radionuclides that emit gamma radiation, photons. Provides 3D image of the CNS. Detects: circulation of cerebrospinal fluid and same as PET reveal physiological activity in the brain. e.g. PET,SPECT Obsessive compulsive disorder Reduced activity in the frontal lobe

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Neurotrophic Factors

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Functional Magnetic Resinance Imaging fMRI

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Steroid hormones Brainstem

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Positro Emission Tomography PET

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Hypothalamus Mesocortical Pathways Ventral tegmental pathway Cerebellum

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Single Photon Emission Computed Tomography SPECT Functional Imaging Techniques OCD Performing a reason task during a PET scan, the schizophrenic brain will show? PET scan of the OCD brain will show? PET scan of a depression brain will show? PET scan of an Alzheimer's brain will show? Concordance Causes of mental disorders Neurotransmitters most often linked to mental activity are? Inhibitory Potentiate

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Regulation of skeletal muscle coordination, contraction, and maintenance of equilibrium. Smooth and direct movment. Mental activities, conscious sense of being, perception, emotions, memory, control of skeletal muscles, language, and communication. Touch, reading, math, right & left orientation Sound, expression of emotions fear, love, aggression Vision, visual memories

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Cerebrum

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Parietal Cortex Temporal Cortex Occipital Cortex Sensory language functions Motor Functions Basal Ganglia Amygdala hyppocampus 5 Imaging Techniques Computed Tomography CT

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Increased activity in the frontal cortex

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ability to read, understand spoken language, and know names of objects.

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Reduced brain activity, especially in the prefrontal cortex Hypermetabolism in the temporal and parietal lobes. How often one twin will be effected by the same illness as the other. Drugs, genetic predisposition, infection, physical trauma Norepinephrine, dopamine, serotonin, GABA, & glutamate.

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use of muscles for speach and writing regulation of movment Emotions, learning, memory, basic drives Emotions, learning, memory, basic drives CT, MRI, fMRI, PET, and SPECT series of X-rays producing a 3D image. Detects: lesions, abrasions, infarct, and aneurysms
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Calming To promote

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Soporific 5 benzodiazepines approved by FDA for treatment of insomnia In older adults, Benzo's may cause? Which hyponitic has the longest duration? 3 Z-hypnotics Ataxic Benzo's and Zhypnotics are catigorized as Melatonin Ramelteon (Rozerem) Long term use of Ramelteon can lead to? Buspirone (BuSpar)

Sleep producing Flurazepam (Dalmane), Temazepam (Restoril), Triazolam (Halcion), Estazolam (Prosom), & Quazepam (Doral)

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SerotoninNorepinephrine reuptake inhibitors SNRI SerotoninNorepinephrine disinhibitors SNDI Tyramine

increase serotonin and norepinephrine by blocking reuptake. e.g. Effexor, Cymbalta

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Increase serotonin and norepinephrine by antagonizing presynaptic alpha 2 noradrenergic receptors. e.g. Remron Monoamine present in many aged foods. e.g. cheese, wine, pickled or smoked fish. Destroyed by MAO in the liver. Can be fatal if consumed by patient taking MAOI's. Wellbutrin, effective antidepressant also used for smoking cessation as Zyban pupil reflex and eye movement Major processing station for auditory pathways Reflex center. Controls: balance, heart rate, breathing rate and depth, coughing, sneezing, swallowing, maintaining BP, vomiting Glutamate antagonist, GABA agonist. Treats: Bipolar disorders, a mood stabilizer, recomended for mixed episodes. Side effects: weight gain, sedation, tremmors, thrombocytopenia, pancreatitis, & hepatic failure Treats and prevents mania. Reduces excitability of neurons by slowing activity of sodium channels. Anticholinergic side effects. Blood toxicity level: >12mcg/ml Treats Bipolar disorder and depression. Modulates the release of glutamate and asparate. Side effects: Rash which may indicate deadly Stevens-Johnson syndrome. subsidence of erection Clozapine & Olanzapine

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Falls & broken bones

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Eszopiclone

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New class of hypnotics. Includes: Ambien, Sonata, & Lunesta Unsteady Schedule C-IV by the DEA

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Bupropion Midbrain Pons Medulla Oblongata

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hormone secreted at night as part of the normal circadian rhythm Melatonin receptor agonist. Acts similar to naturaly occurring melatonin. Side effects: head ache & dizziness Sexual dysfunction
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Valporate (Depakote or Depakene)

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Serotonin feedback inhibitor. Reduces anxiety, strong seditive effects without sleepiness or slugishness. No addiction. Side effects: head ache, dizzy, nausea, insomnia Antidepressant used to treat anxiety in patients with OCD, SAD, and PD. Antidepressant used to treat anxiety in patients with GAD Deficiency of Serotonin, Norepinephrine, or Dopimine. Increasing these should alleviate depression low levels of neurotransmitters cause upregulation(increased sinsitivity or number) of receptors on the postsynaptic cell. High levels cause low downregulation(desensitization) destroys monoamines after reuptake in the presynaptic neuron Increased use of antidepressants cause increased production of neurotrophic factors which in turn keep the nerve cells alive and anhance sprouting of axons

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Carbamazepine (Tegretol)

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Effexor Cymbalta Monoamine hypothesis of depression Monoamine receptor hypothesis of depression Monoamine Oxidase Neurotrophic factors theory of depression

Lamotrigine (lamictal)

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detumescence What 2 medications have the highest risk of causing metabolic syndrome? What 2 medications have the lowest risk of causing metabolic syndrome?

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Aripiprazole & Ziprasidone

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Clozapine (Clozaril) Risperidone (Risperdal) Quetiapine (Seroquel) Olanzapine (Zyprexia) Ziprasidone (Geodon) Aripiprazole (Abilify) Akathisia Paliperidone (Invega) Methylphenidate (Ritalin)

1st atypical, Blocks DA receptors in mesolimbic system. SE: drowsy, sedation, hypersalivation, convulsions, suppress bone marrow & induce agranulocytosis. Monitor WBC 6 months. First atypical available in long-acting injection. Side effects: high risk for EPS, sexual disfunction, orthostatic hypotension, weight gain, sedation, CVA Atypical antipsychotic. Blocks histamine-1, Setotonin, & a1 Adrenergic recptors. Low risk for EPS. Side effects: sedation, weight gain, metabolic syndrome Atypical antipsychotic. Side effects: sedation, weight gain, hyperglycemiain new diabetics type-2, metabolic syndrome Atypical antipsychotic. Serotonin-norepinephrine reuptake inhibitor. Side effects: dizzy, sedation. Contraindicated with QT Prolongation, recent MI, or uncompinsated Heart Failure Atypical antipsychotic. "Dopamine stabilizer". Dopamine receptor antagonist in high concentration and also stimulates increase of dopamine in low concentrations. Side effects: insomnia, akathisia Motor restlessness such as fidgeting, rocking, or pacing due to the neuromuscular or neurologic adverse effects associated with the use of antipsychotics. Newest Atypical in USA. Side effects: orthostasis, sedation, EPS, & prolactin elevation. Simpathomimetic amine which mimics norepi. Psychostimulant for the treatment of ADHD. Agonist of adrenergic receptor cites.

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