Biological Basis of Psychopharmacology Study Guide PDF

Preview

Summary

Download Biological Basis of Psychopharmacology Study Guide PDF

Description

Bi ol ogi cal Basi sofPs y c hophar macol ogy Neur ot r ansmi t t er sar echemi cal sr el easedf r om neur onst hatf unct i on asneur omess enger sandi nfl uencebr ai nf unc t i ons . Theneur ot r ansmi t t erGABApl ay sar ol ei nmodul at i ngneur onal ex c i t abi l i t yandanx i et y .Manyant i anxi et y( anx i ol y t i c )dr ugsi nc r eas e t heeffec t i v enes soft hi sneur ot r ansmi t t er ,pr i mar i l ybyi nc r eas i ng si mpl i c at edi nanxi et ydi s or der s . r ec ept orr esponsi v eness .GABAi Dopami nei si nv ol v edi nt houghtpr oc es sesandr egul at i onof mov ement .Dopami nei si mpl i cat edi nsc hi z ophr eni a( i nc r eas e)and Par ki ns ondi seas e( decr ease) . Gl ut amat ei sass oc i at edwi t hmemor yandl ear ni ng. Monoami neoxi dasei sanenz ymei nv ol v edi nr egul at i ngmet abol i sm ofnor epi nephr i ne. Acet yl chol i nei si mpl i c at edi nAl z hei merdi seas e( dec r easei n i ngt ondi s eas e,andPar k i ns ondi seas e.The Ac et y l chol i ne) ,Hunt bl ocki ngofac et y l chol i ne( ACh)r ecept or scaus ess y mpt omss uc has dr ymout h,c onst i pat i on,andbl ur r edv i si on.Ps y c hot r opi cdr ugsmos t l i k el ybl ockt heAChr ecept or scausi ngt hes es y mpt oms . Hi st ami nei sass oci at edwi t hal l er gi cr eact i ons .

Li t hi um i samoods t abi l i z ert hatc ancausedi st ur bancesi nfl ui d bal ancei nv ar i ousbodyc ompar t ment s .Sodi um andpot ass i um pl aya ponat r emi ac ani nc r easet he s t r ongr ol ei nr egul at i ngfl ui dbal ance.Hy r i s kofl i t hi um t ox i ci t ybecaus ei nc r eas edr enal r eabsor pt i onofs odi um l eadst oi nc r eas edr eabsor pt i onofl i t hi um. Nar r owt her apeut i cr ange:0. 51. 5

1.Howdoesat r i cy cl i cant i depr essanthel pt or el i ev edepr essi on? * I tpr ev ent st hedest r uct i onofnor epi nephr i ne Nor epi nephr i nebi ndst ot her ecept or soft hepost s ynapt i cneur ons , whi chc aus esex ci t at i onoft hepost s y napt i cneur on.Uponi nt er act i on wi t ht hemonoami neox i daseenz yme,nor epi nephr i nei sr emov edf r om t her ecept or sandi sdes t r oy ed.Theex c i t at or yeffecti nt he pos t s y napt i cneur onal sodi sappear s .I nor dert opr ol ongt heac t i onof nor epi nephr i ne,t hei nt er act i onofnor epi nephr i newi t hmonoami ne si st hemechani s m ofact i onoft r i c y c l i c oxi dasei si nhi bi t ed.Thi ant i depr ess ant s .

2.Whi chneur oi magi ngt echni quesdemonst r at est r uct ur al r at her t hanf unct i onal pr obl ems ? ndMRIs canss howbr ai ns t r uct ur ewi t hov er al li magesand *CTa l ay er soft hebr ai n.EEG showsel ect r i calact i v i t y . Funct i onali magi ngt ec hni quessuchasPETandSPECTr ev eal phy si ol ogi c alact i v i t yi nt hebr ai n. APETscandet ect sbr ai nac t i v i t y .CTscans,v ent r i cul ogr ams ,and el ect r oenc ephal ogr amsar el i mi t edt ov i sual i z at i onofs t r uct ur es . PETus esani nj ect edr adi oac t i v esubst ance( t r acer )t hatt r av el st ot he br ai nandshowsupasbr i ghts pot sont hesc an.Dat acol l ec t edbyt he es det ect or sar er el ay edt oacomput er .Si mi l art oPET,SPECTus r adi onucl i dest hatemi tgr adi at i on( phot ons ) .Thi sal l owsf ort he meas ur i ngofv ar i ousas pect sofbr ai nf unct i oni ngandpr ov i desi mages ofmul t i pl el ay er soft hecent r al ner v ouss y s t em ( CNS) .Noi nj ec t i oni s r equi r edf oranEEG,CT,orMRI .

Ant i convul santMoodSt abi l i z i ngDr ugs

3.Whi c hant i convul santmoodst abi l i z erof t enpr es cr i bedf or bi pol ardi s or dercar r i esabl ackboxwar ni ngt hati nc l udes panc r eat i t i s ? * Val pr oi caci d( Depakene)i shel pf uli nbi pol arpat i ent sunr esponsi v e ac kboxwar ni ngsf orv al pr oi caci di ncl udehepat ot oxi ci t y , t ol i t hi um.Bl t et r at ogeni c i t y ,andpancr eat i t i s .

Theus eofLamot r i gi ne( Lami ct al )mayt r i ggeras ev er eal l er gi cs ki n r eact i oncal l edSt ephens J ohnsons y ndr ome( SJ S) .

Theus eofCar bamaz epi ne( Tegr et ol )war r ant saper i odi cc ompl et e bl oodcountduet or ar e,butser i ousbl ooddy s cr as i as( e. g. ,apl as t i c anemi aandagr anul oc yt os i s) .

4.Basedont hecur r entunder st andi ngofneur ot r ansmi t t er s ,what ev enti sr es pons i bl ef oracl i ent ’ ss y mpt omsofpr of ound depr es si on? * Adec r eas edser ot oni nl eveli shi ghl yassoci at edwi t hdepr ess i on

5.Whi c hi st hepr i or i t ynur si ngi nt er v ent i onwhenadmi ni st er i ng r i sper i done ? * Ri sper i donehasahi ghr at eofex t r apy r ami dals i deeffect s( EPSs ) , ev enatdos esonl ys l i ght l yhi ghert hant heeffect i v edos e,t husmak i ng i ti mper at i v et omoni t orf orEPSs .Ri s per i donebl ock sα1 and H1 r ecept or sandc anc auseor t host at i chy pot ensi onands edat i on, whi chc anl eadt of al l s ,s ot henur s es houl dmoni t ort hecl i ent ’ ss i t t i ng, s t andi ng,andl y i ngbl oodpr es sur edai l y .

6.Whi c hst at ement sr egar di ngt heeffect sofphar macogenet i cs onmedi cat i onadmi ni st r at i onr el at ednur s i ngcar ear et r ue ? * Byunder s t andi nghowgenesi nfl uenc edr ugr es pons es ,c l i ni c i ans mayonedaybeabl et opr es c r i bedr ugsbes tsui t edf oreachi ndi vi dual , i not herwor ds ,i namor ec l i ent s peci fi cway .Ther el at i v el ynewfi el dof phar macogenet i csf oc usesonhowgenesaffecti ndi vi dualr es pons es t omedi c i nes .Ani mpor t antv ar i at i ont hati mpact st heabi l i t yt o met abol i z edr ugsr el at est ot hemor et han20CYPenz y mespr esenti n humanbei ngs .Genet i cv ar i at i onsi nt hes eenzy mesmayal t erdr ug met abol i s m,andt hes ev ar i at i onst endt obepr opagat edt hr oughr ac i al andet hni cpopul at i ons .CYPenz y mesmet abol i z emos t ant i depr ess ant sandant i ps y c hot i cs .Onepur poseofgenet i ct est i ngi n t hef ut ur ewi l lbet oenabl ec l i ni ci anst odet er mi nec or r ectdr ugsand dosageus i ngl i v erenz ymes ,notcar di acenz ymes .

Fi r stGener at i onAnt i psychot i cs( FGA’ s Dopami ner ecept oragoni s t s

Tr eat sposi t i v es i gnsofps y chos i sandschi z ophr eni a * * Schi z ophr eni aal soas soc i at edwi t hhear tdi seas eanddi abet es * * Canc aus eEx t r apy r ami dals y mpt omss uchasdy st oni a( musc l e s t i ffnes s) ,ak at hi si a( r es t l es sness ) ,t ar di v edy s ki nesi a( TD) ,anddr ugi nducedpar ki ns oni s m. Ex ampl es :Hal dol( Hal oper i dol ) ,Pr ol i xi n( Fl uphenaz i ne) , Chl or pr omaz i ne( Thor az i ne)

SecondGener at i onAnt i psychot i cs( SGA’ s) Sev er alSGAshav ebeenFDAappr ov edt ot r eatbi pol ardi s or derand depr ess i on.Fur t her mor e,becauseoft hei rdi ffer entbi ndi ngr ecept or ef ewerex t r apyr ami dals i deeffect s( EPS) .The pr ofil es ,t heSGAshav

t er m" secondgener at i onant i ps y chot i c"i sat er mt oi dent i f yt henewer f or m ofant i ps y c hot i cmedi cat i ons .AnSGAhasahi gherr at i oof s er ot oni n( 5HT2)t odopami neD2r ecept orbl ock adet hanfi r s t gener at i onf or ms .SomeSGAsmayhav es i gni fi cantant i chol i ner gi c andant i hi st ami neact i vi t y ,s osomeoft hes i deeffec t smayi nc l udea s dr ymout handc ons t i pat i onr at hert hans al i v at i onanddi ar r hea.SGA’ t r eatnegat i v es i gnsofps y chosi s . Ex ampl esofMeds :Cl oz api ne( Cl oz ar i l ) ,Ol anzapi ne( Zy pr ex a) , Ri sper i done( Ri s per dal ) ,Ar i pi pr az ol e( Abi l i f y ) , Geodon:ADVERSEREACTI ON-el ongat edQT

Ant i depr essantmedi cat i ont ar get ss er ot oni nandnor epi nephr i ne.

Ant i depr es santCl as si fi cat i ons 1.Monoami neOxi daseI nhi bi t or s( MAOI ’ s) :Bl ockt hat

met abol i z esmonoami nes ,t heymayoccas i onal l ybeusedt o i nc r eas et hel ev el sofser ot oni nandnor epi nephr i nei ni nt r act abl e depr es si on.

Tr az odonehel psr el i ev ei nsomni aandl os esi t sant i depr ess ant ON:PRI API SM effect si nl owdos es .ADVERSEREACTI 2.Or i gi nal l yt er medt r i cycl i cant i depr essant s( TCAs) ,t hes e agent sar emor eacc ur at el yc al l edc y c l i cant i depr ess ant s( CAs ) becaus enewermember soft hi sc l as shav eaf our r i ngs t r uct ur e. TCAs ,s uchasami t r i pt yl i ne( El avi l )andnor t r i pt yl i ne( Pamel or ) ,act pr i mar i l ybybl ock i ngt hepr es y napt i ct r ans por t erpr ot ei nr ecept or sf or nor epi nephr i ne,andt oal es serdegr ee,s er ot oni n.Thi sbl ock i ng pr ev ent snor epi nephr i nef r om c omi ngi nt ocont actwi t hi t sdegr adi ng enz yme,MAO,andt husi nc r eas est hel ev el ofnor epi nephr i neatt he s y naps e.

3. Sel ect i veser ot oni nr eupt akei nhi bi t or s( SSRI ’ s) bl oc kt he r eupt ak eofs er ot oni n,i nc r easi ngnor epi nephr i ne.Ser ot oni nt oxi ci t y ( Ser ot oni nSy ndr ome)mayoccurwi t hcoadmi ni st r at i onofot her eg.MAOI ’ s ,SSRI ’ s ,SNRI ’ s ,Li t hi um,Tr i pt an, s er ot oner gi cdr ugs( buspi r one,t r amadol ,ov er t hec ount erc oughandcol dmeds c ont ai ni ngdex t r omet hor phan)

Di az epam bel ongst ot hecl as sofbenz odi az epi nes .Thes edr ugs st hemaj or r el i ev eanxi et ybybi ndi ngt oGABAr ecept or s .GABAi ef or e, i nhi bi t or yneur ot r ansmi t t eri nt hec ent r alner v ouss y s t em.Ther bl ocki ngt heGABAr ecept or swoul dpr ev enti nhi bi t i onoft hec ent r al ner v ouss y s t em andr el i ev eanx i et y .I fbenz odi az epi nesar ecombi ned wi t hot herCNSdepr ess ant ss uchasal cohol ,t hent hei nhi bi t or y act i onsoft hebenz odi az epi nesc anl eadt ol i f et hr eat eni ngCNS depr ess i ons uc hascoma.Benz odi az epi ness houl dnev erbe c ons umedwi t ht r i c y cl i cant i depr ess ant sdr ugs ,becaus et hei r i nt er ac t i onmayc aus eser i ousCNSdepr es s i ons ympt oms ,s uc has c omaandr es pi r at or ydi s t r ess .

Cl onaz epam i si nt hec l as sofdr ugsknown asbenz odi az epi nes ,whi char et hemos tcommonl yusedant i anx i et y agent s ANTI DOTETO BENZODI AZEPI NES-FLUMAZENI L Ramel t eon( Roz er em)i samel at oni nr ecept oragoni s tt hatwor ksasa hy pnot i c .

Br ai nSt r uct ur esandFunct i ons Thecer ebel l um i si nv ol v edpr i mar i l yi nt her egul at i onofs k el et al musc l ecoor di nat i onandcont r ac t i onandt hemai nt enanceof equi l i br i um.I tpl ay sac r uc i alr ol ei nc oor di nat i ngc ont r act i onssot hat

mov ementi saccompl i shedi nas moot handdi r ec t edmanner .Musc l e c oor di nat i oni snotas soci at eddi r ec t l ywi t ht hemi dbr ai n,pons ,or medul l a. dbr ai ni si nv ol v edwi t hpupi l l ar yr efl exandey emov ement . Themi st hemaj orpr oces si ngst at i oni naudi t or ypat hway s . Theponsi l acont ai nsr efl excent er st hatc ont r olbal ance,hear tr at e, Themedul r espi r at i on,andmai nt ai nsbl oodpr essur e. Thet empor all obeconnect st ot hel i mbi cs y st em t oal l owex pr es si on ofemot i ons .Anyi nj ur yt ot het empor all obewoul dr es ul ti nabnor mal l y fl uc t uat i ngemot i ons .Thi sl obei sal s or es pons i bl ef orl anguage c ompr ehens i onandhear i ng. Thef r ont all obei sc hi efl yr esponsi bl ef ori ni t i at i ngv ol unt ar yac t i vi t i es . Thef r ont all obeal s ocont r ol ss oc i alj udgment .Cogni t i on,memor y ,and r ont al anal y t i cal f unct i onsar el ar gel yf unc t i onsofat hi r dr egi onoft hef l obe,knownast hepr ef r ont alc or t ex .Damaget ot hi sar eaoft hef r ont al l obemayc aus ec hangesi ndec i s i onmaki ngandj udgment . Theocci pi t all obei nt er pr et svi s ual i magesands t or esvi sual memor i es . i et all obei sc hi efl yconcer nedwi t ht heper c ept i onof Thepar s ens at i ons .Sensor yper cept i on,pr opr i ocept i on,andt heabi l i t yt o i et al di st i ngui shbet weenr i ghtandl ef tar et hef unct i onsoft hepar l obeoft hecer ebr alcor t ex . Thr oughpr oj ec t i onsoft her et i cul aract i v at i ngs y st em ( RAS) , ai nst em r egul at est heent i r ec y c l eofsl eepandwak ef ul nessand t hebr t heabi l i t yoft hec er ebr um t ocar r youtc ons ci ousment alact i v i t y . Theamygdal aandhi ppocampusar ei nv ol v edi nemot i ons ,l ear ni ng, memor y ,andbas i cdr i v es ....