Psychopharmacology Lecture Notes

Vocabulary flashcards covering psychoactive drug categories, specific medications, side effects, mechanisms of action, and clinical trial methodologies from the lecture notes.

Psychoactive drugs

Chemicals that interact with the CNS in a way that they produce change in mood, consciousness, perception, and behavior by affecting the production, reuptake, release, or receptor binding of neurotransmitters.

Direct agonists

Substances that mimic the effect of a neurotransmitter at a receptor site.

Indirect agonists

Substances that attach to a binding site on a receptor cell other than where the neurotransmitter attaches and facilitate the action of the neurotransmitter.

Inverse agonists

Substances that bind to the same receptor as an agonist but produce the opposite effect.

Direct antagonists

Substances that attach to a neurotransmitter’s receptor site and reduce the effect of the agonist.

Indirect antagonists

Substances that attach to a binding site on a receptor cell – other than where the neurotransmitter attaches – and interfere with the action of the neurotransmitter.

Pharmacokinetic factors

What the body does to a drug, specifically regarding differences in metabolism, absorption, distribution, and excretion.

Psychotropic drugs

Drugs that affect the central nervous system; most often prescribed in primary care offices, except for antipsychotic and antimanic drugs which are typically managed by specialists.

Traditional Antipsychotic Drugs

Also known as neuroleptics or major tranquilizers (e.g., Phenothiazine, Thioxanthene, Butyrophenone), used to treat the positive symptoms of schizophrenia.

Dopamine hypothesis of schizophrenia

The theory that schizophrenia is caused by oversensitive dopamine receptors or excessive dopamine, supported by the fact that amphetamines can cause psychotic symptoms.

Anticholinergic effects

Side effects caused by blocking acetylcholine, including dry mouth, blurred vision, urinary retention, constipation, tachycardia, and delayed ejaculation.

Extrapyramidal effects

Effects on the dopamine receptors in the caudate nucleus, including Parkinsonism, Akathisia, and Acute dystonia.

Akathisia

A common extrapyramidal side effect characterized by extreme motor restlessness.

Acute dystonia

Muscle spasms occurring in the mouth, face, and neck as a side effect of antipsychotic medications.

Tardive dyskinesia

A late-onset and serious side effect involving involuntary rhythmic movement of the jaw, lips, tongue, and extremities; can be alleviated by benzodiazepines or GABA agonists.

Neuroleptic malignant syndrome

A potentially fatal condition with rapid onset characterized by muscle rigidity, tachycardia, hyperthermia (fever), and altered consciousness.

Atypical Antipsychotic Drugs

Novel medications (e.g., Clozapine, Risperidone) that treat both positive and negative symptoms of schizophrenia and act on $D_4$ and other dopamine receptors as well as serotonin and glutamate.

Agranulocytosis

A side effect of unconventional antipsychotics involving a dangerous decrease in a specific type of white blood cells.

Tricyclic Antidepressants (TCAs)

Drugs such as Amitriptyline and Imipramine that block norepinephrine, serotonin, and dopamine reuptake; they are notably cardiotoxic and lethal in overdose.

Catecholamine hypothesis

The theory that depression is caused by a deficiency in norepinephrine.

SSRIs

Selective Serotonin Reuptake Inhibitors (e.g., Fluoxetine, Sertraline) that block serotonin reuptake and are safer in overdose than TCAs.

Serotonin syndrome

A dangerous state caused by mixing SSRIs with MAOIs, resulting in headache, nystagmus, tremor, dizziness, confusion, cardiac arrhythmia, and potentially coma.

MAOIs

Monoamine oxidase inhibitors (e.g., Phenelzine, Tranylcypromine) that inhibit the enzyme that deactivates dopamine, serotonin, and norepinephrine.

Hypertensive crisis

A severe increase in blood pressure occurring when MAOIs are taken with tyramine-rich foods like aged cheeses, cured meats, or draft beer.

Lithium

A mood stabilizer used for classic bipolar disorder that eliminates manic symptoms and requires serum level monitoring to prevent toxicity.

Carbamazepine

An anticonvulsant (Tegretol) used for Bipolar Disorder patients who do not respond to lithium or experience rapid cycling.

Sedative-Hypnotics

CNS depressants including barbiturates, anxiolytics, and alcohol that reduce arousal and induce sleep in a dose-dependent manner.

Cross tolerance

A condition where receiving or developing a tolerance to one drug in a class (like barbiturates) results in tolerance to others in that class (like alcohol).

REM rebound

The occurrence of intense nightmares and increased REM sleep following the abrupt cessation of barbiturates.

Benzodiazepines

Minor tranquilizers or anti-anxiety drugs (e.g., Diazepam, Alprazolam) that stimulate GABA to produce an inhibitory effect.

Azapirone

A non-addictive, non-sedating anxiolytic that is not subject to abuse but takes several weeks to become effective.

Beta-Blockers

Drugs like Propranolol that block beta-adrenergic receptors and are used to treat high blood pressure as well as the physical symptoms of anxiety.

Narcotic-Analgesics

Opioids (e.g., morphine, heroin, methadone) that act on receptors in the brain and spinal cord to reduce pain perception and produce euphoria.

Methadone

A synthetic opioid used in heroin detoxification programs that satisfies physical dependence without producing the same positive euphoric feelings.

Psychostimulants

Drugs (Amphetamines and Methylphenidate) that increase the release and block the reuptake of norepinephrine and dopamine to treat ADHD and narcolepsy.

Sensitization

A greater behavioral response when psychostimulants are used intermittently.

Drug holidays

Temporary cessations of Methylphenidate use intended to stop growth suppression and evaluate if the medication is still required.

Disulfiram

An anti-alcohol drug (Antabuse) that inhibits alcohol metabolism, causing severe unpleasantness (nausea, vomiting, tachycardia) if alcohol is consumed.

Naltrexone

An opioid receptor antagonist that blocks cravings and the reinforcing effects of alcohol.

Phase III efficacy trials

Clinical trials designed to demonstrate intrinsic pharmacological effects and provide data for cataloguing and authorization.

Practical/Pragmatic Clinical Trials (PCTs)

Large simple trials conducted in practice settings to study the effects of interventions under typical community conditions on a mainstream clinical population.

Therapeutic Drug Monitoring (TDM)

The practice of measuring drug concentrations at intervals to maintain constant levels in the bloodstream, particularly for drugs with narrow therapeutic ranges.

Cytogenetics

A genetic screening method involving the examination of chromosomes in dividing human cells, like T-lymphocytes.

Biochemical genetic tests

Tests that evaluate protein function to detect inborn errors of metabolism and disruptions of metabolic pathways.

Direct DNA analysis

A genetic screening method used when the gene sequence is known and biochemical testing is not possible.