[PCOL] Part 5.2 - Central Nervous System Drugs - Antipsychotic Agents, Antidepressant Agents

f. All

Psychosis.

a. General term for breakdown of personality

b. Can be schizophrenia or the typical psychotic

c. Can be affective of mood disorder such as major depression and bipolar disorder

d. a and b

e. b and c

f. All

a. DA

Schizophrenia is caused by increased

a. DA

b. 5-HT

c. Glutamate

d. a and b

e. b and c

f. All

e. b and c

Affective/Mood disorder is caused by decreased

a. DA

b. 5HT

c. NE

d. a and b

e. b and c

f. All

e. None

Drugs for Schizophrenia except:

a. Antipsychotics

b. Neuroleptics

c. Antischizophrenics

d. Major Tranquilizers

e. None

b. 2

Antipsychotics has how many generations?

a. 1

b. 2

c. 3

d. 4

e. 5

a. I, II, III, IV

1st Generation Antipsychotics except:

I. Typical/Classical

II. D2 blockers

III. Greater D2 blockade than 5HT2A blockade

IV. Can cause extrapyramidal syndrome (EPS)

a. I, II, III, IV

b. I, II

c. I, II, III

d. II, III, IV

f. All - known as the Anti "H𝛼m" effect

Other effects of 1st generation antipsychotics.

a. Block histaminic receptors: Causing sedation

b. Block 𝛼 adrenoceptor: Like Alpha 1 → Vasodilation → Orthostatic hypotension

c. Block muscarinic receptors (Anti-cholinergic): Urinary retention

d. a and b

e. b and c

f. All

a. I, II, III, IV

2nd Generation Antipsychotics:

I. Atypical/Newer

II. D4 and 5HT2A blockers

III. Greater D4 and 5HT2A blockade than D2 blockade

IV. Less risk for extrapyramidal syndrome (EPS)

a. I, II, III, IV

b. I, II

c. I, II, III

d. II, III, IV

a. 1st generation antipsychotics

Treatment for positive symptoms of schizophrenia.

a. 1st generation antipsychotics

b. 2nd generation antipsychotics

b. 2nd generation antipsychotics

Treatment for negative symptoms of schizophrenia.

a. 1st generation antipsychotics

b. 2nd generation antipsychotics

f. All

Sub classifications of 1st generation antipsychotics.

a. Phenothiazines

b. Thioxanthene

c. Butyrophenone

d. a and b

e. b and c

f. All

Aliphatics: Chlorpromazine

Piperazine: Fluphenazine

Piperidine: Thioridazine

Thioxanthine: Thiothixene

Butyrophenone: -peridol

1st generation antipsychotics

Chlorpromazine

Fluphenazine

Thioridazine

Phenothiazine 1st generation antipsychotics.

Thiothixene

Thioxanthene 1st generation antipsychotics

Haloperidol

Droperidol

Butyrophenone 1st generation antipsychotics

f. I, II, III, IV, V, VI

2nd generation antipsychotics.

I. Aripiprazole

II. Clozapine

III. Olanzapine

IV. Quetiapine

V. Risperidone

VI. Ziprasidone

a. I, II, III, IV, V

b. II, III, IV, V, VI

c. III, IV, V, VI

d. I, II, III, IV

e. I, II, III

f. I, II, III, IV, V, VI

a. I, II, III, IV

Drugs for major depression.

I. Tricyclic Antidepressants

II. Selective Serotonin Reuptake Inhibitors (SSRI)

III. Atypical Antidepressants

IV. Monoamine Oxidase Inhibitors (MAOI)

a. I, II, III, IV

b. I, II

c. I, II, III

d. II, III, IV

f. All

Inhibit reuptake of Norepinephrine = increase norepinephrine

Blocking reuptake of serotonin = increase serotonin

Mechanism of actions for depression.

a. Inhibit reuptake of Norepinephrine

b. Blocking reuptake of serotonin

c. Monoamine Oxidase Inhibitors

d. a and b

e. b and c

f. All

a. Tricyclic Antidepressants

Inhibit reuptake of Norepinephrine.

a. Tricyclic Antidepressants

b. Selective Serotonin Reuptake Inhibitors (SSRI)

c. Atypical Antidepressants

d. Monoamine Oxidase Inhibitors (MAOI)

c. Atypical Antidepressants

Random and drug-unique MOA.

a. Tricyclic Antidepressants

b. Selective Serotonin Reuptake Inhibitors (SSRI)

c. Atypical Antidepressants

d. Monoamine Oxidase Inhibitors (MAOI)

a. Amoxapine → tetracycline antidepressant

Also blocks dopamine receptors.

a. Amoxapine

b. Trazodone and Nefazodone

c. Mirtazapine

d. a and b

e. b and c

f. All

b. Trazodone and Nefazodone

Antagonists at postjunctional 5-HT2-receptors and also block prejunctional serotonin 5HT1-autoreceptors.

a. Amoxapine

b. Trazodone and Nefazodone

c. Mirtazapine

d. a and b

e. b and c

f. All

c. Mirtazapine

Also has serotonin 5-HT2-receptor antagonist activity and also blocks alpha2-receptors.

a. Amoxapine

b. Trazodone and Nefazodone

c. Mirtazapine

d. a and b

e. b and c

f. All

a. I, II, III, IV

Tricyclic Antidepressants (TCAs).

I. Inhibit reuptake of NE

II. Narrow therapeutic index

III. Include the -triptylline, and -pramine

IV. Has toxic effects including coma, convulsion, cardiotoxic

a. I, II, III, IV

b. I, II

c. I, II, III

d. II, III, IV

3C

Coma

Convulsion

Cardiotoxicity

Toxic effects of TCA

f. Desipramine - this is secondary amine

Tertiary amines: (ACID)

Amitriptyline

Clomipramine

Imipramine

Doxepin

Tertiary amine TCA except:

a. Amitriptyline

b. Imipramine

c. Trimipramine

d. Doxepin

e. Clomipramine

f. Desipramine

d. Amoxapine - this is dibenzoxazepine

Secondary amine TCA except:

a. Desipramine

b. Nortriptyline

c. Protriptyline

d. Amoxapine

e. None

d. Amoxapine

Dibenzoxazepine.

a. Desipramine

b. Nortriptyline

c. Protriptyline

d. Amoxapine

f. None

Selective Serotonin Reuptake Inhibitors (SSRIs) except:

a. Inhibit the reuptake of 5HT only

b. Safer than TCAs

c. Increase suicidal thoughts, should be included in BBW

d. Interact with fluoxetine and paroxetine which are enzyme inhibitors

e. Interact with MAOIs causing Serotonin Syndrome

f. None

d. I, II, IV, V, VI, VII

SSRIs: -xetine, -lopram, Sertraline except Duloxetine (SNRI)

SSRIs.

I. Fluoxetine

II. Paroxetine

III. Duloxetine

IV. Citalopram

V. Escitalopram

VI. Fluvoxamine

VII. Sertraline

a. I, II, III, IV, V, VI, VII

b. I, II, III, IV, V, VI

c. II, III, IV, V, VI, VII

d. I, II, IV, V, VI, VII

e. I, III, IV, V, VI, VII

f. I, II, III, IV, VI, VII

e. Duloxetine

SSRIs except:

a. Fluoxetine

b. Paroxetine

c. Citalopram

d. Escitalopram

e. Duloxetine

f. None

a. I, II, III, IV, V, VI, VII

Atypical antidepressants.

I. Trazodone

II. Maprotiline

III. Bupropion

IV. Venlafaxine

V. Nefazodone

VI. Mirtazapine

VII. Duloxetine

a. I, II, III, IV, V, VI, VII

b. I, II, III, IV, V, VI

c. II, III, IV, V, VI, VII

d. I, II, IV, V, VI, VII

e. I, III, IV, V, VI, VII

f. I, II, III, IV, VI, VII

e. None

Highly sedating atypical antidepressants except:

a. Trazodone

b. Nefazodone

c. Mirtazapine

d. Maprotiline

e. None

f. All

a. Trazodone

Atypical antidepressant that causes postural hypotension and priapism (sustained erection of penis).

a. Trazodone

b. Mirtazapine

c. Bupropion

d. Maprotiline

e. Amoxapine

b. Mirtazapine

Atypical antidepressant that causes marked weight gain.

a. Trazodone

b. Mirtazapine

c. Bupropion

d. Maprotiline

e. Amoxapine

c. Bupropion

Atypical antidepressant that may cause seizure; also used for smoking cessation.

a. Trazodone

b. Mirtazapine

c. Bupropion

d. Maprotiline

e. Amoxapine

e. Amoxapine

Atypical antidepressant that may cause movement disorders.

a. Trazodone

b. Mirtazapine

c. Bupropion

d. Maprotiline

e. Amoxapine

d. Venlafaxine

Atypical antidepressant that causes sexual disturbances, anxiety, and insomnia.

a. Bupropion

b. Maprotiline

c. Amoxapine

d. Venlafaxine

e. Duloxetine

e. Duloxetine

Atypical antidepressant that causes GI disturbances, sexual dysfunction, insomnia, nausea.

a. Bupropion

b. Maprotiline

c. Amoxapine

d. Venlafaxine

e. Duloxetine

a. MAOA

Metabolizes Norepinephrine, Epinephrine, Serotonin.

a. MAOA

b. MAOB

b. MAOB

Metabolizes Dopamine only.

a. MAOA

b. MAOB

a. I, II, III, IV, V

MAO inhibitors.

I. Tranylcypromine

II. Isocaroxazid

III. Phenelzine

IV. Moclobemide

V. Selegiline

a. I, II, III, IV, V

b. I, II, III

c. IV

d. V

e. I, II, III

b. I, II, III

Nonselective MAO inhibitors.

I. Tranylcypromine

II. Isocaroxazid

III. Phenelzine

IV. Moclobemide

V. Selegiline

a. I, II, III, IV, V

b. I, II, III

c. IV

d. V

e. I, II, III

c. IV - Moclobemide

MAOA selective inhibitors.

I. Tranylcypromine

II. Isocaroxazid

III. Phenelzine

IV. Moclobemide

V. Selegiline

a. I, II, III, IV, V

b. I, II, III

c. IV

d. V

e. I, II, III

d. V

MOAB selective inhibitors.

I. Tranylcypromine

II. Isocaroxazid

III. Phenelzine

IV. Moclobemide

V. Selegiline

a. I, II, III, IV, V

b. I, II, III

c. IV

d. V

e. I, II, III

e. Selegiline

MAO inhibitors not effective as antidepressant.

a. Tranylcypromine

b. Isocaroxazid

c. Phenelzine

d. Moclobemide

e. Selegiline

f. All

MAOIs interact with

a. Sympathomimetics like Tyramine

b. SSRIs, certain TCAs, and Meperidine

c. BRBs, Alcohol, Opioids

d. a and b

e. b and c

f. All

a. Sympathomimetics like Tyramine

MAOIs drug interaction:

Hypertensive crisis.

a. Sympathomimetics like Tyramine

b. SSRIs, certain TCAs, and Meperidine

c. BRBs, Alcohol, Opioids

d. a and b

e. b and c

f. All

b. SSRIs, certain TCAs, and Meperidine

MAOIs drug interaction:

Serotonin Syndrome.

a. Sympathomimetics

b. SSRIs, certain TCAs, and Meperidine

c. BRBs, Alcohol, Opioids

d. a and b

e. b and c

f. All

c. BRBs, Alcohol, Opioids

MAOIs drug interaction:

Additive sedation and CNS depression.

a. Sympathomimetics

b. SSRIs, certain TCAs, and Meperidine

c. BRBs, Alcohol, Opioids

d. a and b

e. b and c

f. All

f. SSRI

Preferred for major depressive disorder.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

b. Lithium

For bipolar disorder.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

f. SSRI

For anxiety.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

e. Imipramine

For enuresis.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

c. TCA and Atomoxetine

For ADHD.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

d. TCA and Venlafaxine

For chronic pain.

a. TCA

b. Lithium

c. TCA and Atomoxetine

d. TCA and Venlafaxine

e. Imipramine

f. SSRI

a. True

Antidepressant agents are also used for bulemia and premenstrual dysphoric disorder.

a. True

b. False