NSG552 Psychopharmacology Exam 1 EXAM QUESTIONS AND CORRECT DETAILED ANSWER

NSG552 Psychopharmacology Exam 1 EXAM QUESTIONS AND CORRECT DETAILED ANSWERS What are the 6 general principles of psychopharmacological treatment? Safety Tolerability Efficacy Practicality Treatment accessibility Treatment compliance Pharmacokinetics How the drug moves in the body. (ex. Where is it absorbed? How and where is it metabolized? Where is it excreted?) Pharmacodynamics What the drug does to the body. (consider mechanism of action) Define First-generation antipsychotics Referred to as Typical Antipsychotics. Most have strong bond with D2 receptors only, cause EPS symptoms faster due to prolonged receptor dissociation, have more dangerous side effect profiles, have been around longer, more effective at treating positive symptoms, less expensive. (Ex. Haloperidol, Chlorpromazine, Thioridazine, Fluphenazine) Define Second-generation antipsychotics Referred to as Atypical Antipsychotics. Most have a weak bond with D2 receptors and block serotonin receptors leading to antidepressive and anxiolytic effects. They cause less EPS due to rapid receptor disassociation which leads to rapid dopamine neurotransmission. Have less dangerous side effect profiles but can cause metabolic syndromes, have been around shorter time, more expensive, more effective at treating negative symptoms but can treat positive symptoms as well, long-acting injections available for several of these. (Ex. Risperidone, Clozapine, Quetiapine, Aripiprazole, Ziprasidone) Extra Pyramidal Symptoms (EPS) Side effects caused by certain antipsychotic medications, which include: involuntary or uncontrollable movements. tremors. muscle contractions. Tardive dyskinesia A neurological disorder characterize by involuntary movement of the face and jaw. Upregulation Occurs through chronic use of antagonists which causes an increase in the number of receptors, externalization of receptors, and increased sensitivity of the receptors. Prolonged use of antagonist - Up-regulation of receptors - Sudden withdrawal of antagonist - increased number of receptors and increased sensitivity of receptors *YOU MUST GRADUALLY TAPER A DRUG TO AVOID BINDING TO ALL NEW RECEPTORS FROM UPREGULATION Down regulation Occurs by chronic exposure of agonists which causes decreased number of receptors, internalization of receptors, and decreased sensitivity of the receptors. Prolonged use of agonist - downregulation of receptors - decreased effectiveness of agonist mediated clinical response. You have two options: 1 Increase the drug dose OR 2 Switch to another drug(BEST OPTION) Receptor profile The receptors that each drug binds to (example, risperidone's receptor profile would like... (a) Blockade of 5HT2A and D2 receptors (b) High affinity for a1, a2, and H1 receptors) Binding Refers to a drug metabolite or neurotransmitter attaching to a receptor Affinity