NSG552 Psychopharmacology Exam 1 Review UPDATED ACTUAL Questions
and CORRECT Answers
1. General Safety, Tolerability, Eflcacy, Practicality, Treatment accessibility, Treatment compli-
principles of ance
psychopharmaco-
logical treatment
2. Pharmacokinet- How the drug moves in the body. (ex. Where is it absorbed? How and where is it
ics metabolized? Where is it excreted?)
3. Pharmacodynam- What the drug does to the body. (consider mechanism of action)
ics
4. First-generation Referred to as Typical Antipsychotics. Most have strong bond with D2 receptors
antipsychotics 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)
5. Second-genera- Referred to as Atypical Antipsychotics. Most have a weak bond with D2 receptors
tion and block serotonin receptors leading to anti-depressive and anxiolytic effects.
antipsychotics 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)
6. Extra Pyramidal Side effects caused by certain antipsychotic medications, which include: involun-
Symptoms (EPS) tary or uncontrollable movements, tremors, muscle contractions.
7. Tardive dyskine- A neurological disorder characterized by involuntary movement of the face and
sia jaw.
8. 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 sensi-
tivity of receptors. *YOU MUST GRADUALLY TAPER A DRUG TO AVOID BINDING TO
ALL NEW RECEPTORS FROM UPREGULATION.
9. 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 -> down-regulation of receptors -> decreased effective-
ness of agonist mediated clinical response. You have two options: 1 Increase the
drug dose OR 2 Switch to another drug (BEST OPTION).
10. 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 aflnity for a1, a2,
and H1 receptors).
11. Binding Refers to a drug metabolite or neurotransmitter attaching to a receptor.
12. Affinity Refers to the 'preference' or likelihood of a drug to bind to a certain receptor.
Linked to potency.
13. CYP450 A group of enzymes in the liver that metabolize different drugs. There are six.
14. CYP450 Enzymes A family of enzymes involved in drug metabolism.
15. CYP1A2 Metabolizes Acetaminophen.
16. CYP2B6 Metabolizes artemisinin, bupropion, cyclophosphamide, efavirenz, ketamine, and
methadone.
17. CYP2C9 Metabolizes Warfarin/Coumadin.
18. CYP2C19 Metabolizes PPIs, antidepressants, antiplatelet, antifungals, and anticancer drugs.
, 19. CYP2D6 Metabolizes cardiovascular drugs.
20. CYP3A4 Most common and ambiguous CYP450 enzyme.
21. CYP2EI Metabolizes ethanol (ETOH).
22. CYP450 in- Decreases drug metabolism.
hibitors
23. Valproate A CYP450 inhibitor.
24. Ketoconazole A CYP450 inhibitor.
25. Isoniazid A CYP450 inhibitor.
26. Sulfonamides A CYP450 inhibitor.
27. Chloramphenicol A CYP450 inhibitor.
28. Amiodarone A CYP450 inhibitor.
29. Macrolides A group of CYP450 inhibitors, excluding azithromycin.
30. Quinidine A CYP450 inhibitor.
31. Grapefruit juice A CYP450 inhibitor.
32. CYP450 inducers Increases drug metabolism.
33. Carbamazepine A CYP450 inducer.
34. Rifampin A CYP450 inducer.
35. Alcohol A CYP450 inducer.
36. Phenytoin A CYP450 inducer.
and CORRECT Answers
1. General Safety, Tolerability, Eflcacy, Practicality, Treatment accessibility, Treatment compli-
principles of ance
psychopharmaco-
logical treatment
2. Pharmacokinet- How the drug moves in the body. (ex. Where is it absorbed? How and where is it
ics metabolized? Where is it excreted?)
3. Pharmacodynam- What the drug does to the body. (consider mechanism of action)
ics
4. First-generation Referred to as Typical Antipsychotics. Most have strong bond with D2 receptors
antipsychotics 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)
5. Second-genera- Referred to as Atypical Antipsychotics. Most have a weak bond with D2 receptors
tion and block serotonin receptors leading to anti-depressive and anxiolytic effects.
antipsychotics 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)
6. Extra Pyramidal Side effects caused by certain antipsychotic medications, which include: involun-
Symptoms (EPS) tary or uncontrollable movements, tremors, muscle contractions.
7. Tardive dyskine- A neurological disorder characterized by involuntary movement of the face and
sia jaw.
8. 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 sensi-
tivity of receptors. *YOU MUST GRADUALLY TAPER A DRUG TO AVOID BINDING TO
ALL NEW RECEPTORS FROM UPREGULATION.
9. 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 -> down-regulation of receptors -> decreased effective-
ness of agonist mediated clinical response. You have two options: 1 Increase the
drug dose OR 2 Switch to another drug (BEST OPTION).
10. 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 aflnity for a1, a2,
and H1 receptors).
11. Binding Refers to a drug metabolite or neurotransmitter attaching to a receptor.
12. Affinity Refers to the 'preference' or likelihood of a drug to bind to a certain receptor.
Linked to potency.
13. CYP450 A group of enzymes in the liver that metabolize different drugs. There are six.
14. CYP450 Enzymes A family of enzymes involved in drug metabolism.
15. CYP1A2 Metabolizes Acetaminophen.
16. CYP2B6 Metabolizes artemisinin, bupropion, cyclophosphamide, efavirenz, ketamine, and
methadone.
17. CYP2C9 Metabolizes Warfarin/Coumadin.
18. CYP2C19 Metabolizes PPIs, antidepressants, antiplatelet, antifungals, and anticancer drugs.
, 19. CYP2D6 Metabolizes cardiovascular drugs.
20. CYP3A4 Most common and ambiguous CYP450 enzyme.
21. CYP2EI Metabolizes ethanol (ETOH).
22. CYP450 in- Decreases drug metabolism.
hibitors
23. Valproate A CYP450 inhibitor.
24. Ketoconazole A CYP450 inhibitor.
25. Isoniazid A CYP450 inhibitor.
26. Sulfonamides A CYP450 inhibitor.
27. Chloramphenicol A CYP450 inhibitor.
28. Amiodarone A CYP450 inhibitor.
29. Macrolides A group of CYP450 inhibitors, excluding azithromycin.
30. Quinidine A CYP450 inhibitor.
31. Grapefruit juice A CYP450 inhibitor.
32. CYP450 inducers Increases drug metabolism.
33. Carbamazepine A CYP450 inducer.
34. Rifampin A CYP450 inducer.
35. Alcohol A CYP450 inducer.
36. Phenytoin A CYP450 inducer.
