1
NSG552 PSYCHOPHARMACOLOGY EXAM 1
Safety
What are the 6 Tolerability
general principles of Efficacy
psychopharmacologic Practicality
Treatment
al 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)
Referred to as Typical Antipsychotics. Most
have strong bond with D2 receptors only,
Define First- cause EPS symptoms faster due to
generation prolonged receptor dissociation, have more
antipsychotics dangerous side effect profiles, have been
around longer, more effective at
treating positive symptoms, less expensive. (Ex.
Haloperidol, Chlorpromazine, Thioridazine,
Fluphenazine)
,2
Referred to as Atypical Antipsychotics.
Most have a weak bond with D2 receptors
and block serotonin receptors leading to anti-
depressive and anxiolytic effects. They
Define Second- cause less EPS due to rapid receptor
generation disassociation which leads to rapid
antipsychotics 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)
Side effects caused by certain antipsychotic
Extra Pyramidal medications, which include: involuntary or
Symptoms (EPS)
uncontrollable movements. tremors.
muscle contractions.
Tardive dyskinesia A neurological disorder characterize by
involuntary movement of the face and jaw.
, 3
Occurs through chronic use of antagonists which
causes an
increase in the number of receptors,
externalization of receptors, and increased
Upregulation
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
Occurs by chronic exposure of agonists which
causes decreased number of receptors,
internalization of receptors, and decreased
Down regulation sensitivity of the receptors. Prolonged use of
agonist -> down- regulation 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)
The receptors that each drug binds to
(example, risperidone's receptor profile would like...
Receptor profile (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 refers to the "preference" or likelihood of a
drug to bind to a certain receptor. Linked to
NSG552 PSYCHOPHARMACOLOGY EXAM 1
Safety
What are the 6 Tolerability
general principles of Efficacy
psychopharmacologic Practicality
Treatment
al 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)
Referred to as Typical Antipsychotics. Most
have strong bond with D2 receptors only,
Define First- cause EPS symptoms faster due to
generation prolonged receptor dissociation, have more
antipsychotics dangerous side effect profiles, have been
around longer, more effective at
treating positive symptoms, less expensive. (Ex.
Haloperidol, Chlorpromazine, Thioridazine,
Fluphenazine)
,2
Referred to as Atypical Antipsychotics.
Most have a weak bond with D2 receptors
and block serotonin receptors leading to anti-
depressive and anxiolytic effects. They
Define Second- cause less EPS due to rapid receptor
generation disassociation which leads to rapid
antipsychotics 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)
Side effects caused by certain antipsychotic
Extra Pyramidal medications, which include: involuntary or
Symptoms (EPS)
uncontrollable movements. tremors.
muscle contractions.
Tardive dyskinesia A neurological disorder characterize by
involuntary movement of the face and jaw.
, 3
Occurs through chronic use of antagonists which
causes an
increase in the number of receptors,
externalization of receptors, and increased
Upregulation
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
Occurs by chronic exposure of agonists which
causes decreased number of receptors,
internalization of receptors, and decreased
Down regulation sensitivity of the receptors. Prolonged use of
agonist -> down- regulation 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)
The receptors that each drug binds to
(example, risperidone's receptor profile would like...
Receptor profile (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 refers to the "preference" or likelihood of a
drug to bind to a certain receptor. Linked to
