PMHNP Psychopharm Exam 4 2024
What are the five factors that influence absorption? - Gastric emptying
Time of contact with intestinal wall
Bowel perfusion
Food
Formation of non-absorbable complexes
Explain the hepatic first pass. - Part of the drug is metabolized by the liver before it reaches
the blood.
Explain bioavailability. - Percentage of administered drug that reaches systemic circulation.
Name the 3 highly water-soluble drugs. - Lithium, Amisulpride, Paliperidone
What are the 7 inhibitors of CYP? - Paroxetine, Fluoxetine, Fluvoxamine, Fluconazole,
Ciprofloxacin, Ritonavir, Grapefruit juice
What are the 6 inducers of CYP? - Carbamazepine, Phenytoin, Phenobarbital, Primidone,
smoking, St-John's Wort
What are the 6 factors that influence pharmacokinetics? - Age, pregnancy, obesity, sexe,
comorbidities, genetics
Explain the half-life. - The time it takes for the concentration of a drug to be reduced by 50%
What are the 11 indications for TDM. - Non-compliance/toxicity
Lack of efficacy/adverse effects at normal dose
Relapse in maintenance treatment
Change in drug formulation
Pregnancy
Age
Comorbidities
Drug interactions
Change in BMI
Finding the optimal drug concentration
Genetic polymorphisms
What are the 4 factors influencing receptor binding? - Affinity
Specificity
Saturability
Reversibility
Define intrinsic activity. - The ability of a drug to initiate a response after binding to a
receptor
Define complete agonist vs. partial agonist. - Decreased intrinsic activity, decreased
pharmacological effect, good affinity with receptor
, Define competitive antagonist vs. non-competitive antagonist. - Differences in dose response
curves
Increasing dose of agonist will change the response of a competitive antagonist.
What are the 4 targets of psychotropic drugs? - Transporters, G-coupled protein receptor, ion
channels, enzymes
What is tachyphylaxis? - Neurotransmitter depletion
What drugs are involved in induced psychotic disorders? - Dopamine agonists Chloroquine
Corticosteroids
Fluoroquinolones
Stimulants
What are the side effects of Cogentin? - Dry mouth
Mydriasis
Blurred vision
Constipation
Urinary retention
Tachycardia
Delirium
Confusion
What is the effect of 5-HT2A receptor antagonist? - Less EPS, improvement negative
symptoms, less hyperprolactinemia
What are the pharmacological treatments for tardive dyskinesia? - Vitamin B6, Gingko
biloba, tetrabenazine, clonzepam
What antipsychotics increases the risk of akathisia? - Latuda, Abilify
What antipsychotics increases the risk of EPS and hyperprolactinemia? - Risperidone,
paliperidone
What is the treatment for hyperprolactinemia? - D2 partial agonist, dopamine agonist
What is the mechanism of action for weight gain? What serotonin receptor is involved in
weight gain? - H1 antagonism
5-HT2c
What are the adverse events of antagonism of 5-HT2c? - Orthostatic hypotension, weight
gain, hyperglycemia
What are the adverse events of antagonism of alpha1? - Orthostatic hypotension, dizziness,
reflex tachycardia, urinary incontinence
What are the adverse events of antagonism of muscarinic receptors? - Anticholinergic effect
What are the adverse events of antagonism of H1? - Orthostatic hypotension, weight gain,
increased appetite, sedation
What are the five factors that influence absorption? - Gastric emptying
Time of contact with intestinal wall
Bowel perfusion
Food
Formation of non-absorbable complexes
Explain the hepatic first pass. - Part of the drug is metabolized by the liver before it reaches
the blood.
Explain bioavailability. - Percentage of administered drug that reaches systemic circulation.
Name the 3 highly water-soluble drugs. - Lithium, Amisulpride, Paliperidone
What are the 7 inhibitors of CYP? - Paroxetine, Fluoxetine, Fluvoxamine, Fluconazole,
Ciprofloxacin, Ritonavir, Grapefruit juice
What are the 6 inducers of CYP? - Carbamazepine, Phenytoin, Phenobarbital, Primidone,
smoking, St-John's Wort
What are the 6 factors that influence pharmacokinetics? - Age, pregnancy, obesity, sexe,
comorbidities, genetics
Explain the half-life. - The time it takes for the concentration of a drug to be reduced by 50%
What are the 11 indications for TDM. - Non-compliance/toxicity
Lack of efficacy/adverse effects at normal dose
Relapse in maintenance treatment
Change in drug formulation
Pregnancy
Age
Comorbidities
Drug interactions
Change in BMI
Finding the optimal drug concentration
Genetic polymorphisms
What are the 4 factors influencing receptor binding? - Affinity
Specificity
Saturability
Reversibility
Define intrinsic activity. - The ability of a drug to initiate a response after binding to a
receptor
Define complete agonist vs. partial agonist. - Decreased intrinsic activity, decreased
pharmacological effect, good affinity with receptor
, Define competitive antagonist vs. non-competitive antagonist. - Differences in dose response
curves
Increasing dose of agonist will change the response of a competitive antagonist.
What are the 4 targets of psychotropic drugs? - Transporters, G-coupled protein receptor, ion
channels, enzymes
What is tachyphylaxis? - Neurotransmitter depletion
What drugs are involved in induced psychotic disorders? - Dopamine agonists Chloroquine
Corticosteroids
Fluoroquinolones
Stimulants
What are the side effects of Cogentin? - Dry mouth
Mydriasis
Blurred vision
Constipation
Urinary retention
Tachycardia
Delirium
Confusion
What is the effect of 5-HT2A receptor antagonist? - Less EPS, improvement negative
symptoms, less hyperprolactinemia
What are the pharmacological treatments for tardive dyskinesia? - Vitamin B6, Gingko
biloba, tetrabenazine, clonzepam
What antipsychotics increases the risk of akathisia? - Latuda, Abilify
What antipsychotics increases the risk of EPS and hyperprolactinemia? - Risperidone,
paliperidone
What is the treatment for hyperprolactinemia? - D2 partial agonist, dopamine agonist
What is the mechanism of action for weight gain? What serotonin receptor is involved in
weight gain? - H1 antagonism
5-HT2c
What are the adverse events of antagonism of 5-HT2c? - Orthostatic hypotension, weight
gain, hyperglycemia
What are the adverse events of antagonism of alpha1? - Orthostatic hypotension, dizziness,
reflex tachycardia, urinary incontinence
What are the adverse events of antagonism of muscarinic receptors? - Anticholinergic effect
What are the adverse events of antagonism of H1? - Orthostatic hypotension, weight gain,
increased appetite, sedation
