WILKES NSG 552 PSYCHOPHARMACOLOGY
EXAM 1 ACTUAL EXAM 2026
◉ Pharmacokinetics. Answer: How the drug moves in the body. (ex.
Where is it absorbed? How and where is it metabolized? Where is it
excreted?)
◉ Pharmacodynamics. Answer: What the drug does to the body.
(consider mechanism of action)
◉ First-generation antipsychotics. Answer: 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)
◉ Second-generation antipsychotics. Answer: 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 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). Answer: Side effects caused by
certain antipsychotic medications, which include: involuntary or
uncontrollable movements, tremors, muscle contractions.
◉ Tardive dyskinesia. Answer: A neurological disorder characterized
by involuntary movement of the face and jaw.
◉ Upregulation. Answer: 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. Answer: 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
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. Answer: 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. Answer: Refers to a drug metabolite or neurotransmitter
attaching to a receptor.
◉ Affinity. Answer: Refers to the 'preference' or likelihood of a drug
to bind to a certain receptor. Linked to potency.
◉ CYP450. Answer: A group of enzymes in the liver that metabolize
different drugs. There are six.
◉ CYP450 Enzymes. Answer: A family of enzymes involved in drug
metabolism.
◉ CYP1A2. Answer: Metabolizes Acetaminophen.
◉ CYP2B6. Answer: Metabolizes artemisinin, bupropion,
cyclophosphamide, efavirenz, ketamine, and methadone.
◉ CYP2C9. Answer: Metabolizes Warfarin/Coumadin.
EXAM 1 ACTUAL EXAM 2026
◉ Pharmacokinetics. Answer: How the drug moves in the body. (ex.
Where is it absorbed? How and where is it metabolized? Where is it
excreted?)
◉ Pharmacodynamics. Answer: What the drug does to the body.
(consider mechanism of action)
◉ First-generation antipsychotics. Answer: 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)
◉ Second-generation antipsychotics. Answer: 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 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). Answer: Side effects caused by
certain antipsychotic medications, which include: involuntary or
uncontrollable movements, tremors, muscle contractions.
◉ Tardive dyskinesia. Answer: A neurological disorder characterized
by involuntary movement of the face and jaw.
◉ Upregulation. Answer: 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. Answer: 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
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. Answer: 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. Answer: Refers to a drug metabolite or neurotransmitter
attaching to a receptor.
◉ Affinity. Answer: Refers to the 'preference' or likelihood of a drug
to bind to a certain receptor. Linked to potency.
◉ CYP450. Answer: A group of enzymes in the liver that metabolize
different drugs. There are six.
◉ CYP450 Enzymes. Answer: A family of enzymes involved in drug
metabolism.
◉ CYP1A2. Answer: Metabolizes Acetaminophen.
◉ CYP2B6. Answer: Metabolizes artemisinin, bupropion,
cyclophosphamide, efavirenz, ketamine, and methadone.
◉ CYP2C9. Answer: Metabolizes Warfarin/Coumadin.
