Psychopharmacology and MAOIs Quiz
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Questions and Answers

What must be avoided in the diet of patients taking MAOIs to prevent toxicity?

  • Caffeine
  • Fiber
  • Sodium
  • Tyramine (correct)

Selegiline is primarily used for treating depression.

False (B)

What syndrome can occur from an excess amount of serotonin building up in the body due to MAOIs?

Serotonin Syndrome

MAOIs irreversibly inhibit the activity of ____ to carry out metabolism.

<p>MAO (monoamine oxidase)</p> Signup and view all the answers

Match the following MAOIs with their brand names:

<p>Phenelzine = Nardil® Tranylcypromine = Parnate® Selegiline = Zelapar®</p> Signup and view all the answers

Which of the following is a first-generation antipsychotic that is structurally different from both thioxanthenes and phenothiazines?

<p>Haloperidol (C)</p> Signup and view all the answers

All first-generation antipsychotics block dopamine receptors in the brain.

<p>True (A)</p> Signup and view all the answers

What is the primary mechanism of action for first-generation antipsychotics?

<p>Blocking dopamine receptors</p> Signup and view all the answers

Chlorpromazine, Fluphenazine, and Prochlorperazine are all examples of __________.

<p>phenothiazines</p> Signup and view all the answers

Match the following antipsychotic drugs to their corresponding type:

<p>Chlorpromazine = Phenothiazine Thiothixene = Thioxanthene Haloperidol = Phenylbutylpiperidine Risperidone = Benzisoxazole</p> Signup and view all the answers

Which first-generation antipsychotic is known for its antiemetic effect?

<p>Prochlorperazine (D)</p> Signup and view all the answers

Thioxanthenes generally exhibit more hypotension effects compared to phenothiazines.

<p>False (B)</p> Signup and view all the answers

Which of the following antibiotics is contraindicated with Pimozide due to its effect on the QT interval?

<p>Clarithromycin (D)</p> Signup and view all the answers

Antipsychotic medications are considered both physically and psychologically addictive.

<p>False (B)</p> Signup and view all the answers

What is a significant risk associated with long-term treatment using Clozapine?

<p>Agranulocytosis</p> Signup and view all the answers

Risperidone is primarily used to treat __________ and irritability associated with autistic disorder.

<p>schizophrenia</p> Signup and view all the answers

Match the antipsychotic drugs with their primary action:

<p>Clozapine = Works on dopamine and serotonin receptors Olanzapine = Blocks dopamine and serotonin receptors Risperidone = Used for schizophrenia and autistic irritability Aripiprazole = Treats schizophrenia and bipolar disorder</p> Signup and view all the answers

Which generation of antipsychotic drugs is more effective in treating psychotic symptoms?

<p>Second Generation (B)</p> Signup and view all the answers

Extrapyramidal symptoms (EPS) are characterized by involuntary muscle movements similar to Parkinson’s disease.

<p>True (A)</p> Signup and view all the answers

What is the recommended method to withdraw from antipsychotic medication?

<p>Tapering gradually</p> Signup and view all the answers

Akathisia is characterized by __________ motor restlessness.

<p>distressing</p> Signup and view all the answers

Which group of antidepressants includes Serotonin Reuptake Inhibitors?

<p>Second Generation (B)</p> Signup and view all the answers

The risk of suicidal thoughts associated with antidepressants is highest among older adults.

<p>False (B)</p> Signup and view all the answers

What should be monitored closely during the first few weeks of antidepressant treatment?

<p>Risk of suicidal thoughts and mood improvement</p> Signup and view all the answers

Tricyclic antidepressants and MAOIs are examples of ______ antidepressants.

<p>First Generation</p> Signup and view all the answers

Match the following types of antidepressants with their categories:

<p>Tricyclic antidepressants = First Generation Serotonin Reuptake Inhibitors = Second Generation MAOIs = First Generation Serotonin-norepinephrine reuptake inhibitors = Second Generation</p> Signup and view all the answers

At what stage of treatment is the risk of suicide highest?

<p>At the onset of treatment (B)</p> Signup and view all the answers

Which of the following is NOT an indication for the use of benzodiazepines?

<p>Bipolar disorder (C)</p> Signup and view all the answers

Older adults are at a higher risk of suicidal thoughts when taking antidepressants compared to younger adults.

<p>False (B)</p> Signup and view all the answers

Buspirone hydrochloride is known to cause significant sedation and dependence.

<p>False (B)</p> Signup and view all the answers

Identify one primary type of Second Generation antidepressant.

<p>Serotonin Reuptake Inhibitors or Serotonin-norepinephrine reuptake inhibitors</p> Signup and view all the answers

Close monitoring is essential during the first few weeks of treatment to reduce the risk of ______.

<p>suicidal thoughts</p> Signup and view all the answers

What is the mechanism of action for benzodiazepines?

<p>Increases the action of GABA.</p> Signup and view all the answers

Which of the following is NOT a First Generation antidepressant?

<p>Serotonin Reuptake Inhibitors (D)</p> Signup and view all the answers

Lithium toxicity is increased by _________.

<p>sodium depletion</p> Signup and view all the answers

Match the type of anxiolytic drug with its characteristic:

<p>Benzodiazepines = High risk of dependence Buspirone = Not sedating or addictive Lithium = Narrow therapeutic range Sunscreen usage = Recommended with phenothiazines</p> Signup and view all the answers

What should be monitored to maintain the therapeutic effects of lithium?

<p>Serum sodium levels (C)</p> Signup and view all the answers

It is safe to use benzodiazepines for continuous long-term therapy.

<p>False (B)</p> Signup and view all the answers

Name one adverse effect of benzodiazepines.

<p>CNS depression</p> Signup and view all the answers

In cases of benzodiazepine overdose, excessive ________ can occur.

<p>sedation</p> Signup and view all the answers

Which of the following drugs is NOT classified as a benzodiazepine?

<p>Buspirone (A)</p> Signup and view all the answers

Flashcards

Antipsychotic Drugs - Gen 1

A group of medications that are effective in treating schizophrenia and other psychotic disorders. They work by blocking dopamine receptors in the brain, reducing dopamine activity in specific areas.

Dopamine Receptor Blocker

The primary mechanism of action for first-generation antipsychotics. They bind to dopamine receptors, preventing dopamine from activating them.

Phenothiazines

A large group of first-generation antipsychotics characterized by the presence of 'azine' in their generic name. They are known for their low potency and potential side effects.

Thioxanthenes

A class of first-generation antipsychotics with similar effectiveness to phenothiazines, but potentially lower hypotension and sedative effects.

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Phenylbutylpiperidines

A distinct class of first-generation antipsychotics characterized by their unique molecular structure and powerful antipsychotic properties.

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Extrapyramidal Symptoms (EPS)

A serious side effect associated with some first-generation antipsychotics. These symptoms include involuntary movements, tremors, stiffness, and restlessness.

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Haloperidol

A powerful antipsychotic from the phenylbutylpiperidine class known for its strong antipsychotic effects and association with EPS.

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MAOIs

A class of antidepressants that work by inhibiting the activity of monoamine oxidase (MAO), an enzyme that breaks down neurotransmitters like serotonin, norepinephrine, and dopamine.

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Tyramine

An amino acid found in certain foods that can cause potentially fatal hypertensive crisis when combined with MAOIs.

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Hypertensive Crisis

A life-threatening condition caused by a rapid and severe increase in blood pressure, often triggered by consuming tyramine-rich foods while taking MAOIs.

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Serotonin Syndrome

A potentially life-threatening condition caused by an overabundance of serotonin in the body. Typically occurs when taking medications (e.g., MAOIs) that increase serotonin levels.

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What are dietary restrictions with MAOIs?

Patients taking MAOIs must avoid foods containing tyramine, an amino acid that can cause hypertensive crises when metabolized by MAO.

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Benzodiazepines Mechanism of Action

Enhance the effects of GABA, a neurotransmitter that inhibits nerve activity, leading to reduced CNS activity.

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Benzodiazepines Indications

Short-term management of anxiety, insomnia, seizures, muscle spasms, and pre-operative sedation.

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Benzodiazepines Adverse Effects

CNS depression, hypotension, paradoxical reactions (e.g., increased anxiety), dependence, and addiction.

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Benzodiazepine Overdose

Usually not life-threatening unless combined with alcohol or other CNS depressants. Signs include excessive sedation, hypotension, seizures, and respiratory depression.

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Pimozide (Orap®)

A drug contraindicated with antibiotics that affect the QT interval, such as Clarithromycin and Erythromycin.

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Benzodiazepine Overdose Treatment

Supportive care, including monitoring vital signs and managing symptoms. Flumazenil (benzodiazepine receptor blocker) may be used in severe cases.

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Buspirone Mechanism of Action

Not fully understood, but believed to work by influencing serotonin and dopamine receptors.

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Mechanism of Action (Gen 2)

Block serotonin and dopamine receptors, specifically targeting dopamine D2 and serotonin 2(5-HT2) receptors, resulting in tranquilizing effects.

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Buspirone Administration

Can be taken on a schedule or as needed. Less sedating and addictive than benzodiazepines.

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Clozapine (Clozaril®)

A dibenzodiazepine antipsychotic that works on dopamine receptors in the limbic system, also binding to serotonin and histamine receptors, but can cause agranulocytosis during long-term treatment.

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Buspirone Adverse Effects

Possible paradoxical anxiety, dizziness, blurred vision, headache, nausea.

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Olanzapine (Zyprexa®) & Quetiapine (Seroquel®)

Dibenzodiazepines that block dopamine and serotonin receptors, considered equally or more effective than other drugs with fewer side effects.

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Lithium Mechanism of Action

Not fully understood, but involves influencing sodium transport in nerve cells, enhancing GABA effects, and inhibiting excitatory neurotransmitters like serotonin, dopamine, and norepinephrine.

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Lithium Administration Considerations

Taken orally and often used alongside other medications. Requires close monitoring due to its narrow therapeutic range and potential for toxicity.

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Risperidone (Risperdal®) & Aripiprazole (Abilify®)

Benzisoxazoles and Quinolinone antipsychotics that work on dopamine and serotonin levels, but can cause EPS, especially Risperidone.

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Akathisia

Distressing motor restlessness, a common EPS symptom characterized by an inability to sit still.

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Black Box Warning

A serious warning on the label of medications that alerts doctors and patients about potential severe side effects.

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Antidepressant Risk of Suicide

Antidepressant medications can increase the risk of suicidal thoughts, particularly in younger people, especially in the early stages of treatment.

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First-Generation Antidepressants

Older antidepressants, like tricyclics and MAOIs, were the first to be used in treating depression.

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Tricyclic Antidepressants

A type of antidepressant medication that works by increasing levels of certain neurotransmitters in the brain.

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MAOI (Monoamine Oxidase Inhibitors)

Antidepressant medications that work by inhibiting the enzyme mono-amine oxidase, which breaks down neurotransmitters.

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Second-Generation Antidepressants

Newer antidepressants, often more potent and with fewer side effects, including SSRIs, SNRIs, and miscellaneous others.

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SSRI (Selective Serotonin Reuptake Inhibitor)

A type of antidepressant that specifically increases serotonin levels in the brain.

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SNRI (Serotonin-Norepinephrine Reuptake Inhibitor)

A type of antidepressant that acts on both serotonin and norepinephrine, two important brain chemicals.

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Tetracyclic Antidepressants

A type of antidepressant that shares similarities with tricyclics and other antidepressant classes.

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Miscellaneous Antidepressants

A broad group of medications that don't fit neatly into the other categories, but are still helpful in treating depression.

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Study Notes

Psychotherapeutic Drugs

  • Psychotherapeutic drugs are used to treat mental health conditions.
  • These drugs aim to correct neurotransmitter imbalances.
  • These need to be combined with non-pharmacological treatments, such as counselling.
  • The goal is to improve quality of life, ability to perform daily activities, and social and occupational functioning.
  • Response to medication varies between patients.
  • Children and older adults are more sensitive to drugs and have a higher risk of adverse effects.
  • Treatment may require "trial and error" to find the most effective medication for an individual.
  • Stigma and fear of adverse effects can hinder treatment acceptance.
  • Some drugs may be initially approved for one condition but later approved or expanded for other conditions.

Antipsychotic Drugs (Neuroleptics)

  • Antipsychotic drugs are used to treat psychoses associated with schizophrenia.
  • They are effective in controlling symptoms but do not cure the illness.
  • Antipsychotic drugs are also used to treat extreme mania, bipolar disorder, autism, and other medical conditions.
  • Antipsychotic drugs have two generations, each with different indications and potential side-effects.

First Generation Antipsychotics

  • These are the older generation drugs.
  • They have various chemical structures such as Phenothiazines, Thioxanthenes, and Phenylbutylpiperidines.
  • First-generation antipsychotics have a significant risk of extrapyramidal side effects (EPS).
  • They are primarily used for sedation and antiemetic.

First Generation Antipsychotic Examples

  • Chlorpromazine hydrochloride

  • Fluphenazine

  • Perphenazine

  • Prochlorperazine hydrochloride

  • Trifluoperazine hydrochloride

  • Thiothixene (Navane®)

  • Haloperidol (Haldol®)

  • Pimozide (Orap®)

  • First-generation antipsychotic drugs, by blocking dopamine receptors, reduce dopamine concentration in the limbic system and basal ganglia.

  • These drugs have other effects (e.g., blocking dopamine receptors in chemoreceptors, inhibiting the vagus nerve, depressing brainstem), reducing blood pressure and acting as an antiemetic.

Second Generation Antipsychotics

  • Newer generation; usually used for schizophrenia and other conditions.
  • Significantly less EPS (extrapyramidal symptoms) than first-generation drugs.
  • They block both dopamine and serotonin receptors.
  • The effects of second-generation drugs are more potent in treating psychosis.

Second Generation Antipsychotic Examples

  • Clozapine (Clozaril®)
  • Loxapine (Xylane, Loxapac®)
  • Olanzapine (Zyprexa®)
  • Quetiapine (Seroquel®)
  • Risperidone (Risperdal®)
  • Aripiprazole (Abilify®)

Antipsychotic Drugs - CNS Adverse Events

  • Extrapyramidal symptoms (EPS) are involuntary motor symptoms that can occur with antipsychotic use.
  • This can include Akathisia, Tardive Dyskinesia, and Acute dystonia.
  • Neuroleptic Malignant Syndrome (NMS) is a rare but potentially life-threatening condition.
  • Symptoms include muscle rigidity, altered thermoregulation (high fever), vital sign instability, and autonomic instability.
  • Treatment for EPS involves discontinuing the medication and administering anticholinergic medications.
  • Treatment for NMS involves prompt withdrawal of the causative medication and supportive treatment for symptoms.

Anxiolytic Drugs

  • These drugs are used to treat anxiety.
  • They include benzodiazepines (e.g., diazepam, lorazepam) and buspirone
  • Benzodiazepines work by increasing the action of GABA.
  • Buspirone's mechanism is still less clear but is thought to relate to serotonin and dopamine
  • Benzodiazepines are primarily used for short-term symptom management and are not a cure for underlying anxiety.

Mood Stabilizer Drugs (Lithium)

  • Lithium is a mood stabilizer used to treat bipolar disorder.
  • Lithium is not well understood in its mechanism but is thought to affect sodium ion transport in nerve cells and potentially modulate GABA action.
  • It inhibits excitatory neurotransmitters and affects receptor sensitivity.
  • Lithium administration is usually oral and peaks in between 30 minutes and 3 hours.
  • It crosses the blood-brain barrier slowly, so treatment response can take weeks to be seen.
  • Lithium has a narrow therapeutic range requiring careful monitoring of serum levels to prevent toxicity.

Antidepressant Drugs

  • Used to treat major depression and other related mental health disorders.
  • Two main generations exist, each with advantages and disadvantages regarding side-effects.

First Generation Antidepressants

  • Tricyclic antidepressants (e.g., amitriptyline, nortriptyline).
  • Monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine, tranylcypromine).
  • Tetracyclic antidepressants.
  • Tricyclic antidepressants are metabolized by monoamine oxidases (MAO) affecting neurotransmitters like norepinephrine and serotonin.
  • MAOIs prevent the breakdown of neurotransmitters like NE.
  • These drugs need a specific diet to prevent toxicity.

Second Generation Antidepressants

  • Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine, sertraline, paroxetine, fluvoxamine and citalopram).

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) (e.g., venlafaxine, duloxetine).

  • Miscellaneous antidepressants (e.g., bupropion, mirtazapine).

  • SSRIs primarily target serotonin levels.

  • SNRIs target serotonin and norepinephrine.

General Information

  • Several warnings, contraindications, and precautions are important for each of the drugs listed and need to be discussed in greater detail with other mental health professionals.

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Psychotherapeutic Drugs PHAR1059 2024-2025 PDF

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Test your knowledge on the dietary restrictions for patients taking MAOIs, the mechanisms of first-generation antipsychotics, and their brand names. Explore important concepts such as serotonin syndrome and the effects of various antipsychotic drugs. This quiz is essential for students in pharmacology or nursing programs.

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