Pharmacology - Psychopharmacology: Antidepressants and Antipsychotics (Practice)

1. Antipsychotics questions are usually about phenothiazines and usually about chlorpromazine. (Since we are now well into the era of 2nd generation antipsychotics, I would imagine that they ask more questions about those than they do about 1st generation drugs. And really, the only 1st generation drug still used to any extent is haloperidol (Haldol), a specific D2 receptor blocker, so focus on those questions) They ask for:

•Mechanism of antipsychotic action: blockade of dopaminergic sites in the brain

•Major side effects: i) anticholinergic effects, ii) extrapyramidal stimulation resulting in tardive dyskinesia

•2nd generation drugs like clozapine:

a. Block dopamine receptors but also serotonin (5- HT) receptor

b. Treat negative as well as positive symptoms

c. Fewer extrapyramidal side effects like tardive dyskinesia

2. Antidepressant questions are usually about tricyclic antidepressants such as imipramine or amitriptyline-usually of the type …which of the following is used to treat depression? … TCAs are the most commonly used antidepressant medication, but remember that MAO inhibitors such as tranylcypromine or phenylene are also used. 2nd generation drugs are fluoxetine and trazodone. (2nd generation antidepressants (SSRIs) like fluoxetine (Prozac) are much more commonly used than TCAs or MAOIs, so figure more questions regarding these) The drug ID the questions may ask for:

•Mechanism of action: blockade of amine reuptake or alterations of receptor number (SSRIs block serotonin reuptake selectively)

• Side effect: anticholinergic or atropine side effects

3. The last type of question, again a drug ID asks that you remember that lithium is the drug of choice for the manic phase of manic depression.