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Summary Psychopharmacology - Answers to all study questions
- Instelling
- Universiteit Utrecht (UU)
All answers to the study questions part of the exam for psychopharmacology
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Voorbeeld van de inhoud
All study questionsLecture 1: Introduction, brush up basics (neuroanatomy, neurotransmitters; ‘Psychopharmacology’
chapters 1-4)
1. Which two overarching classes of psychoactive substances can be discerned based on their use?
Medical and recreational
2. What are the different names that are given to medications once they become available for
prescription, and what is the difference between these names?
WG question 1
Formula code name generic name brand name.
These names get more easy to communicate when certainty is bigger, for selling a brand
name is given by the producer.
3. What is pharmacokinetics and pharmacodynamics? Describe these terms and understand their
difference.
Pharmacokinetics is a field that looks at the way drugs travel through the body, whether
these are degraded and through which fluids and organs they travel for example.
Pharmacodynamics is a field that looks at the way drugs have influence of the receptors they
bind to, so more about the function of a drug in the body.
4. Considered known (part of the prerequisites; self-study if unfamiliar): types of
neurotransmitters, types of receptors, common principles of neurotransmitter synthesis (incl.
precursors), degradation (incl. reuptake), principles of communication between cells through
receptors and how this influences the chance of the postsynaptic neuron firing an action
potential.
See slides for all this information.
5. Medications have a certain indication, meaning the illness, symptoms or disorder for which they
are prescribed. In general, within which area do the indications for psychoactive substances fall?
WG question 2
These are for indications in the field of clinical psychology, they concern mental illnesses.
6. Describe the most common mechanisms of modulation of neurotransmission along which
psychoactive substances exert their influence on the brain.
WG question 3
Psychoactive substances can cause more or less synthesis of a neurotransmitter to occur. It
can block receptors where the neurotransmitter binds on or modulate these receptors. It can
also be degraded by these substances after the release, so it influences the ending of effect.
7. Many of the currently used psychoactive substances have been discovered by serendipity, but
once every so often new medications are developed on purpose through hypothesis-driven
research lines. Describe in broad terms the (pre)clinical development phases which a new
medicine has to pass before it can be made available to patients.
It will be tested on animals mostly regarding safety, ways of administration and efficacy. If it
is tested good on all these terms it can be tested on humans.
8. In the development of new medicines, there are many bottle necks. What are the most
important conceptual bottle necks (think for example of brain mechanisms that cause the
disorder)? And what are the most important practical hindrances (for example, think of
pharmacokinetic properties)? And what are financial hindrances?
, Conceptual bottle necks are that before you can develop a drug that has a desired effect on a
psychological process (behaviour, affect, cognition), you first need to know how that process is
implemented in the brain, only if you know that you can start thinking what sort of
pharmacological manipulation would exert the desired effect. And then again, it may turn out not
to work that way.
Practical hindrances can be the difficulty to get the substance to the brain. Sometimes it will
be degraded before it can reach the brain or it won’t be able to cross the blood-brain barrier.
Financial hindrances can be the shortage of patent left for selling or the small market to sell
the drug on, so you will not be sure whether you will earn your investment back.
9. There are various reasons why most psychoactive substances not only exert their main
(intended) effect, but also unwanted side-effects. Describe the two most important reasons.
WG question 4 [questions 5 and 6 are below under Lecture 2]
Receptors on which the substance reacts can be present in more than the needed brain areas
and thus influence more parts of the brain and these show effects too.
Substances can influence certain receptors and these parts of the brain interact with other
parts of the brain as well. Effects on a receptor can be transferred to a lot of other parts due
to this interaction.
10. Describe the golden standard in executing (psycho)pharmacological research: placebo –
controlled and double-blind. Why are these aspects of importance?
You want to make sure people won’t know they are having a placebo, since you want to test
whether the effect is caused by taking a random pill or that the pill itself has the needed
effects. Double-blind means that both parties do not know who takes the real and who takes
the placebo pill, so that the interaction between participant and researcher won’t cause any
differences in effect outside of the substance too.
11. Which result will allow the conclusion that a placebo (fake pill) medicine may be useful in
treatment?
If the effects in both groups do not differ substantially you can say that the effect is caused
by just taking a pill which you think will help cure your symptoms. If there are substantial
differences you can say that the substance in the pill does cause some type of effect and you
should look what this effect is.
12. What is an active placebo?
An active placebo is a pill that is already made for certain symptoms and proven effective,
comparing this one to the new pill can show which one is more effective. Both groups thus
are treated.
13. What is meant with ‘Evidence-based medicine’? Why is this important? What do the conflicting
interests of patients, treating physicians, pharmaceutical industry and policy-makers mean for
the credibility of the different sources of information that you can find, for example on the
internet?
WG question 7
This means that there is been done plenty of research which has shown the efficacy and
safety of a new medicine. This is important because you want to make sure people are cured
and don’t experience any large side effect due to this medicine. Sometimes sources of
information can be influenced by opinions for or against a certain medicine, or profits will be
going to the researching party. In this case it is very likely that you will find a bigger effect
than that is the case, since you want to find that it is very effective, so that you can make
more profit out of it.
, Lecture 2: Principles of psychopharmacology (dose-response-curve, receptor-interaction,
pharmacokinetics, tolerance etc; Kenemans chapter 5)
1. Give a definition of psychopharmacology.
Studies which look at substances and the effects on behaviour, cognition and affect via the
brain.
2. (See also Kenemans, paragraph 1.2) What is a dose-response-curve (DRC)?
A dose-response-curve shows what the effect of a certain dose of a substance is on the brain,
behaviour, other substances in the brain etc. this depends on what you put on your y-axis.
3. See Kenemans Fig. 5.2: Does the DRC for one particular substance always look the same? What
does it depend on? How about differences between individuals?
No, it depends on what is on the y-axis. Differences between individuals are not shown in the
curve, these are averages.
4. What type of responses in a DRC and the relationship between them are especially relevant for
medications?
The responses of the brain activity and the behavior someone shows. If it shows the expected
effect.
5. Wat is efficacy? Potency? Therapeutic window?
Efficacy is the maximum effect of a drug, potency is the minimum dose which gives a visible
effect. Therapeutic window is the range in which you can choose a dose for a patient, this is a
range between a small desired effect and minimal undesired effect and the point at which
you’ve got the maximum desired effect but the lowest undesired effect possible for that
value.
6. Which considerations are relevant for the individual titration of the optimal dose of a substance?
How much effect is needed and how much of the side-effects is fine for the patient.
7. What is receptor interaction?
The amount of binding and the effect of binding of a substance on a receptor. Efficacy and
affinity.
8. What is the relationship between receptor interaction and statistical interaction?
There are two factors which together explain what the effect will be. Binding of different
substances to the same receptor will cause different outcomes.
9. What is the importance of a statistical interaction between a pharmacological variable and a
psychological variable?
You want to make sure that your pharmacological variable works on the symptoms someone
is experiencing and that it works for the right symptoms. That the right symptoms with the
substance give a good outcome.
10. With receptor interaction, what is affinity, and what is efficacy?
Affinity is how easily the substance binds to a receptor. Efficacy is the effect the substance
has on the post-synaptic neuron that the receptor is on.
11. (See also Kenemans paragraph 4.4) In what respect do full and partial agonists differ, in affinity
or efficacy?
The affinity is the same, but a partial agonist has less efficacy than a full agonist.
12. (See also Kenemans paragraph 4.4) What is high with a pure antagonist, affinity, efficacy or
both?
The affinity is high, efficacy is 0.
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