Neuropsychology of Religious

Carlson Ch. 4: Psychopharmacology Experience Neuropsychology of Religious 1. Pharmacokinetics a. Routes of administration i. Intravenous ii. Intraperitoneal iii. Intramuscular iv. Subcutaneous v. Oral vi. Sublingual vii. Inhalation viii. Topical ix. Intracerebral x. Intracerebroventricular b. Distribution of drugs in the body c. Inactivation and excretion 2. Drug effectiveness a. Dose response curve- understand the effects of a drug at a variety of different dosages. i. Determining appropriate dosages 1. Effective dose (ED-50) a. Dosage that is effective in 50% of the population 2. Lethal dose (LD-50)/toxic dose (TD-50) a. Dosage that is lethal/toxic in 50% of the population b. Therapeutic index i. Ratio- LD-50 (or TD-50): ED-50 ration. ii. Clinical safety factor of a drug c. Effects of repeated administration i. Tolerance 1. Cross tolerance a. Exposure to 1 drug produces tolerance to another. b. Drugs that are chemically similar- opioids 2. Selective tolerance a. Tolerance to some drug effects but not others b. Overdose- tolerant to psychoactive but not lethal effects. 3. Sensitization a. Some drug effects increase sensitivity. b. Cocaine- people take more but then have issues like movement disorders. 4. Metabolic tolerance a. Decrease in a mount of drug reaching target cells. 5. Functional tolerance a. Decrease in drug’s ability to influence target cells. b. Receptors may down-regulate or up-regulate 6. Theories of drug tolerance a. Drug exposure theory. i. Exposure to drug is the only cause of tolerance. b. Learned tolerance. i. The environment plays an important role in tolerance. ii. Situationally specific tolerance 3. Placebo effects a. Placebo= pharmacologically inert substance b. A belief in the effectiveness of a drug can produce a real psychological and physiological effects. c. Can have therapeutic effect, side effects. i. Side effects: “nocebo” effect d. Total drug effect+ placebo response + active drug effect e. 2 groups of patients with ulcers i. Group 1: “medication” given by physician; said drug was effective. 1. 70% reported relief. ii. Group 2: “medication” given by nurse; said drug was experimental. 1. 25% reported relief. f. Indicates need for double-blind experiments. i. Neither patient nor observer knows what treatment has been administered. 4. Effects of drugs on neurochemicals a. Agonist i. Molecule that enhances neurotransmitter function 1. Example: binds to and activates the same receptor a neurotransmitter would b. Antagonist i. Molecule that interferes with neurotransmitter function 1. Binds to receptor of a neuron but do not activate it; causes increasing neurotransmitter deactivation. c. Mixed agonist/antagonist i. Molecule with properties of both an agonist and an antagonist 1. Has different effects on different receptor subtypes; binds to and activates receptor but to a lesser extent than the neurotransmitter d. Drug actions at the synapse. i. Synthesis ii. Storage iii. Exocytosis (release) iv. Receptor effects 1. Direct agonist 2. Receptor blocker/direct antagonist 3. Noncompetitive binding a. Indirect antagonist b. Indirect agonist v. Reuptake & enzymatic degradation 5. Neurochemicalsa. Criteria i. released by one cell, produce response in another. ii. Present within presynaptic cell. iii. Released in response to presynaptic depolarization. iv. Interacts with specific receptors on postsynaptic cell. b. Acetylcholine c. Monoamines i. Catecholamines 1. Dopamine 2. Norepinephrine 3. Epinephrine ii. Indolamines 1. Serotonin d. Amino acids i. Glutamate ii. GABA iii. Glycine e. Peptides i. Endogenous opiates f. Lipids i. Endocannabinoids g. Nucleosides i. Adenosine h. Soluble gases (aka gasotransmitters) i. Nitric oxide ii. Carbon monoxide 6. Functional classes of psychoactive drugs: Recreational drugs a. Tobacco b. Alcohol c. Marijuana d. Stimulants i. Caffeine, cocaine, amphetamine e. Hallucinogens i. LSD, MDMA, psilocybin