Flashcards in 00 Psychiatry Review Deck (139):
What is the generic name of Thorazine?
Chlorpromazine (typical antipsychotic)
What is the generic name of Prolixin?
Fluphenazine (typical antipsychotic)
What is the generic name of Haldol?
Haloperidol (typical antipsychotic)
What is the generic name of Compazine?
Prochlorperazine (typical antipsychotic)
What is the generic name of Abilify?
Aripiprazole (atypical antipsychotic)
What is the generic name of Clozaril?
Clozapine (atypical antipsychotic)
What is the generic name of Latuda?
Lurasidone (atypical antipsychotic)
What is the generic name of Zyprexa?
Olanzapine (atypical antipsychotic)
What is the generic name of Invega?
Paliperidone (atypical antipsychotic)
What is the generic name of Seroquel?
Quetiapine (atypical antipsychotic)
What is the generic name of Risperdal?
Risperidone (atypical antipsychotic)
What is the generic name of Geodon?
Ziprasidone (atypical antipsychotic)
What is the generic name of Maintena?
Abilify long-acting injectable (atypical antipsychotic)
What is the generic name of Relprevv?
Olanzapine long-acting injectable (atypical antipsychotic)
What is the generic name of Sustenna?
Paliperidone long-acting injectable (atypical antipsychotic)
What is the generic name of Consta?
Risperidone long-acting injectable (atypical antipsychotic)
Why antipsychotics have an indication as adjunctive treatment for MDD?
Aripiprazole, Quetiapine XR, Olanzapine-fluoxetine
Which antipsychotic is indicated for refractory schizophrenia?
What is the BBW with antipsychotics?
Increased mortality in elderly patients with dementia-related psychosis. Increased risk of suicide
What are the multiple BBWs for Clozapine?
Agranulocytosis (ANC < 500 - blood testing required weekly for first 6 months). Orthostatic hypotension. Seizure
You should inform patients and caregivers that if the patient misses taking Clozapine for more than how many days, should they not restart their medication at the same dosage, but rather contact their physician for dosing instructions?
What is an absolute contraindication to Clozapine treatment?
WBC < 3500 or ANC < 2000
When should Clozapine treatment be interrupted?
WBC< 3000 or ANC < 1500
When should Clozapine treatment be discontinued?
WBC < 2000 or ANC < 1000
What is the starting and target dose of Clozapine?
Starting: 12.5mg QD or BID. Target: 300-450mg QD in divided doses
If someone gets tardive dyskinesia, what is a good antipsychotic to switch to?
Clozapine, doesn't block D2
What are two treatment options for Irritability Associated with Autism?
Risperidone or Aripiprazole
What are the medication options for Bipolar Depression?
Quetiapine (SR or XR), Olanzapine-Fluoxetine, Lurasidone
What is the generic name of Symbyax?
Olanzapine-Fluoxetine Combination (fixed dosed)
What are the contraindications to Geodon (Ziprasidone) use?
Causes QT prolongation. Do not use with MI or other heart issues
What is a unique indication for Invega (Paliperidone)?
Treatment of schizoaffective disorder as monotherapy and as an adjunct to mood stabilizers and/or antidepressant therapy in adults. Given in special delivery capsule that causes GHOST SHELL in the stool
What two medications can cause a ghost shell in the stool?
Concerta and Invega
What is the generic for Saphris?
Asenapine (atypical - only sublingual antipsychotic)
What are the two long-acting injectable (LAI) typical antipsychotics?
Haloperidol and Fluphenazine
All antipsychotics that have long-acting injectables require an overlap of 2-3 weeks with the first long-acting injection except which two?
Olanzapine and Paliperidone
How is Relprevv dosed?
By intramuscular gluteal injection every 2-4 weeks
What is a rare and unique side effect of Relprevv (Zyprexa)?
Post-injection delirium sedation syndrome (PDSS). Usually happens within 3 hours after injection. You will need to stay in the clinic for at least 3 hours after injection to monitor
What are the common and expected ADRs of atypicals?
Dizziness. Sedation/Activation. Orthostatic hypotension. Hyperprolactinemia. Weight gain/hyperglycemia/Dyslipidemia
Which atypicals cause sedation?
Clozapine, Olanzapine, Quetiapine
Which atypicals cause activation?
Aripiprazole, Ziprasidone, Lurasidone
Which atpyicals cause orthostatic hypotension?
Clozapine, Quetiapine (both cause sedation as well), Risperidone
Which atypicals cause Hyperprolactinemia?
Risperidone, Paliperidone, Olanzapine
Which atypicals cause Metabolic Syndrome (weight gain/hyperglycemia/dyslipidemia)?
Clozapine, Olanzapine, Quetiapine, Risperidone
What is Neuroleptic Malignant Syndrome (NMS)?
Caused by antipsychotic drugs. Can cause muscle rigidity, altered mental status, acute renal failure, etc. It is NOT EPS
Which antipsychotics have a higher incidence of causing EPS?
High-potent D2-receptor antagonists (Haloperidol, Fluphenazine, Risperidone, Olanzapine)
What is Haloperidol Lactate?
Used in the cocktail for acute agitation/aggression/delirium. Given IM or IV. Higher risk of QTc prolongation
Which Haloperidol preparation comes in sesame oil base?
Haloperidol deconate (IM)
What are the common Mood Stabilizers?
Lithium, Divalproex sodium (Depakote), Valproic acid (Depakene), Carbamazepine, Lamotrigine
What is the PK of Lithium like?
100% F, 100% renal clearance (can use in hepatic failure)
What is the formula to convert from mEq to Mg?
mEq = (mg/MW) x valence
What are the Lithium levels for acute mania and maintenance?
Acute mania: 0.8-1.5 mEq/L
Maintenance: 0.6-1.2 mEq/L
What are some general side effects with Lithium?
GI (N/V) - take with food. Lethargy. Polyuria/Polydipsia/Nocturia
What are some long term effects of Lithium use?
Nephrogenic DI. Hypothyroidism
What is seen in Lithium toxicity?
> 1.5 (tremor, persistent diarrhea, loss of coordination, slurred speech, lethargy). > 2.0 (arrhythmias, CNS depression, seizures, coma, death)
How is Valproic Acid usually dosed?
15-20mg/kg given BID
What are the BBWs with Valproic Acid?
Pancreatitis, Hepatotoxicity, Teratogenic
What is the main contraindication to Valproic Acid use?
Urea cycle disorder
What is the generic name of Prozac?
What is the generic name of Sarafem?
What is the generic name of Paxil?
What is the generic name of Zoloft?
What is the generic name of Celexa?
What is the generic name of Lexapro?
Which SSRI has the longest half-life?
Fluoxetine, 4-16 days (d/t its active metabolite)
Which is the more activating SSRI?
Which SSRI is cleared the fastest from the body?
Paroxetine (most likely to have withdrawal symptoms)
Which SSRI must be given with food to increase "F"?
Why is there an FDA warning on Citalopram to not exceed 40mg/day?
Which SSRIs have the fewest DDIs?
Citalopram and Escitalopram
What are the class side effects of SSRIs?
Sexual dysfunction (5HT2 agonism), GI upset (5HT3 agonism)
What is the generic name of Effexor?
What is the generic name of Pristiq?
What is the generic name of Cymbalta?
What is the generic name of Fetzima?
What are some common ADRs with Venlafaxine?
Increase in Blood Pressure (dose related). Nausea
Which SNRI causes ghost tablets?
What is the only TCA approved for OCD?
What is the generic name of Elavil?
What are the ADRs caused by TCAs?
Anticholinergic (dry mouth, urinary retention, blurred vision, constipation). Sedation. Orthostatic hypotension. Weight gaine. Sexual side effects. Cardiovascular complications. Can be fatal in overdose
What is the generic name of Nardil?
What is the generic name of Marplan?
What is the generic name of Parnate?
What is the generic name of Emsam?
Selegiline (MAO-I PATCH)
What are the MAO-I drugs?
PITS: Phenelzine, Isocarboxazid, Tranylcypromine, Selegiline
What are the MAO-I ADRs?
Anticholinergic effects. Orthostasis. Sedation. Sexual dysfunction, weight gain, HA, insomnia. Hypertensive crisis
What is the only MAO-I that causes stimulation?
Where can the Emsam patch be placed?
Upper arm, upper back, chest, thighs
What is the generic name of Wellbutrin?
What is the generic name of Zyban?
Bupropion - smoking cessation, not depression
What is the generic name of Remeron?
What is the generic name of Desyrel?
What is the generic name of Oleptro?
What is the generic name of Viibryd?
What are the common ADRs with Bupropion?
Insomnia (activating), weight loss, no sexual dysfunction
What are the contraindications with Bupropion?
What are the common ADRs with Mertazapine?
Sedation! Increased appetite, weight gain, dry mouth, dizziness
What are the common ADRs with Trazodone?
Sedation (used commonly as a sleep aid). Orthostasis, Priapism
What is something that you need to make sure you mention to patients taking Viibryd (vilazodone)?
TAKE WITH FOOD
What are anxiety disorders primarily treated with?
SSRIs and SNRIs
When are Beno's used for anxiety disorders?
Short term (ex. while initiating an SSRI/SNRI). Use > 2 weeks increases risk of dependence. Abrupt discontinuation in patients treated long term should be avoided
When are Benzo's contraindicated?
Narrow angle glaucoma
What is the generic name of Buspar?
Buspirone (5HT1 partial agonist). Approved for generalized anxiety disorder. No effect when used PRN (takes a few weeks to kick in). NO ABUSE POTENTIAL. Often added to SSRI is not completely controlled
When is Buspirone use contraindicated?
With MAO-Is, require 10 day washout
What is the only Beta-Blocker approved for anxiety?
Propranolol (Inderal), a non-selective BB
What is the generic name of Vistaril?
Hydroxyzine (antihistamine/anticholinergic used for anxiety, mainly GAD). Works mostly be sedating
What is the generic name of Xyrem?
Sodium Oxybate (C III). Used for narcolepsy. It is the sodium salt of gamma-hydroxybutyric acid (GHB)
What is the BBW for Xyrem?
(Sodium Oxybate). CNS depressant with abuse potential; only to prescribers and patients enrolled in the Xyrem Patient Success Program; Respiratory depression
What is the generic name of Provigil?
Modafanil (C IV). Stimulant for sleep disorders (ex. narcolepsy)
What is the generic name of Nuvigil?
Armodafanil (C IV). Stimulant for sleep disorders (ex. narcolepsy)
What is there a risk for with Provigil and Nuvigil?
Risk of rash; requires MedGuide
Besides Provigil and Nuvigil, what other stimulants are used for Narcolepsy?
Methylphenidate (C II). Dextroamphetamine and Amphetamine (C II)
What medication classes are used for Insomnia?
Non-benzodiazepine (Z-hypnotics). Melatonin receptor agonist. TCAs (Doxepin (Silenor). Amitriptyline, Nortriptyline off label). Benzos. Antihistamines (tolerance develops)
What is the generic name of Ambien?
What is the generic name of Sonata?
What is the generic name of Lunesta?
What is the new FDA warning for Ambien?
New max dose for women, 5mg IR (instead of 10mg) and 6.25mg CR (instead of 12.5mg)
What is the generic name of Rozerem?
Ramelteon (melatonin receptor agonist)
What is the generic name of Hetlioz?
Tasimelteon (melatonin receptor agonist)
Which hypnotic benzos can be used for insomnia?
Temazepam (Restoril). Estazolam (Prosom). Quazepam (Doral). Flurazepam (Dalmane). Triazolam (Halcion)
What medication options are there for Restless Leg Syndrome?
Iron replacement if indicated. Dopamine Agonists (Ropinirole, Pramipexole, Rotigotine). Anticonvulsants (Gabapentin Enacarbil (Hirozant))
Which sleep aids for insomnia have no potential for abuse?
Melatonin receptor agonists (Rozerem and Hetlioz)
Which medication is indicated for cataplexy in narcolepsy?
What are some of the first line agents for the management of ADHD?
Methylphenidate. Dextroamphetamine & Amphetamine. Stimulants. Dexmethylphenidate. Lisdexamfetamine
What is the generic name of Focalin?
What is the generic name of Ritalin?
What is the generic name of Methylin?
What is the generic name of Concerta?
What is the generic name of Daytrana?
Methylphenidate Transdermal Patch
Where should the Daytrana patch be placed?
Applied to the hip area in the morning, 2 hours prior to desired effect
What is the generic name of Quillivant?
Methylphenidate powder long acting suspension (stable for 4 months after reconstitution stored at room temp)
What is the generic name of Adderall?
Dextroamphetamine & Amphetamine
What is the generic name of Dexedrine or Dextrostat?
What is the generic name of Vyvanse?
Lisdexamfetamine (prodrug of dextroamphetamine) - may have less risk of abuse since cannot be injected or snorted
What warning did the FDA issue for Methylphenidate?
Warning on the risk of long-lasting erections (Priapism)
What is the generic name of Straterra?
Atomoxetine, a non-stimulant option for ADHD
What is the BBW for Straterra (Atomoxetine)?
Increased risk of suicidal ideation
What is the generic name of Intuniv?
Guanfacine XR, a non-stimulant option for ADHD
What is the generic name of Kapvay?
Clonidine XR, a non-stimulant option for ADHD