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Step 1 Exam > Psych Drugs > Flashcards

Psych Drugs Flashcards

1
Q

CNS Stimulants (4)

A
  1. methylphenidate 2. dextroamphetamine 3. methamphetamine 4. phentermine
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2
Q

Mechanism of CNS Stimulants

A

-increase catecholamines at the synaptic cleft, esp. NE and DA.

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3
Q

Clincial use of CNS stimulants

A

ADHD Narcolepsy Appetite control

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4
Q

Antipsychotics (neuroleptics) (5)

A
  1. Haloperidol 2. Trifluoperazine 3. Fluphenazine 4. Thioridazine 5. Chlorpromazine
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5
Q

Mechanism of Antipsychotics

A

All typical antipsychotics block dopamine D2 receptors (increase cAMP).

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6
Q

Clinical use of antipsychotics

A

-schizophrenia (mainly + symptoms) -psychosis -acute mania -Tourette’s

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7
Q

Antipsychotics are very slow to be removed from the body because…

A

they are highly lipid soluble and are stored in body fat.

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8
Q

Toxicity of antipsychotics

A

-extrapyramidal system effects (dyskinesias) -endocrine side effects (galactorrhea) -dry mouth, constipation (from blocking muscarinic receptors) -hypotension (from blocking alpha-1 receptors -sedation (from blocking histamine receptors)

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9
Q

Neuroleptic malignant syndrome

A

toxicity of antipsychotics causing rigidity, myoglobinuria, autonomic instability and hyperpyrexia

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10
Q

Treatment forNeuroleptic malignant syndrome

A

-dantrolene -D2 agnoists (bromocriptine)

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11
Q

Tardive dyskinesia

A

toxicity of antipsychotics casuing oral-facial movements

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12
Q

High potency antipsychotics

A

-Trifluoperazine, Fluphenazine, Haloperidol *these cause neurologic side effects (EPS system)

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13
Q

Low potency antipsychotics

A

-Chlorpromazine, Thioridazine *these cause non-neurologic side effects

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14
Q

Chlorpromazine can also cause…

A

cornela deposits.

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15
Q

Thioridazine can cause…

A

retinal deposits.

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16
Q

Haloperidol can also cause…

A

NMS or tardive dyskinesia.

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17
Q

Evolution of EPS side effects

A

-4 hr acute dystonia -4 day akathisia -4 wk bradykinesia -4 month tardive dyskinesia

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18
Q

Atypical Antipsychotics (6)

A
  1. Olanzpaine 2. Clozapine 3. Quetiapine 4. Risperidone 5. Aripiprazole 6. Ziprasidone
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19
Q

Clinical use of atypical antipsychotics

A

-schizophrenia (+ and - symptoms) -Bipolar -OCD -anxiety disorder -depression -mania -tourette’s

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20
Q

Olanzapine/Clozapine may cause…

A

significant weight gain.

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21
Q

Clozapine may cause…

A

agranulocytosis (requires weekly WBC monitoring) and seizure.

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22
Q

Risperidone may increase…

A

prolactin (lactation/gynecomastia) leading to decreased GnRH, LH and FSH (irregular menstruation/fertility).

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23
Q

Ziprasidone may…

A

prolong the QT interval.

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24
Q

Clinical use of Lithium

A

-mood stabilizer for bipolar disorder -blocks relapse and acute manic episodes -SIADH

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25
Q

Toxicity of Lithium

A

-tremor -sedation -edema -heart block -polyuria -teratogenesis

26
Q

Lithium causes polyuria because…

A

it is an ADH antagonist causing nephrogenic DI.

27
Q

Fetal cardiac defects from lithium include…

A

Ebstein anomaly and malformation of the great vessels.

28
Q

Buspirone mechanism

A

stimulates 5-HT(1A) receptors

29
Q

Use of Buspirone

A

-generalized anxiety disorder (1-2 wks to take effect) (does not interact with alcohol)

30
Q

SSRIs (4)

A
  1. Fluoxetine 2. Paroxetine 3. Sertraline 4. Citalopram
31
Q

Mechanism of SSRIs

A

5-HT specific reuptake inhibitors

32
Q

Use of SSRIs

A

-depression -GAD -Panic disorder -OCD -bulimia -social phobias -PTSD

33
Q

Toxicity of SSRIs

A

-GI distress -sexual dysfunction -serotonin syndrome w/ any drug that increases 5HT (MAO inhibitors, SNRIs, TCAs)

34
Q

Serotonin Syndrome

A

-hyperthermia -confusion -myoclonus -CV collapse -flushing -diarrhea -seizures

35
Q

Serotonin Syndrome is treated with…

A

Cyproheptadine (5-HT2 receptor antagonist)

36
Q

For SSRIs to start taking effect, it takes…

A

4-8 wks.

37
Q

SNRIs (2)

A

Venlafaxine Duloxetine

38
Q

Mechanism of SNRIs

A

inhibit 5-HT and NE reuptake

39
Q

Use of SNRIs

A

depression -Venlafaxine also for GAD and panic disorder -Duloxetine also for diabetic peripheral neuropathy

40
Q

Toxicity of SNRIs

A

increased BP stimulant effects sedation nausea

41
Q

Tricyclic Antidepressants (7)

A
  1. amitriptyline 2. nortriptyline 3. imipramine 4. desipramine 5. clomipramine 6. doxepin 7. amoxapine
42
Q

TCAs mechanism

A

block reuptake of NE and 5-HT

43
Q

Uses of TCAs

A

-depression -OCD (clomipramine) -fibromyalgia

44
Q

Toxicity of TCAs

A

-sedation -alpha-1 blocking effects (postural hypotension) -atropine-like effects (anticholinergic - tachycardia, urinary retention, dry mouth) -convulsions -coma -cardiotoxicity -respiratory depression -hyperpyrexia

45
Q

Tertiary TCAs (amitriptyline) have more…

A

anticholinergic effects than secondary TCAs (nortriptyline) have.

46
Q

Desipramine is less…

A

sedating but has higher seizure incidence.

47
Q

In the elderly, TCAs can cause…

A

confusion and hallucinations due to anticholinergic side effects (use nortriptyline).

48
Q

Treatment for cardiotoxicity from TCAs

A

NaHCO3.

49
Q

Monoamine oxidase inhibitors (4)

A
  1. Tranylcypromine 2. Phenelzine 3. Isocarboxazid 4. Selegine (slective MAO-B inhibitor)
50
Q

Mechanism of MAO inhibitors

A

inhibition of MAO leading to increased levels of amine neurotransmitters (NE, 5-HT, DA)

51
Q

use of MAO inhibitors

A

-atypical depression -anxiety -hypochondria

52
Q

Toxicity of MAOIs

A

-hypertensive crisis (typically w/ ingestion of tyramine) -CNS stimulation

53
Q

MAOIs are contraindicated with…

A

SSRIs TCAs St. John’s wort Meperidine Dextromethorphan

54
Q

Atypical Antidepressants

A
  1. Buproprion 2. Mirtazapine 3. Trazodone
55
Q

Buproprion increases…

A

NE and DA

56
Q

Besides depression, buproprion is also used for…

A

smoking cessation.

57
Q

Toxicity of Buproprion

A

-stimulant effects -HA -seizure in bulimic pts

58
Q

Mirtazapine MOA

A

-alpha2-antagonist (increased release of NE and 5-HT) -potent 5-HT2 and 5-HT3 antagonist

59
Q

Toxicity of Mirtazapine

A

-sedation -increased appetite -weight gain -dry mouth

60
Q

Trazodone mechanism

A

-blocks 5-HT2 and alpha1-adrenergic receptors

61
Q

Trazodone is primarily used for…

A

insomnia.

62
Q

Toxicity of Trazodone

A

sedation nausea priapism postural hypotension

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