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Neuro > Psych drugs 0427 > Flashcards

Psych drugs 0427 Flashcards

1
Q

alcohol withdrawal

A

benzodiazepines

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2
Q

bulimia

A

SSRI

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3
Q

anxiety

A

benzos
buspirone
SSRI

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4
Q

ADHD

A

methylphenidate (ritalin)

amphetamines (dexedrine)

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5
Q

atypical depression

A

MAO inhibitors

SSRI

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6
Q

bipolar d/o

A 
mood stabilizers (lithium, valproate, carbamazepine)
atypical antipsychotics
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7
Q

depression

A

SSRI, SNRI

TCA

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8
Q

depression with insomnia

A

mirtazapine

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9
Q

OCD

A

SSRI

clomipramine

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10
Q

panic d/o

A

SSRI
TCA
benzos

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11
Q

PTSD

A

SSRI

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12
Q

schizophrenia

A

antipsychotics

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13
Q

Tourettes syndrome

A

antipsychotics (haloperidol, resperidone)

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14
Q

social phobias

A

SSRI

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15
Q

CNS stimulants

A

methylphenidate
dextroamphetamine
mixed amphetamine salts

moa: increase catecholamines at synaptic cleft, esp NE and DA
use: ADHD, narcolepsy, appetite control

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16
Q

antipsychotics (neuroleptics)

A 
haloperidol
trifluoperazine
fluphenazine
thioridazine
chlorpromazine

“-azine” (and haloperidol)

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17
Q

antipsychotics (neuroleptics) moa

A

block dopamine D2 receptors (increase cAMP)

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18
Q

antipsychotics (neuroleptics) use

A

schizophrenia (pos sx)
psychosis
acute mania
Tourette syndrome

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19
Q

antipsychotics (neuroleptics) tox

A
  1. highly lipid soluble - stored in body fat, slow removal from body
  2. extrapyramidal system effects
  3. endocrine (DA receptor antagonist) - hyperprolactinemia and galactorrhea
  4. anti muscarinic: dry mouth, constipation
  5. anti alpha: hypotension
  6. anti histamine: sedation
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20
Q

neuroleptic malignant syndrome

A

tox with antipsychotics.
rigidity, myoglobinuria.
autonomic instability.
hyperpyrexia.

"FEVER"
Fever
Encephalopathy
Vitals unstable
Elevated enz
Rigidity of mm.

tx: dantrolene, D2 agonists (bromocriptine)

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21
Q

tardive dyskinesia

A

tox with antipsychotics.
stereotypic oral-facial mvmts due to long term antipsychotic use.
often irreversible.

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22
Q

extrapyramidal effects over time

A

4 h: acute dystonia - muscle spasm, stiffness, oculogyric crisis

4d: akinesia, parkinson sx

4 wk: akathisia (restlessness)

4 mo: tardive dyskinesia

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23
Q

chlorpromazine

A

corneal deposits

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24
Q

thioridazine

A

retinal deposits

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25
Q

atypical antipsychotics

A 
olanzapine
clozapine
quetiapine
risperidone
aripiprazole
ziprasidone
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26
Q

atypical antipsychotics moa

A

varied effects on 5HT2, dopamine, alpha, and H1 receptors

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27
Q

atypical antipsychotics use

A

schizophrenia (BOTH pos and neg sx)

28
Q

other uses for olanzapine

A 
OCD
anxiety d/o
depression
mania
Tourettes syndrome
29
Q

atypical antipsychotics tox

A

fewer extrapyramidal and anticholinergic SE than typical antipsychotics

30
Q

olanzapine tox

A

significant weight gain

31
Q

clozapine tox

A

significant weight gain
agranulocytosis - weekly WBC monitor
seizures

32
Q

ziprasidone tox

A

prolonged QT interval

33
Q

LITHIUM moa

A

not established

may be related to inhibition of phosphoinositol cascade

34
Q

lithium use

A

mood stabilizer for bipolar d/o.
blocks relapse and acute manic events.
also for SIADH [ADH ANTAGONIST]

35
Q

lithium tox

A 
"LMNOP"
Lithium side effects
Movement (tremor)
Nephrogenic DI
hypOthyroidism
Pregnancy problems (fetal heart)

also: sedation, edema, heart block.
narrow therapeutic window (monitor serum levels).

36
Q

fetal cardiac defect with lithium

A

Ebstein anomaly: apical displacement of tricuspid valve leaflets. decrease RV volume, atrialization of RV.

malformation of great vessels

37
Q

lithium excretion

A

almost all by kidneys - reabsorbed at PCT following SODIUM.

38
Q

buspirone moa

A

stimulates 5HT1a receptors (selective agonist)

39
Q

buspirone use

A

generalized anxiety d/o

does NOT cause sedation, addiction, tolerance.
does NOT interact with alcohol.
less abuse potential than benzos.

40
Q

tricyclic antidepressants

A 
most end in -iptyline or ipramine:
amitryptyline
nortryptiline
imipramine
desipramine
clomipramine
doxepin
amoxapine
41
Q

TCA moa

A

block reuptake of NE and serotonin

42
Q

TCA use

A

major depression
fibromyalgia
bedwetting (imipramine)
OCD (clomipramine)

43
Q

TCA SE

A

sedation
alpha blocker
atropine-like (anticholinergic) - tachycardia, urinary retention

44
Q

least sedating TCA

A

desipramine

–also has lower seizure threshold

45
Q

TCA with more anticholinergic effect

A

3G (amitryptyline) > 2G (nortriptyline)

46
Q

TCA tox

A

“tri C’s”
Convulsions
Coma
Cardiotoxicity (arrhythmias)

also: resp depression
hyperpyrexia
confusion, hallucinations (elderly, due to anticholinergic effects)

47
Q

tx of TCA tox

A

sodium bicarb for CV toxicity

48
Q

SSRI

A

FLuoxetine
PARoxetine
SErtraline
CITalopram

“FLashbacks PARalyze SEnior CITizens”

49
Q

SSRI moa

A

serotonin-specific reuptake inhibitors

50
Q

SSRI use

A 
depression
OCD
bulimia
social phobias
PTSD
51
Q

SSRI tox

A

less than TCA.

GI distress
sexual dysfunction (anorgasmia)
SEROTONIN SYNDROME

52
Q

serotonin syndrome

A

with any drug that increases serotonin (ex: MAO-I)

hyperthermia
myoclonus
CV collapse
flushing
diarrhea
seizures

tx: cyproheptadine (5HT2 receptor antagonist)

53
Q

SNRI

A

venlafaxine

duloxetine

54
Q

SNRI moa

A

inhibit serotonin and NE reuptake

55
Q

SNRI use

A

depression

venlafaxine: GAD
duloxetine: diabetic peripheral neuropathy

56
Q

which SNRI has greater effect on NE?

A

duloxetine

57
Q

SNRI tox

A

increase BP
stimulant effects
sedation
nausea

58
Q

MAO inhibitors

A

tranylcypromine
phenelzine
isocarboxazid
selegiline (MAO-B specific)

59
Q

MAO inhibitors moa

A

nonselective MAO inhibition increases levels of amine NTs (NE, serotonin, dopamine)

60
Q

MAO inhibitors use

A

atypical depression
anxiety
hypochondriasis

61
Q

MAO inhibitors tox

A

HYPERTENSIVE CRISIS with TYRAMINE INGESTION (wine, cheese, sausage) and BETA AGONISTS

also: CNS stimulation

62
Q

MAO inhibitors contraindicated with what tx…?

A

SSRI or meperidine – to prevent serotonin syndrome

63
Q

atypical antidepressants

A

bupropion
mirtazapine
maprotiline
trazodone

64
Q

bupropion

A

increase NE and dopamine by unknown moa.
also used for smoking cessation.

tox: stimulant effects (tachycardia, insomnia)
headache
seizure in bulimic pts
NO sexual side effects

65
Q

mirtazapine

A

alpha 2 antagonist (increase release of NE and serotonin).
potent 5HT2 and 5HT3 receptor antagonist.

tox: sedation
increase appetite
weight gain
dry mouth

66
Q

maprotiline

A

blocks NE reuptake

tox: sedation
orthostatic hypotension

67
Q

trazodone

A

primarily inhibits serotonin reuptake

use: insomnia
(high dose needed for antidepressant effect)

toxicity: sedation
nausea
priapism
postural hypotension

Neuro (15 decks)

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