Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Summary Notes Royal College > Psychopharm > Flashcards

Psychopharm Flashcards

1
Q

Which of the following antidepressants has minimal norepinephrine selectivity?

A
  • citalopram and escitalopram most selective serotonin and very little inhibition of NE and dopamine

NE activitity of SSRIs (highest to lowest): Paroxetine (somewhat significant) Fluoxetine (somewhat significant) Sertraline FluvoxamineCitalopram (very minimal) Escitalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which TCA has most norepinephrine sensitivity?

A
  1. Desimipramine

2. Nortryptilline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Serotonin Syndrome?

A

Lab abnormalities: metabolic acidosis, rhabdomylosis, elevated serum AAT, creatiine, DIC*
hypERthermia, agitation, tremor, akithesia, deep tendon hypERreflexia, spontaenous CLONUS, DILATED PUPILS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Drugs associated with serotonin syndrome?

A

SSRI
Trazodone, Nefazodone, Clomipramine, Buspirone, Venlafaxine
MAOi - phenelzine, moclobemide, clorgiline,
Anticonvulsants - valproate
Analgesics - meperidine, fentanyl, pentazocine
Antiemetics - ondansetron, graniesteron, metclopramide
Antibiotics - linezolid
Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MAOI side effects

A 
OWEIS
O- Orthostasis
W - Weight gain
E - edema/peripheral
I - Insomnia
S - sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pharmacokinetics w/aging

A

no change to conjucation and glucornidation
decreased hydroxylation and demethylation
decreased oxidation/decreased reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What don’t you use with clozapine?

A

Carbamezapine - increases agranulocytosis - BM suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clozapine toxcitiy?

A

hypotension NOT hypERtension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clonidine- pharm actions?

A

works on presynaptic - 2 adrenergic receptors- agonist
opp of heroin withdrawal
dry mouth, constipation, dizziness, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CYP1A2

A
  1. Fluvoxamine
  2. Fluoxetine

Minimal

  • Bupropion
  • Mirtazapine
  • Paroxetine
  • Sertraline
  • Venlafaxine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CYP2D6

A
  1. Bupropion, Fluoxetine, Paroxetine

Mod - Citalopram, Escitalopram, Sertraline

Low - 
Fluvoxamine
Mirtazapine
Nefazodone
Venlafaxine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CYP3A4/CYT p450

A

High:
Fluvoxamine
Nefazodone
Tricyclics

Fluoxetine
Sertraline

Low:
citralopram
escitalopram
mirtazapine
paroxetine
venlafaxine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Largest risk for TD ?

A

elderly female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SSRI - side effects

A

platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is least histaminergenic/ach?

A

desimpramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common side effect of Trazodone?

A

Headache

2A & C reuptake inhibitor

17
Q

NMS

A 
Hyperthermia
Mental status change
CK elevation
Blood pressure elevation
Diaphoresis
Urinary incontience
18
Q

Lamotrogine - MOA

A

blockade of voltage gated Na channels

modulates release of glutumate and aspartate

19
Q

Buspirone - MOA

A 
affinity 5HT1A
moderate affinity D2
no effect on GABA
in GAD.
Buspirone does not cause weight gain, sexual dysfunction, discontinuation symptoms, or significant sleep disturbance. It does not produce sedation or cognitive and psychomotor impairment. The most common adverse effects of buspirone are headache, nausea, dizziness, and (rarely) insomnia.
20
Q

Tetrabenzine

A

Depression

VMAT

21
Q

Carbamezapine

A 
rash
mild hematopoetic suppression
sedation
H- Headache
A - Ataxia
R - Rash
D - Dizziness
S - Sexual Dysfunction
A - Anemia/Agranulocytosis
N - Nausea
D - Diplopia
22
Q

Lithium induced tremor - tx

A

Propanolol

23
Q

Anticholinergic toxcitiy

A 
BLIND AS A BAT, MAD AS A HATTER
blurred vision - mydriasis
fever
dry mouth
tachycardia
urinary retention
ileus
hypotension
24
Q

Worst SSRI - sexual dysfunction

A

paroxetine
stimulation of 5Ht2
worse because it impairs NOS

25
Q

Desimipramine

A

no SRI activity

all NRI*

26
Q

MOA - Mirtazapine

A

alpha-2 antagonist, 5HT2A/C antagonist, H1 antagonist

27
Q

Psychostimulants - key interactions

A

Psychostimulants may increase the level of phenytoin, carbamazepine, and phenobarbital.

At the same time, these antiepileptics may lower the psychostimulant level as they act as universal enzyme inducers.

Psychostimulants increase the level of MAO inhibitor and TCAs. Possible increase in SSRI level.
Psychostimulants may increase the effect of warfarin.

Valproic acid – increased concentrations of valproic acid: consider monitoring serum valproic acid concentrations.

Heart rate-lowering drugs: concomitant use not recommended.

28
Q

Contraindications to psychostimulants

A

Treatment with MAO inhibitors and for up to 14 days
Pre-existing severe gastrointestinal narrowing after discontinuation
Advanced arteriosclerosis
Glaucoma
Known hypersensitivity or allergy to the products
Untreated hyperthyroidism
Moderate to severe hypertension

Summary Notes Royal College (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions