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Pharmacology E5 > Antidepressants and Antipsychotics > Flashcards

Antidepressants and Antipsychotics Flashcards

(44 cards)

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1
Q

What type of medication has a side effect of Bruxism due to extrapyramidal effects?

A

SSRIs

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2
Q

You should take Epi with caution when taking these two types of meds:

A

tricyclics and MAOIs

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3
Q

What is lithium primarily used for?

A

tx of bipolar disorder

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4
Q

What type of mild/moderate pain reliever would you give a pt who is taking lithium: aleve, aspirin, Advil or Tylenol?

A

Tylenol (acetaminophen) b/c lithium is contraindicated with NSAIDS (COX-2) as they inhibit renal excretion of lithium

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5
Q

What are the 4 types of drug interactions associated with lithium?

A
  1. Diuretics
  2. NSAIDS
  3. anticonvulsants
  4. antihypertensives
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6
Q

What are the 3 effects produced by benzos?

A
  1. behavior
  2. anticonvulsant
  3. muscle relaxation
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7
Q

What type of changes in behavior do benzos produce at high vs. low doses?

A

High doses: drowsiness, depressions, anterograde amnesia (surgery)

Low doses: reduction in anxiety, aggression, hostility

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8
Q

T/F benzos can only prevent seizure activity, they cannot arrest an ongoing seizure

A

False - benzos can prevent or arrest generalized seizure activity produced by electric shock or analeptic agents

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9
Q

What are the 2 drugs of choice used to prevent/arrest local anesthetic induced seizures in dentistry?

A

diazepam (Valium)

midazolam (Versed)

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10
Q

Diazepam (Valium) and cholrdiazepoxide (Librium) are two potent benzos that are used to produce what effect(s)?

A

muscle relaxation

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11
Q

Muscle relaxation produced by benzos is ______ mediated, requires an intact ___________ and can depress motor nerve and function in both ________ persons and in patients with ________________ disorders.

A

centrally mediated
intact spinal cord
healthy persons
skeletal muscle disorders

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12
Q

What is the MOA of benzos?

A

enhances inhibitory effects of GABA causing hyperpolarization and neuronal stabilization

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13
Q

T/F GABA receptors in neuronal plasma membranes can bind both GABA and Benzos

A

True

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14
Q

T/F The binding of Benzos is reduced by the presence of GABA

A

False - the presence of GABA enhances the binding of benzos

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15
Q

Why is it important to reduce apprehension prior to surgery?

A

apprehension may reduce anesthesia effects

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16
Q

Name 5 uses of benzos in medicine

A
  1. anti-anxiety
  2. skeletal m. relaxation
  3. hypnotic to tx insomnia
  4. tx alcoholism withdrawls
  5. pre-op apprehension reduction
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17
Q

Name the main uses of benzos in dentistry

A
  1. dec. pre-op anxiety
  2. IV sedative and amnesic
  3. EM seizure intervention
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18
Q

What benzo drug is a good choice for dental use b/c it is rapidly metabolized to inactive compounds therefore does not have significant accumulation?

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A

Lorazepam (Ativan)

19
Q

If a patient is on benzos and perscribe an opiate for pain how should your dosage differ than if the patient was not on a benzo?

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A

reduce the opiate dosage by 1/3 of normal dose to counteract CNS effects

20
Q

Which benzo has a very long half-life?

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A

Lorazepam (Ativan)

21
Q

Which benzo is referred to as “dazzle”?

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A

midazolam (Versed)

22
Q

What is the MOA of buspirone (BuSpar)?

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A

binds Serotonin receptors w/o affecting GABA receptors

23
Q

What are the drug interactions associated with BuSpar?

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A
  1. ciprofloxiacin
  2. clarithromycin
  3. erythromycin
  4. doxycyline
24
Q

What is the MOA of tranquilizers (antipsychotics)?

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A

D2 dopa receptor antagonists

25
What is the major side effect(s) of tranquilizers?
movement disorders or resting tremors
26
Where is the primary site for dopaminergic neurons?
striatum
27
T/F effective doses (potency) are indirectly proportional to tranquillizers D2 antatonism
False - Effective doses (potency) are directly proportional to their D2 antagonism
28
T/F all tranquilizers have a high therapeutic index and similar efficacy
True
29
What drug is used for pts with severe nausea/vomiting due to chemo b/c it's effective dose is not directly proportional to it's antagonism?
Clozapine (Clozaril) = low D2 antagonism
30
Where does the antipsychotic action of tranquilizers primarily take effect?
prefrontal cortex | limbic areas
31
Where do the extrapyramidal side effects of tranquilizers primarily take effect?
basal ganglia
32
Where does the antiemetic effects of tranquilizers primarily take effect?
chemo receptor trigger zone in medulla
33
What does the Dopaminergic hypothesis of Schizophrenia state?
Schizo is doe to overactivity of dopaminergic system
34
T/F Tranquilizers block receptors within hours of administration but therapeutic activity begins immediately
False: receptors are blocked within 2-4 hours after drug administration but therapeutic activity requires several weeks of treatment to achieve full effect
35
T/F Schizos have alterations in their prefrontal cortex and limbic system neuronal structures
True - Drugs help to recover normal cell morphology | after drugs are discontinued morphological abnormalities come back and symptoms of disease return
36
What are the major extrapyramidal effects of tranquilizers?
``` Parkinsonism Akinesia (difficulty initiating movement) Tremor Rigidity Akathisia (restless leg syndrome) Dystonia (sustained m. contraction) Tardive Dyskinesia Bruxism ```
37
What type of drugs can be administered to tx extrapyramidial effects of tranquilizers?
anti-cholinergic drugs
38
What causes the sedation and autonomic of side effects of tranquilizers?
blockade of histamine, cholinergic and adrenergic receptors
39
What potential CV effects are pts taking tranquilizers at risk for?
altered QT interval
40
What are the drug interactions associated with lithium?
1. potentiate CNS effects of sedatives, analgesics, antihistamines 2. potentiate respiratory depression caused by opioids 3. antacids: dec. absorption of antipsychotics 4. anticonvulsants: dec plasma levels of antipsychotics 5. may alter antihypertensive meds
41
What is typical antipsychotic used for tx of nausea and vomiting during chemo?
promethazine (Phenadoz, Phenergan, Promethegan)
42
What is the atypical antipsychotics used as cross over tx for bipolar disorders?
aripiprazole (Abilify)
43
What type of atypical antipsychotic is most commonly used for older people?
risperdone (Risperdal)
44
What are the indications for use of antipsychotics?
``` psychotic disorders acute delirium and dementia manic episodes during induction of lithium movement disorders intractable hiccups severe nausea and vomiting ```

Pharmacology E5 (3 decks)

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