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Family medicine > Antipsychotics > Flashcards

Antipsychotics Flashcards

1
Q

Anti-depressants: After therapeutic dose is achieved, how long does it take for symptoms to improve?

A

3-6 wks

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2
Q

When do u switch for another med/increase dose in antidepressant?

A

2 months

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3
Q

Which drug causes QT lengthening?

A

TCA

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4
Q

Tertiary TCA examples?

A

amitriptyline, Imipramine, doxepin, clomipramine

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5
Q

Secondary TCA examples?

A

Desipramine, notrtriptyline

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6
Q

Effective med for depression?

A

MAOI

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7
Q

MAOI S/E?

A

Sedation, weight gain
dry mouth, Postural HT
Sexual dys, sleep disturbance

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8
Q

what med if taken with tyramine rich food cause HTN crisis?

A

MAOI

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9
Q

How long do u wait before switching from SSRI to MAOI?

A

2 EXCEPT fluoxetine 5 wks

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10
Q

Serotonin syndrome symptoms include

A
  • Abdominalpain • Diarrhea
  • Sweats • Tachycardia
  • HTN
  • Myoclonus
  • Irritability • Delirium
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11
Q

Severe S/E in serotonin syndrome?

A

Hyperpyrexia, cardiovascular shock and death.

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12
Q

SSRI is treatment for

A

depression and anxiety

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13
Q

SSRI S/E

A

GI upset, sexual dys

insomnia+sedation=fatigue

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14
Q

discontinuation syndrome caused by?

A

SSRI, SNRI

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15
Q

discontinuation syndrome cause

A

agitation, nausea, disequilibrium and dysphoria

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16
Q

Fluoxetine + and - ?

A 
\+
low incidence of discontinuation syndrome
-
active metabolite may build up
Significant P450 interactions
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17
Q

Antidepressant: Bad choice in pts already on a number of meds

A

Fluoxetine

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18
Q

QT interval prolongation in Citalopram dose above

A

40 mg/day

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19
Q

Antidepressant (SSRI) with fast response?

A

Escitalopram

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20
Q

Venlafaxine not given to pts w/

A

HTN

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21
Q

Venlafaxine s/e

A

Sexual s/e
QT prolongation
nausea
Discontinuation syndrome

22
Q

effective for physical symptoms of depression?

A

Duloxetine

23
Q

What antidepressant inc cholesterol and triglyceride?

A

Mirtazapine

24
Q

what drug is sedating at low doses and activating at high doses?

A

Mirtazapine, 30mg is cutpoint

25
Q

hyperlipidemia pt, what antidepressant is avoided?

A

Mirtazapine

26
Q

Bupropion is good for?

A

depression and smoking cessation

27
Q

Which med decreases suicide rate?

A

Lithium

28
Q

prophylaxis for mania/depressive ep?

A

lithium

29
Q

Factors predicting positive response to lithium

A
  • classic mania
  • mania followed by depression
  • Prior long-term response or family member with good response
30
Q

Affective in mania only (depression no)

A

valporic acid

31
Q

Factors predicting a positive response to valporic acid?

A

-rapid cycling patients
- comorbid substance issues
– mixed patients
– Patients with comorbid anxiety disorders

32
Q

___ is better tolerated than lithium

A

valporic acid

33
Q

First line agent for acute mania and mania prophylaxis

A

Carbamazepine

34
Q

used for neuropathic/chronic pain

A

Lamotrigine

35
Q

before Lamotrigine is started check?

A

Liver function test

36
Q

when to use antipsychotics?

A 
Schizophrenia
Psychotic depression
Bipolar
delirium
dementia
37
Q

Typical antipsychotics (high pot)?

A

Haloperidol, Pimozide

38
Q

which drug have higher extrapyramidal S/E?

A

Typical antipsychotics: HIGH potency

39
Q

Typical antipsychotics: low potency s/e?

A

Higher risk for Cardiotoxic and Anticholinergic adverse effects

40
Q

Typical antipsychotics (low pot)?

A

Chlorpromazine and Thioridazine.

41
Q

which atypical antipsychotic drug act like typical in high doses?

A

Risperidone at 6 mg

42
Q

which antipsychotic drug is used with patients who have hyperactivity?

A

Risperidone

43
Q

Olanzapine s/e?

A

Weight gain
hypertriglyceridemia
hypercholesterolemia
hyperglycemia

44
Q

Extrapyramidal side effects include

A

Acute dystonia, Parkinson syndrome, Akathisia

45
Q

Anxiolytics indications

A

– Panic disorder
– Generalized Anxiety disorder
– Substance-related disorders and their withdrawal
– Insomnias

46
Q

Buspirone +/-

A

+
no sedation
-
2 wks for results

47
Q

Buspirone will not work on the anxiety if

A

patient used to take BZD

48
Q

How long is BZD given for

A

3-5 days

49
Q

Benzodiazapine s/e?

A

Dependence
Tolerance
Cognitive deficits
Disinhibition

50
Q

drug to treat insomnia? (BZD)

A

triazolam

51
Q

drug to treat anxiety? (BZD)

A

Lorazepam
Oxazepam
Diazepam

Family medicine (1 decks)

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