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Psych > Medications > Flashcards

Medications Flashcards

1
Q

What SSRI has been shown to be the best choice for pediatric patients?

A

fluoxetine

UWorld

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2
Q

NMS is more commonly associated with ___ antipsychotics.

A

first-generation

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3
Q

When is electroconvulsive therapy preferred?

A

elderly patients unable to eat/drink, psychotic or actively suicidal

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4
Q

What is the treatment for NMS?

A

bromocriptine or dantrolene

supportive care - hydration andcooling

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5
Q

What is the MOA of bromocriptine or amantadine?

A

dopaminergic agonists

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6
Q

What is the MOA of dantrolene?

A

direct-acting muscle relaxant

Ryanodine-Receptor agonist

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7
Q

What is the best medication for treatment resistant schizophrenia?

A

clozapine

ONLY medication that has evidence that it is superior to others

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8
Q

Which benzodiazepine is safe to use in alcohol withdrawal?

A

lorazepam

no liver metabolism

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9
Q

Which benzos are long-acting? Are they metabolized by the liver or not?

A

chlordiazepoxide and diazepam

YES - not safe in pts with possible liver disease

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10
Q

What is benztropine used for?

A

acute dystonic reaction to antipsychotic EPS
AND
parkinsonism effects of antipsychotic meds

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11
Q

How do you treat parkinsonism effects of antipsychotic medications?

A

benztropine OR amantadine

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12
Q

What is the MOA of benztropine?

A

muscarinic agonist

Mercedes-Benz car in Sketchy

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13
Q

How do you treat tardive dyskinesia?

A

valbenazine

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14
Q

What is the MOA of valbenazine?

A

monamine transporter 2 inhibitor

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15
Q

A patient on antipsychotic medication is experiencing restlessness and inability to stay still. Treatment?

A

(Akathisia)
beta blocker
benzo
benztropine

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16
Q

Which second generation antipsychotic is most likely to cause EPS?

A

risperidone

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17
Q

Which SGA has the highest association with weight gain and metabolic side effects?

A

olanzapine

vs ziprasidone has low risk profile

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18
Q

What type of therapy is found to be high-yield intervention for schizophrenia?

A

family therapy and psychoeducation

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19
Q

What is the goal of psychodynamic psychotherapy?

A

unconver unconscious patterns originating in childhood experiences

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20
Q

Sx: low GFR, nausea, vomiting, diarrhea, confusion agitation, ataxia, tremors/fasciculations

Dx: intoxication of ____

A

lithium

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21
Q

Treatment for lithium intoxication?

A

hemodialysis in severe cases

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22
Q

What other medications may increase risk of lithium toxicity?

A

NSAIDs, thiazide diuretics, ACE-I, tetracyclines, metronidazole

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23
Q

What medication must be prescribed with caution in patients with dementia with lewy bodies?

A

antipsychotic meds

can cause extreme antipsychotic hypersensitivity

24
Q

What are major adverse effects of lithium therapy?

A

tremor, ataxia, polyuria/polydipsia, vomiting, diarrhea

(chronic) - nephrogenic DI, CKD, thyroid dysfunction, hyperparathyroid

25
Q

Sx: mental status change, seizures, tachycardia, hypotension, cardiac conduction delay, anticholinergic effects

Dx: toxicity of ____

A

tricyclic antidepressants

26
Q

What is the treatment for catatonia?

A

benzos - lorazepam
OR
ECT

27
Q

What are side effects of bupropion?

A

weight LOSS
insomnia
dizziness
tremor

28
Q

What is first line treatment for acute bipolar depression?

A

SGA = quetiapine or lurasidone
OR
lamotrigine

29
Q

For a single-episode, unipolar major depression, what is the time frame for continuation-phase treatment?

A

additional 6 months after achieving level for remission

30
Q

What is the definition of “maintenance-phase treatment”?

A

continuing antidepressant meds past the initial continuation-phase treatment

31
Q

When is maintenance for 1-3 years of antidepressive therapy appropriate?

A

chronic episodes >2 years, recurrent MDD, strong family hx, suicide attempt

32
Q

Fluoxetine has a (long/short) half-life with long-term use?

A

LONG 4-6 days

33
Q

Paroxetine has a (long/short) half-life?

A

SHORT

34
Q

What is the best treatment for antipsychotic induced acute dystonia?

A

diphenhydramine
OR
benztropine

35
Q

Performance-only social anxiety disorder should be treated with ___.

A

beta blockers or benzos

36
Q

What Parkinson medications are associated with greater risk of psychosis?

A

dopamine agonists - pramipexole or ropinirole

37
Q

What is the best treatment of Parkinson Disorder psychosis?

A

1 - reduction of antiparkinson meds
2 - med substitution
3 - addition of low-potency antipsychotic meds

38
Q

Alpha-adrenergic agonists (clonidine, guanfacine) are more useful in treating ADHD in (KIDS/ADULTS)

A

KIDS and adolescents

39
Q

Dicontinuation of ___ medications may lead to dysphoria, fatigue, insomnia, myalgias

A

antidepressants (SSRIs)

40
Q

What are evidence-based therapy options for bipolar I maintenance therapy?

A

lithium, valproate, quetiapine, lamotrigine

41
Q

What is first line combination therapy for Bipolar I?

A

lithium OR valproate
PLUS
SGA

42
Q

How do you treat tardive dyskinesia?

A
  • Discontinue med if possible
  • Switch to SGA like quetiapine, clozapine
  • treat with valbenazine
43
Q

Which mood stabilizer can be associated with hepatotoxicity?

A

Valproate

44
Q

____ antidepressant therapy is associated with dose-dependent HTN, especially at doses above 300 mg daily

A

venlafaxine

45
Q

What is the difference in MOA between risperidone and quetiapine?

A

risperidone = Dopamine-2 receptor antagonist

Quetiapine = low-potency D2R antagonist (less dopamine side effects)

46
Q

What medications can increase lithium levels in the blood?

A 
thiazide diuretics
ACE-i
NSAIDs
TCAs
metronidazole
47
Q

Which SSRI is generally avoided in post-MI patients because of risk for QT prolongation?

A

Citalopram

48
Q

What are the preferred SSRIs for patients post-MI?

A

sertraline and escitalopram

-least drug interactions with cardiac meds

49
Q

What are cardiac side effects of venlafaxine?

A

tachycardia

increased BP

50
Q

What are the two first-line mood stabilizers for biploar disorder?
And when would you choose one over the other?

A

lithium and valproate

if baseline creatinine elevation –> valproat>Lithium

51
Q

What is a renal side effect of lithium use?

A

nephrogenic DI

Chronic tubulointerstitial nephropathy

52
Q

What are first line medications for bipolar disorder?

A

lithium, valproate, quetiapine, lamotrigine

53
Q

Treatment for acute dystonia?

A

benztropine
or
diphenhydramine

54
Q

Treatment for akathisia

A

beta-blocker
benzodiazepine
benztropine

55
Q

Treatment for parkinsonism

A

benztropine
or
amantadine

56
Q

Phenytoin –> megaloblastic anemia from ____ deficiency

A

folate

waitress with salad in Sketchy

Psych (3 decks)

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