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Adv. Pharm > Mental Health > Flashcards

Mental Health Flashcards

Exam 3 (73 cards)

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1
Q

What drugs are antidepressants?

A

Escitalopram
Sertraline
Venlafaxine
Duloxetine
Amitriptyline
Bupropion
Selegiline
Mirtazapine

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2
Q

What drugs are SSRIs?

A

Escitalopram
Sertraline

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3
Q

What drugs are SNRIs?

A

Venlafaxine
Duloxetine

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4
Q

What drugs are tricyclic antidepressants?

A

Amitriptyline

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5
Q

What drugs are sopamine and norepinephrine reuptake inhibitors?

A

Bupropion

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6
Q

What drugs are monoamine oxidase inhibitors?

A

Selegiline

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7
Q

What drugs are “other”?

A

Mirtazapine

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8
Q

What drugs are anxiolytics?

A

Buspirone
Hydroxyzine
Benzodiazepines- alprazolam

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9
Q

What drugs are antipsychotics?

A

Haloperidol (1st gen)
Aripiprazole (2nd gen)
Clozapine (2nd gen)
Lurasidone (2nd gen)
Quetiapine (2nd gen)
Lithium (mood stabilizer)

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10
Q

What drugs are for ADHD?

A

Methylphenidate (stimulant)
Amphetamine/dextroamphetamine (stimulant)
Lisdexamfetamine (stimulant)

Atomoxetine (non-stimulant)
Guanfacine (non-stimulant)
Clonidine (non-stimulant)

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11
Q

What drugs are used for pain management?

A

Acetaminophen (non-opioid)
NASAID: (non-opioid)
Ibuprofen
Ketorolac
Meloxicam
Diclofenac

Opioid:
Morphine
Oxycodone
Hydromorphone
Fentanyl
Tramadol

Naloxone

Neuropathic agents:
Gabapentin
Pregabalin

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12
Q

What drugs are for migraine management?

A

Triptan- sumatriptan
CGRP antagonist- Rimegepant
Topiramate

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13
Q

Neurotransmitters involved in MDD?

A

Serotonin (most important)
Norepinephrine
Epinephrine
Dopamine
Glutamate
Acetylcholine

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14
Q

Diagnostic criteria for MDD?

A

At least 5 criteria for two consecutive weeks
Including depressed mood and/or diminished interest/pleasure

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15
Q

What is the trial period for a MDD medication?

A

6-8weeks, then reassess

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16
Q

SSRIs- MOA?

A

Inhibits reuptake of serotonin -> increases serotonin concentration

Inhibits reuptake of norepinephrine and dopamine

(Escitalopram & Sertraline)

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17
Q

SSRIs- side effects?

A

Discontinuation syndrome- avoid abrupt d/c
Decreased libido, ED

Contraindicated:
MAO inhibitors (linezolid)- 14day washout

Increased bleed risk w/ anticoagulants, antiplatelets, NSAIDs

QT prolongation
SIADH/hyponatremia, fall risk

(Escitalopram & Sertraline)

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18
Q

SNRIs- MOA?

A

Inhibit reuptake of serotonin and norepinephrine -> increased concentration of serotonin and NE

(Venlafaxine & Duloxetine)

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19
Q

SNRIs- side effects?

A

Increased NE -> increased HR, dilated pupils, dry mouth, sweating, increased BP

Contraindicated: MAO- linezolid: 14 day washout

SIADH/hyponatremia
Bleeding
Serotonin syndrome

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20
Q

Tricyclic antidepressant- MOA?

A

Inhibits NE and serotonin reuptake
Blocks ACh and histamine receptors

(Amitriptyline-broader)

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21
Q

Tricyclic antidepressants- side effects?

A

Cardiotoxicity- QT prolongation, arrhythmia risk
Anticholinergic- dry mouth, blurred vision, urinary retention, constipation, sedation
Weight gain, muscle twitching(toxicity)

Contraindicated:
MAO inhibitor- linezolid: 14day washout
Recent myocardial infarction

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22
Q

Bupropion- MOA?

A

Inhibits reuptake of dopamine and NE
(no effect on serotonin)

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23
Q

Bupropion- side effects?

A

Contraindicated:
Seizure disorder, anorexia, bulimia (seizure/weight loss risk)
MAO inhibitors -> serotonin syndrome, hypertensive crisis

Nueropsych. effects

CNS stimulation- lowers seizure threshold, insomnia, weight loss

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24
Q

Selegiline- MOA?

A

Inhibits monoamine oxidase (breaks down catecholamines) -> increased concentrations of catecholamines (serotonin, NE, epinephrine, dopamine)

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25
Selegiline- side effects?
Contraindications: Cardiovascular disease Sympathomimetics Drugs that increase serotonin Tyrosine rich foods (can increase NE) Hypertensive crisis, serotonin syndrome Anticholinergic effects, orthostasis, sedation, sexual dysfunction, weight gain, insomnia, headache
26
Mirtazapine- MOA?
Increased release of NE and serotonin
27
Mirtazapine- side effects?
Sedation Increased appetite Weight gain
28
What drugs are used as anxiolytics?
Buspirone Hydroxyzine Benzodiazepine- Alprazolam
29
What drugs are first line for GAD?
SSRIs: Sertraline Escitalopram
30
What drugs are second line for GAD?
SSRI: (different than 1st line) Sertraline Escitalopram SNRI: Venlafaxine Duloxetine
31
Anxiety management drugs?
Buspirone - after SSRI or SNRI failure Hydroxyzine- used as bridge
32
Buspirone- MOA?
Serotonin receptors
33
Buspirone- indications?
GAD Used after failure w/ SSRI / SNRI
34
Buspirone- side effects?
Serotonin syndrome- w/ other serotonergic drugs Dizziness Drowsiness Headache Lightheadedness 2-4weeks to work, no abuse risk Contraindications: MAO Linezolid
35
Hydroxyzine- indication?
GAD, short-term for symptoms not cause
36
Hydroxyzine- MOA?
Histamine receptor antagonist Anticholinergic properties
37
What drug is a benzodiazepine?
Alprazolam (Xanax)
38
Alprazolam- indication?
GAD, anxiety relief Short-term, treats symptoms not cause Selective use d/t risk of dependence/tolerance (<1-2weeks)
39
Alprazolam- MOA?
Enhances GABA (inhibitory NT -> CNS depression -> sedative/muscle relaxant properties)
40
Alprazolam- side effects?
Elderly: confusion, dizziness, falls Risk of dependence/tolerance BBW: profound sedation, RR depression, coma, death CNS depression No abrupt d/c Additive effects w/ CNS depressants: alcohol, antipsychotics, etc.
41
What drugs are used for ADHD?
Stimulants: Methylphenidate Amphetamine/dextroamphetamine Lisdexamfetamine Non-stimulants: Atomoxetine Guanfacine Clonidine
42
What drugs are first-line for ADHD?
Stimulants: Methylphenidate Amphetamine/dextroamphetamine Lisdexamfetamine
43
What schedule are ADHD stimulants?
Schedule 2 meds
44
Methylphenidate- MOA?
Blocks reuptake of NE and DA Increases normal release of NE and DA
45
Methylphenidate- indications?
ADHD
46
Amphetamine/dextroamphetamine- indications?
ADHD
47
Amphetamine/dextroamphetamine- MOA?
Promotes release of NE and DA Blocks reuptake of NE and DA
48
Stimulants- side effects?
Cardiovascular events (MI, increased BP/HR) Growth suppression Decreased appetite Insomnia Irritability BBW: Abuse/dependence BBW Amphetamine: Sudden cardiac death/ serious cardiac effects Contraindicated: MAO-i within 14days (Methylphenidate Amphetamine/dextroamphetamine Lisdexamfetamine)
49
Atomoxetine- MOA?
Selective inhibition of NE reuptake
50
Atomoxetine- indications?
ADHD- non stimulant
51
Atomoxetine- side effects?
BBW: suicidal ideation Aggression Cardiovascular events Growth suppression, hepatotoxicity Decreased appetite, nausea, insomnia Contraindications: MAO-i within 14days, glaucoma, Dx/Hx: pheochromocytoma, cardiovascular disease
52
Guanfacine- indications?
ADHD- pediatric
53
Guanfacine- MOA?
Non-stimulant Alpha 2 agonist -> decreased sympathetic outflow -> working memory/behavioral inhibition
54
Guanfacine- side effect?
Sedation Hypotension Dizziness Abdominal pain Headache CNS depression warning
55
Schizophrenia- first line rteatment?
2nd gen antipsychotics: Aripiprazole Clozapine Lurasidone Quetiapine To treat positive Sx
56
Extrapyramidal Symptoms (EPS)
Dystonia- prolonged contractions of muscles/muscle spasm Akathisia- restlessness w/ anxiety Parkinsonism- tremors, abnormal gait Tardive Dyskinesia- abnormal facial movement, tongue/mouth
57
Haloperidol- indications?
1st gen antipsychotic Schizophrenia
58
Haloperidol- MOA?
Blocks dopamine receptors
59
Haloperidol- side effects?
QT prolongation Sedation EPS Hyperprolactinemia Neuroleptic malignant syndrome
60
2nd gen antipsychotics- MOA?
Blocks dopamine and serotonin receptors Can prolong QT interval (Aripiprazole Clozapine Lurasidone Quetiapine)
61
Aripiprazole- indications?
Antipsychotic Schizophrenia
62
Aripiprazole- side effects?
Lower risk of weight gain
63
Clozapine- indications?
Antipsychotic Schizophrenia
64
Clozapine- side effects?
BBW: Agranulocytosis Monitor ANC Seizures, constipation, bradycardia
65
Lurasidone- indications?
Antipsychotic Schizophrenia
66
Lurasidone- side effects?
Somnolence EPS Nausea Risk of metabolic syndrome Contraindications: CYP inducers/inhibitors
67
Quetiapine- indications?
Antipsychotic Schizophrenia
68
Quetiapine- side effects?
Lower EPS risk Somnolence Metabolic syndrome Ocular effects
69
What drugs are used for acute bipolar disorder?
Lithium Or lithium w/ antipsychotic
70
Lithium- indications?
Mood stabilizer Bipolar disorder
71
Lithium- MOA?
Decreased reuptake of serotonin and NE Modulate glutamate Therapeutic range: 0.6-1.2mEq/L
72
Lithium- side effects?
BBW: serum lithium levels monitored to prevent toxicity Renal impairment Hyponatremia Dehydration Serotonin syndrome GI upset Cognitive effects Weight gain Therapeutic range: 0.6-1.2mEq/L >1.5mEq/L: ataxia, coarse hand tremor, vomiting, diarrhea, confusion >2.5mEq/L: CNS depression, arrhythmia, seizure, comaL
73
Lithium- DDI?
NSAIDS Increased risk serotonin syndrome w/ SSRI, SNRI, Linezolid Increased risk neurotoxicity w/ diltiazem

Adv. Pharm (9 decks)

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