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Nt Flashcards

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1
Q

Where is the majority of serotonin

A

G.I. tract

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2
Q

Where is serotonin released from in the brain

A

Ralphe nuclei of synaptic vesicles

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3
Q

Serotonin plays a role in

A

Sleep mood sexual desire sexual function appetite memory and learning temperature regulation social behavior

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4
Q

Serotonin is responsible for on its own

A

Obsessions compulsions memory

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5
Q

Serotonin and dopamine are responsible for

A

Appetite sex aggression

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6
Q

Doug mean on its own is responsible for

A

pleasure reward motivation

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7
Q

Serotonin norepinephrine are responsible for

A

Anxiety impulse irritability

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8
Q

Norepinephrine on its own is responsible for

A

Alertness concentration energy

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9
Q

Norepinephrine and dopamine are responsible for

A

Attention

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10
Q

Norepinephrine serotonin and dopamine are all responsible for

A

Mood and cognition

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11
Q

Dopamine and norepinephrine are derived from

A

Tyrosine

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12
Q

Tire seen concentrates in

A

The midbrain (substantia nigra) the hypothalamus

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13
Q

Dopamine is stored here

A

Synaptic vesicles

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14
Q

Three Marano systems that dopamine is primarily in

A

Nigrostriatal
Mesolimbic
Mesocortical

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15
Q

This degrades norepinephrine

A

MAO

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16
Q

Norepinephrine is really used in the brain by

A

locus ceruleus

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17
Q

Noradrenergic neurons are found in these three places in the brain

A

Pons Maduell and thalamus

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18
Q

How serotonin is made

A

Tryptophan plus tryptophan hydroxylase equals serotonin

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19
Q

Most commonly prescribed drug class for psychiatric illnesses and other uses

A

SSRI

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20
Q

Mechanism of action for SSRI

A

Increase serotonin activity by decreasing the action of the presynaptic serotonin reuptake pump

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21
Q

Name the six SSRIs and their brand name

A 
Citalopram-celexa 
Escitalopram-lexapro 
Fluoxetine-Prozac
Fluvoxamine -Luvox
Sertraline-Zoloft
Paroxetine-Paxil
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22
Q

Indications for SSRIs

A

Anxiety disorders
anorexia
premenstrual dysphoric disorder
major depressive disorder

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23
Q

Class of drugs that uses CYP 450

A

SSRIs except Celexa and Lexapro

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24
Q

What to drugs should you avoid while taking SSRIs to prevent serotonin syndrome

A

Triptans and tramadol

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25
What happens if you give a bipolar patient SSRIs
Mania or rapid cycling
26
Which SSRI is specifically associated with headaches
Prozac
27
Which drug class is associated with hematologic effects even though there is no reduction platelet number
SSRIs
28
Which drug class has a suicide risk as a FDA blackbox warning
SSRIs in ages 18 to 24
29
Symptoms of serotonin syndrome
``` Diarrhea restlessness agitation myoclonus delirium/death ```
30
Treatments for serotonin syndrome
Benzodiazepines and cyproheptadine a serotonin antagonist
31
Mechanism of action for SNRIs
Block presynaptic serotonin and norepinephrine
32
3 SNRis
Venlaxafine-Effexor Desvenlafaxine-pristine Duloxetine-cymbalta
33
Indications for Effexor
MDD generalized anxiety disorder social anxiety disorder panic disorder
34
Indications for pristiq
MDD
35
Indications for Cymbalta
MDD | Neuropathic pain
36
What drug can't you use SNRIs in conjunction with
Maoi --> serotonin syndrome
37
When are atypical antidepressants
When SSRIs aren't effective
38
To a typical antidepressants
Bupropion-wellbutrin | Mirtazapine-remeron
39
What has a similar structure to amphetamines
Bupropion
40
Bupropion MOA
Inhibits presynaptic reuptake of dopamine and norepinephrine greatest effect on dopamine inhibits CYP 450
41
What two types of patients can you not use bupropion in
Bulimia and anorexia causes seizures
42
When is the worst time to take bupropion
Nighttime.
43
What is structurally similar to TCAs and tetracyclic antidepressants
Mirtazapine
44
mirtazapine MOA
Antagonizes presynaptic alpha-2 adrenergic receptors and postsynaptic serotonin receptors (increases norepinephrine and serotonin release)
45
What receptors does Remeron have a high affinity for
Histamine
46
The Remeron make you sleepy or awake
Sleepy, this is great for people with insomnia
47
To side effects of Remeron
Drowsiness and weight gain
48
Main side effect of Wellbutrin
Insomnia
49
MOA of TCAs
Inhibit reuptake of serotonin norepinephrine and acetylcholine
50
For TCAs
Amitryptiline-elavil Nortriptyline-panel or Desipramine-norpramin Doxepin-silenor
51
Indications for TCAs
MDD OCD bedwetting
52
Metabolism of TCAs
Liver
53
Why TCAs are falling from favor
``` Central and peripheral anti-cholinergic side effects fatal overdose drowsiness orthostatic hypotension weight gain sexual dysfunction ```
54
Most common cause of death with TCAs
Prolonged QT leading to arrhythmia lipophilic property means it is in effectively removed by dialysis
55
MOA for MAOis
Monoamine oxidase inhibitor
56
For MAOIs
Isocarboxazid-marplan Phnelzine-nardil Seligiline-eldepryl Trancypromine- parnate
57
First antidepressant ever approved
Isoniazid
58
What must you avoid with MAOIs
Tyramine containing foods
59
What drugs must you avoid with MAOIs
Cold medication asthma medication pain medication antihistamines
60
What is the worst side effect of MAOIs
Lethal hypertension
61
What are typical and hide psychotics primarily used for
Depression with psychotic symptoms but also schizophrenia and delusional disorders
62
Mechanism of action for typical antipsychotics
Dopamine receptor antagonist
63
For typical antipsychotics
Chlorpromazine- thorazine Fluphenazine- prolixin Haloperidol- half ok Pimozide- orap
64
MOA of atypical antipsychotics
Serotonin dopamine antagonists
65
What are atypical antipsychotics more selective for
Mesolimbic dopamine pathway
66
Three indications of atypical antipsychotics
Major depression acute mania bipolar disorder
67
Seven atypical antipsychotics
``` Risperidone- risperdal Olanzapine- zypreza Quetiapine- Seroquel Ziprasidone- geodon Clozapine- clozaril Paliperidone- invega Carbamazepine- tegretol ```
68
Indication of mood stabilizers
Bipolar disorder
69
First-line treatment for bipolar
Lithium
70
Mechanism of action for lithium
Unknown
71
To indications for lithium
Bipolar maintenance and acute mania
72
Six labs needed for lithium
``` CBC BMP EKG TSH pregnancy test Lithium levels ```
73
Lithium toxicity
``` NVD tremor ataxia slurred speech confusion arrhythmia ```
74
Long-term side effects of lithium
Kidney hypothyroid cardiac arrhythmia
75
Valproate (depakene/ depakote) classification
Mood stabilizer/anticonvulsant
76
Also I first-line treatment for bipolar acute mania and maintenance
Depakote
77
Depakote mechanism of action
Unknown
78
To blackbox warnings for depakote
Hepatotoxicity within the first six months and pancreatitis within the first six months
79
Can Depakote be combined with lithium
Yes
80
Can Depakote be combined with Lamictal
No it causes SJS
81
Labs to be run with Depakote
``` Serum levels LFT CBC platelet pregnancy ```
82
Two indications for lamictal
Epilepsy and bipolar disorder
83
Mechanism of action for lamictal
Block sodium channels in the brain related to neurons firing. Diminishes the build up of glutamate in the CSF
84
Does lamictal have anti-mania properties
No
85
When you increase the dose of lamictal too fast
Sjs
86
Side effects of back/joint pain
Lamictal

Behavioral Health (4 decks)

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