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Psych drugs 0427 Flashcards

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1
Q

alcohol withdrawal

A

benzodiazepines

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2
Q

bulimia

A

SSRI

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3
Q

anxiety

A

benzos
buspirone
SSRI

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4
Q

ADHD

A

methylphenidate (ritalin)

amphetamines (dexedrine)

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5
Q

atypical depression

A

MAO inhibitors

SSRI

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6
Q

bipolar d/o

A 
mood stabilizers (lithium, valproate, carbamazepine)
atypical antipsychotics
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7
Q

depression

A

SSRI, SNRI

TCA

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8
Q

depression with insomnia

A

mirtazapine

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9
Q

OCD

A

SSRI

clomipramine

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10
Q

panic d/o

A

SSRI
TCA
benzos

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11
Q

PTSD

A

SSRI

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12
Q

schizophrenia

A

antipsychotics

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13
Q

Tourettes syndrome

A

antipsychotics (haloperidol, resperidone)

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14
Q

social phobias

A

SSRI

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15
Q

CNS stimulants

A

methylphenidate
dextroamphetamine
mixed amphetamine salts

moa: increase catecholamines at synaptic cleft, esp NE and DA
use: ADHD, narcolepsy, appetite control

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16
Q

antipsychotics (neuroleptics)

A 
haloperidol
trifluoperazine
fluphenazine
thioridazine
chlorpromazine

“-azine” (and haloperidol)

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17
Q

antipsychotics (neuroleptics) moa

A

block dopamine D2 receptors (increase cAMP)

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18
Q

antipsychotics (neuroleptics) use

A

schizophrenia (pos sx)
psychosis
acute mania
Tourette syndrome

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19
Q

antipsychotics (neuroleptics) tox

A
  1. highly lipid soluble - stored in body fat, slow removal from body
  2. extrapyramidal system effects
  3. endocrine (DA receptor antagonist) - hyperprolactinemia and galactorrhea
  4. anti muscarinic: dry mouth, constipation
  5. anti alpha: hypotension
  6. anti histamine: sedation
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20
Q

neuroleptic malignant syndrome

A

tox with antipsychotics.
rigidity, myoglobinuria.
autonomic instability.
hyperpyrexia.

"FEVER"
Fever
Encephalopathy
Vitals unstable
Elevated enz
Rigidity of mm.

tx: dantrolene, D2 agonists (bromocriptine)

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21
Q

tardive dyskinesia

A

tox with antipsychotics.
stereotypic oral-facial mvmts due to long term antipsychotic use.
often irreversible.

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22
Q

extrapyramidal effects over time

A

4 h: acute dystonia - muscle spasm, stiffness, oculogyric crisis

4d: akinesia, parkinson sx

4 wk: akathisia (restlessness)

4 mo: tardive dyskinesia

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23
Q

chlorpromazine

A

corneal deposits

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24
Q

thioridazine

A

retinal deposits

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25
atypical antipsychotics
``` olanzapine clozapine quetiapine risperidone aripiprazole ziprasidone ```
26
atypical antipsychotics moa
varied effects on 5HT2, dopamine, alpha, and H1 receptors
27
atypical antipsychotics use
schizophrenia (BOTH pos and neg sx)
28
other uses for olanzapine
``` OCD anxiety d/o depression mania Tourettes syndrome ```
29
atypical antipsychotics tox
fewer extrapyramidal and anticholinergic SE than typical antipsychotics
30
olanzapine tox
significant weight gain
31
clozapine tox
significant weight gain agranulocytosis - weekly WBC monitor seizures
32
ziprasidone tox
prolonged QT interval
33
LITHIUM moa
not established | may be related to inhibition of phosphoinositol cascade
34
lithium use
mood stabilizer for bipolar d/o. blocks relapse and acute manic events. also for SIADH [ADH ANTAGONIST]
35
lithium tox
``` "LMNOP" Lithium side effects Movement (tremor) Nephrogenic DI hypOthyroidism Pregnancy problems (fetal heart) ``` also: sedation, edema, heart block. narrow therapeutic window (monitor serum levels).
36
fetal cardiac defect with lithium
Ebstein anomaly: apical displacement of tricuspid valve leaflets. decrease RV volume, atrialization of RV. malformation of great vessels
37
lithium excretion
almost all by kidneys - reabsorbed at PCT following SODIUM.
38
buspirone moa
stimulates 5HT1a receptors (selective agonist)
39
buspirone use
generalized anxiety d/o does NOT cause sedation, addiction, tolerance. does NOT interact with alcohol. less abuse potential than benzos.
40
tricyclic antidepressants
``` most end in -iptyline or ipramine: amitryptyline nortryptiline imipramine desipramine clomipramine doxepin amoxapine ```
41
TCA moa
block reuptake of NE and serotonin
42
TCA use
major depression fibromyalgia bedwetting (imipramine) OCD (clomipramine)
43
TCA SE
sedation alpha blocker atropine-like (anticholinergic) - tachycardia, urinary retention
44
least sedating TCA
desipramine | --also has lower seizure threshold
45
TCA with more anticholinergic effect
3G (amitryptyline) > 2G (nortriptyline)
46
TCA tox
"tri C's" Convulsions Coma Cardiotoxicity (arrhythmias) also: resp depression hyperpyrexia confusion, hallucinations (elderly, due to anticholinergic effects)
47
tx of TCA tox
sodium bicarb for CV toxicity
48
SSRI
FLuoxetine PARoxetine SErtraline CITalopram "FLashbacks PARalyze SEnior CITizens"
49
SSRI moa
serotonin-specific reuptake inhibitors
50
SSRI use
``` depression OCD bulimia social phobias PTSD ```
51
SSRI tox
less than TCA. GI distress sexual dysfunction (anorgasmia) SEROTONIN SYNDROME
52
serotonin syndrome
with any drug that increases serotonin (ex: MAO-I) ``` hyperthermia myoclonus CV collapse flushing diarrhea seizures ``` tx: cyproheptadine (5HT2 receptor antagonist)
53
SNRI
venlafaxine | duloxetine
54
SNRI moa
inhibit serotonin and NE reuptake
55
SNRI use
depression venlafaxine: GAD duloxetine: diabetic peripheral neuropathy
56
which SNRI has greater effect on NE?
duloxetine
57
SNRI tox
increase BP stimulant effects sedation nausea
58
MAO inhibitors
tranylcypromine phenelzine isocarboxazid selegiline (MAO-B specific)
59
MAO inhibitors moa
nonselective MAO inhibition increases levels of amine NTs (NE, serotonin, dopamine)
60
MAO inhibitors use
atypical depression anxiety hypochondriasis
61
MAO inhibitors tox
HYPERTENSIVE CRISIS with TYRAMINE INGESTION (wine, cheese, sausage) and BETA AGONISTS also: CNS stimulation
62
MAO inhibitors contraindicated with what tx...?
SSRI or meperidine -- to prevent serotonin syndrome
63
atypical antidepressants
bupropion mirtazapine maprotiline trazodone
64
bupropion
increase NE and dopamine by unknown moa. also used for smoking cessation. tox: stimulant effects (tachycardia, insomnia) headache seizure in bulimic pts NO sexual side effects
65
mirtazapine
alpha 2 antagonist (increase release of NE and serotonin). potent 5HT2 and 5HT3 receptor antagonist. tox: sedation increase appetite weight gain dry mouth
66
maprotiline
blocks NE reuptake tox: sedation orthostatic hypotension
67
trazodone
primarily inhibits serotonin reuptake use: insomnia (high dose needed for antidepressant effect) toxicity: sedation nausea priapism postural hypotension

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