Flashcards in Psych Drugs Deck (74):
Drug for alchohol withdrawal?
Drug for anxiety?
SSRI, SNRI, buspirone
Lithium; valproid acid; carbamazepine; atypical antipsychotics
Depression with insomnia?
SSRI and clomipramine
Panic disorder drugs?
SSRI, Vanlafaxine, benzodiazepines
antipsychotics (halo; risperidone)
MOA of typical antipsychotics?
Block dopamine D2 receptors leading to an increase in cAMP
Typical antipsychotics with extrapyramidal symptoms?
Trifluoperazine, fluphenazine, haloperidol (Try to Fly High)
Low potency typical antipsychotics (anticholinergic; antihistamine; alpha 1 blockade)
Chlorpromazine, Thioridazine (Cheating Thieves are low)
Patient presents with myoglobinuria; autonomic instability, hyperpyrexia, rigidity-- What is this called? What is treatment?
Neuroleptic malignant syndrome-- treate with dantrolene (muscle relaxant) and D2 agonists (bromocriptine)
Side effects of typical antipsychotics?
Highly lipid soluble (removed slowly)
Extrapyramidal (eg dyskinesias)
Dopamine block (hyperprolactinemia)
Muscarininc and alpha 1 and histamine blockade
Stereotypic oral facial movements as a result of long term antipsychotic use?
Tardive dyskinesia-- usually irreversible
Fever; encephalopathy; unstable vitals, rigidity of muscles, elevated enzymes?
Neuroleptic malignant syndrome (FEVER)
Haloperidol and "azines" (eg. fluphenazine, thioridazine, chlorpromazine, trifluoperazine)
It's Atypical for OLd CLOSets to QUIETly RISPER from A to Z (Olanzapine, clozapine, Quietiapine, Risperidone, Aripiprazole, Ziprasidone)
Least sedating atypical antipsychotic and why?
Aripiprazole because it's a partial agonist and antagonist
Atypical antipsychotic side effect of agranulocytosis?
Side effect of clozapine?
Agranulocytosis-- requires weekly WBC AND seizures
Atypicals that cause weight gain?
Olanzapine and clozapine (If i gain weight, I can't be on the OC)
Atypical that prolongs QT interval?
Uses of Lithium?
SIADH and bipolar
Side effects of lithium?
LMNOP: Movement (tremor),
Nephrogenic diabetes insipidus
Can also cause heart block
Blood work that must be checked in a patient on Lithium?
Fetal defects associated with lithium?
Cardiac defects include Ebstein anomaly and malformation of great vessels.
Lithium is excreted by?
Kidneys-- reabsorbed at proximal convoluted tubules following Na reabsorption
Stimulates 5HT1a-- used for GAD?
Buspirone-- takes 1-2 weeks to take effect
What should you tell a patient when starting them on Buspirone?
Takes 1-2 weeks to take effect
SSRIs are not used in which two diseases?
Schizophrenia and Bipolar
CNS stimulant (ritalin) increases catacholamines at synaptic cleft-- especially NE and dopamine
Treatment of ADHD?
end in "amphetamine" and Methylphenidate
Work by increasing catecholamines at synaptic cleft?
CNS stimulants (amphetamines and methylphenidate)-- used for narcolepsy and appetite control
4 hr actue muscle spasm, stiffness
dystonia (EPS side effect of typicals)
4 day restlessness?
Akathisia (SE of typicals)
4 week parkinson like symptoms?
Bradykinesia (side effect of typicals)
Typicals that cause deposits in eye?
Chlorpromazine goes to cornea
Thioridazine goes to reTina
Deposits in retina?
Deposits in cornea?
Fluoxetine (Prozac); Paroxetine (Paxol); Sertraline (zoloft); Citalopram--- FLashbacks PARalyze SEnior CITizens
Pt. presents with fever, confusion, twitching of muscles, flushing, and diarrhea after starting a medication for depression. How should this patient be treated?
Pt. presenting with Serotonin syndrome--- treat with cyproheptadine which is a seretonin antagonist
Seretonin antagonist used to treat serotonin syndrome
SNRI-- inhibit serotonin and NE reuptake
SNRI-- inhibit serotonin and NE reuptake
SNRI also indicated for peripheral neuropathy?
SNRI that has greater effect on NE?
Most common side effect of SNRI (duloxetine and venlafaxine)
Increased blood pressure
All TCAs end in blank or blank?
iptyline or ipramine except doxepin and amoxapine (yes, I know this is bullshit, but remember it anyhow)
MOA of TCA?
block reuptake of NE and seretonin
Antidepressant indicated for fibromyalgia?
TCA (end in "iptyline" or "ipramine" except doxepin and amoxapine)
Pt. presents with postural hypotension after starting an antidpressent?
TCA have alpha 1 blocking effects which can cause postural hypotension
Pt. presents with urinary retention, dry mouth and fast heart rate after starting an antidepressant?
TCA-- have atropine like effects
Amitriptyline has greater blank side effects than nortriptyline?
TCA with highest seizure threshold?
Pt. presents with convulsions and arrhythmias after starting an antidepressant? How do we treat?
TCA that should be used in elderly?
Nortriptyline due to lesser anticholinergic side effects
Treatment for cardiovascular toxicity of TCA
(MAO Takes Pride In Shanghai) Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (MaO-B inhibitor)
Pt. is taking an antidepressant. He begins to go into cardiac arrest after a wine and cheese party?
MAO inhibitors (Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline-- hypertensive crisis with ingestion of tyramine
Antidepressant that should not be taken with St. Johns Wart, Meperidine, and Dextromethorphan?
Dextromethorphan and MAO can lead to seretonin syndrome
Used for smoking cessation?
Bupropion-- increased NE and dopamine via unknown mechanism
Atypical antidepressent that may cause insomnia and seizure in bulimic patients but has no sexual side effects?
Atypical antidepressant with alpha 2 antagonist activity and seretonin antagonist?
Mirtazapine-- increased appetite and weight gain which may be desirable in elderly or anorexic patients
atypical antidepressant that is used in elderly population due to weight gain and increase appetite?
Blocks NE reuptake-- causes orthostatic hypotension
Atypical antidepressant that causes orthostatic hypotention?
Maprotiline-- blocks NE reuptake
Used primarily for insomnia?
Trazadone-- causes priapism and postural hypotension