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Flashcards in Psych Drugs Deck (36):
1

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine

Antipsychotics - Neuroleptics
Block D2 receptors - ↑cAMP

2

What are the antipsychotics used for?

Schizophrenia - + symptoms
Psychosis
Acute mania
Tourette

3

What are the high potency antipsychotics

Trifluoperazine, fluphenazine, haloperidol
EPS symptoms

4

What are the low potency antipsychotics

Chlorpromazine, thioridazine
Antichol, antihistamine, α1-blockade

5

What is the evolution of EPS symptoms

4 hr: Acute dystonia (spasm)
4 day: Akathesia (restlessness)
4 week: Bradykinesia (Parkinonism)
4 month: Tardive dyskinesia (oral/facial movements)

6

How do you treat the EPS symptoms from antipsychotics?

Benztropine
Diphenhydramine

7

What is a unique side effect of chlorpromazine?

Corneal deposit

8

What is a unique side effect of Thioridazine?

Retinal deposits

9

Neuroleptic Malignant Syndrome

Fever
Encephalopathy
Vitals unstable - autonomic instability
Enzymes ↑
Rigidity

→Dantrolene, D2 agonist (Bromocriptine)

10

What are the atypical antipsychotics?

Olanzapine, clozapine, quetiapine, risperidone, aripirazole, ziprasidone

11

What is the mechanism of the atypical antipsychotics

Varied effects on 5-HT, dopamine, α, H1 receptors

12

When are atypical antipsychotics indicated?

Schizophrenia: Neg and Pos symptoms
Bipolar
OCD
Anxiety
Depression
Mania
Tourette

13

What are the side effects of Clozapine?

Agranulocytosis - weekly WBC monitoring
Seizure

14

Which two atypical antipsychotics cause weight gain?

Olanzapine
Clozaine

15

What are the side effects of Risperidone

↑Prolactin -
gynecomastia, ↓GnRH, fertility/menstruation problems

16

What are the side effects of Ziprasidone

Prolong the QT

17

When is Lithium indicated?

Bipolar
Blocks relapse of manic events
SIADH

18

What are the side effects of Lithium?

Nephrogenic diabetes insipidus
Tremor, sedation
Heart block
Hypothyroidism
Fetal: Ebstein anomaly, malformation of the great vessels
**Inc. by Loop/thiazide diuretics**

19

Buspirone

Stimulates 5-HT 1A receptors
Generalized anxiety
Takes 1-2 weeks to work
No interaction with Alcohol

20

SSRI

Fluoxetine, paroxetine, sertraline, citalopram
"flashbacks paralyze senior citizens"

21

What are SSRIs indicated for?

Depression, GAD, panic disorder, OCD
Bulimia, social phobias, PTSD

22

What are the side effects of SSRIs

GI distress, sexual dysfunction
Serotonin Syndrome w/ any drug that ↑5-HT
MAOI, SNRI, TCA

23

Serotonin Syndrome

Too much serotonin - SSRI/SNRI/MAOI/TCA
Hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures
Cyproheptadine - 5HT2 R antagonist

24

How long does it take for antidepressants to have an effect?

4-8 weeks

25

SNRIs

Venlafaxine, duloxetine, milnacipran
Inhibit 5-HT and NE reuptake

26

Duloxetine is also indicated for ___________.

Diabetic Peripheral Neuropathy

27

What are the side effects of SNRIs

↑BP, stimulant effects, sedation, nausea

28

Amitriptyline, nortriptyine, imipramine, desipramine, clomipramine, doxepin, amoxapine

TCAs: Block reuptake of NE and 5-HT
Major depression, OCD, fibromyalgia, peripheral neuropathy

29

What are the side effects of TCAs

Convulsions
Coma
Cardiotoxicity (arrhythmias-block fast NA channels
α-1 blocking
Atropine like

30

MAOIs

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (MAO-B)
↑amine NT: NE, 5-HT, dopamine

31

When are MAOIs indicated?

Atypical depression, anxiety, hypochondriasis

32

What are the side effects of MAOIs

Hypertensive crisis - ingestion of tyramine
Treat with Phentolamine (α-blocker)

33

MAOIs are contraindicated with which things?

SNRIs, TCAs, St. Johns wort, meperidine, dextromethorphan - prevent Serotonin Syndrome

34

Bupropion

Blocks presynaptic reuptake of dopamine and NE
*Seizure in bulimic patients*
*No sexual side effects*

35

Mirtazapine

α2-antagonist - ↑release of NE and 5-HT
5-HT2 and 3 antagonist
SE: sedation, ↑appetite/weight gain, dry mouth

36

Trazodone

Blocks 5-HT2 and α1-adrenergic receptors
Treats Insomnia
SE: Priapism, sedation, nausea