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Flashcards in Psych Drugs Deck (77):
1

fluoxetine

SSRI - used for depression in pregnant women and children/adolescents

2

sertraline

SSRI - used for depression

3

paroxetine

SSRI - used for depression

4

fluvoxamine

SSRI - used for OCD

5

citalopram

SSRI - used for depression

6

escitalopram

SSRI - used for depression and GAD

7

venlafaxine

SNRI - used for depression, GAD, neuropathic pain

8

duloxetine

SNRI - used for depression, neuropathic pain, fibromyalgia

9

buproprion

NE/DA reuptake inh - used for depression and smoking cessation, will not cause sexual side effects so good for younger patients

10

trazodone

used in MDD, insomnia - no sexual side effects

11

mirtazapine

a2 antagonist - useful in MDD especially those with weight loss and insomnia

12

amitriptyline

tertiary amine (TCA) - chronic pain, migraines, insomnia

TCAs prevent reuptake of NE and serotonin.

13

imipramine

tertiary amine (TCA) - enuresis, panic disorder

TCAs prevent reuptake of NE and serotonin.

14

clomipramine

tertiary amine (TCA) - OCD

TCAs prevent reuptake of NE and serotonin.

15

doxepin

tertiary amine (TCA) - chronic pain, insomnia

TCAs prevent reuptake of NE and serotonin.

16

nortriptyline

secondary amine (TCA) - chronic pain

TCAs prevent reuptake of NE and serotonin.

17

desipramine

secondary amine (TCA)

TCAs prevent reuptake of NE and serotonin.

18

common SSRI SEs

- GI upset
- insomnia
- HA
- anorexia --> weight loss
- sexual dysfunction
- akathisia-like restlessness
- serotonin syndrome - fever, diaphoresis, tachycardia, hypertension, delirium, hyperreflexia

19

common SNRI SEs

- same as SSRI
- due to NE, hypertension, dry mouth, constipation

20

trazodone SEs

orthostatic hypotension, arrhythmias, priapism

21

mirtazapine SEs

sedation, weight gain

22

common TCA SEs

- anticholinergic - dry mouth, constipation, urinary retention, blurred vision, tachycardia
- antihistaminergic - sedation, weight gain
- antiadrenergic - orthostatic hypotension, reflex tachycardia, arrhythmias
- serotonergic - sexual SEs like SSRIs

23

phenelzine

MAO-I - refractory depression and anxiety

prevent inactivation of catecholamines (NE, DA, 5-HT, tyramine)

24

tranylcypromine

MAO-I - refractory depression and anxiety

prevent inactivation of catecholamines (NE, DA, 5-HT, tyramine)

25

isocarboxazid

MAO-I - refractory depression and anxiety

prevent inactivation of catecholamines (NE, DA, 5-HT, tyramine)

26

common MAO-I SEs

- 5-HT syndrome when taken with SSRI (wait at least 2 wks before switching from SSRI --> MAO-I)
- hypertensive crisis when tyramine rich foods or sympathomimetics are on board
- orthostatic hypotension
- sedation, sleep dysfunction
- weight gain
- sexual dysfunction
- supplement B6 to prevent peripheral neuropathy

27

mechanism of typical antipsychotics

D2 antagonists

28

mechanism of atypical antipsychotics

D2 and 5-HT-2A antagonists

29

chlorpromazine

- low potency typical antipsychotic
- higher incidence of antiadrenergic, anticholinergic, and antihistaminic side effects
- lower incidence of EPS and NMS
- blue-grey skin discoloration

30

haloperidol

- high potency typical antipsychotic
- lower incidence of antiadrenergic, anticholinergic, and antihistaminic side effects
- higher incidence of EPS and NMS

31

common SEs of typical antipsychotics

- mesocortical - makes negative symptoms worse, de-motivation
- nigrostriatal - EPS (akathisia, dystonia, parkinsonism)
- tubuloinfundibular - hyperprolactinemia
- antihistaminic - sedation, weight gain
- antiadrenergic - orthostatic hypotension, cardiac arrythmias
- anticholinergic - dry mouth, tachycardia, urinary retention, blurry vision, constipation
- TD - often permanent choreoathetoid mvmts of tongue and mouth as a result of > 6 mos of use
- NMS - fever, autonomic instability, leukocytosis, tremor, elevated CK, rigidity, delirium, diaphoresis
- hepatotoxicity
- seizure threshold is lower
- QTc prolongation

32

buproprion SEs

- increased anxiety (avoid in eating disorders)
- lower seizure threshold (avoid in epilepsy)

33

common SEs atypical antipsychotics

- metabolic syndrome - follow weight, waist circumference, FLP, BG
- QTc prolongation
- hepatotoxicity

34

atypical antipsychotics include (in decreasing order of metabolic risk):

- clozapine - treatment refractory schizophrenia, very low risk of agranulocytosis, only antipsychotic that helps to decrase risk of suicide
- olanzapine
- quetiapine
- paliperidone
- ziprasidone
- aripiprazole

35

Li+

mood stabilizer used to treat acute mania, prevent relapse of manic episodes/depressive episodes in bipolar d/o, and decrease suicidality

36

Prior to prescribing Li+, pt should have what tests? Because of what SEs?

- EKG - arrythmias
- BMP - nephrogenic DI and renal toxicity
- TFT - hypothyroidism
- CBC - leukocytosis
- pregnancy test - Ebstein's anomaly in fetus

37

Check blood level of Li+ after ____ days.

5

38

carbamazepine

anticonvulsant used to treat mania with mixed features and rapid cycling bipolar d/o

39

mechanism of carbamazepine

Na+ channel antagonist

40

What labs to order and common SEs of carbamazepine?

- CBC, LFTs, pregnancy test
- GI upset, CNS sedation, SJS
- leukopenia, aplastic anemia, thrombocytopenia, agranulocytosis
- hyponatremia
- hepatitis
- neural tube defects in fetus

41

Carbamazepine ____ it's own metabolism.

auto-induces

42

valproic acid

mood stabilizer used to treat acute mania, mania with mixed features, and rapid cycling bipolar d/o

43

mechanism of valproic acid

Na+ channel antagonist, potentiates GABA activity

44

Check valproic acid levels after ____ days.

4-5

45

Labs to order and common SEs of valproic acid

- LFTs - hepatotoxicity
- CBC - thrombocytopenia
- pregnancy test - neural tube defects

46

lamotrigine

mood stabilizer used ONLY for depressive episodes of bipolar d/o

47

mechanism of lamotrigine

works on Na+ channels that modulate glutamate and aspartate

48

concerning SE of lamotrigine

SJS

49

oxcarbazepine

mood stabilizer that functions like carbamazepine and is better tolerated (only has risk of hyponatremia)

50

gabapentin, pregabalin

helps with GAD, sleep, neuropathic pain, fibromyalgia

51

topiramate

mood stabilizer that helps with impulse control disorders

52

common SEs of topiramate

- weight loss
- met acid
- kidney stones
- cognitive slowing

53

Which benzos are not metabolized by the liver?

lorazepam, oxazepam, temazepam

54

diazepam

long acting benzo used for alcohol withdrawal, benzo/barb withdrawal, seizures

55

clonazepam

long acting benzo used for anxiety, panic attacks

56

alprazolam

int acting benzo used for anxiety, panic attacks

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lorazepam

int benzo used to treat panic attacks, alcohol/benzo/barb withdrawal

58

oxazepam

int benzo used to treat alcohol/benzo/barb withdrawal

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temazepam

int benzo used to treat alcohol/benzo/barb withdrawal

60

triazolam

short acting benzo used for insomnia

61

midazolam

short acting benzo

62

zolpidem/zaleplon/eszopiclone

- bind to omega-1 receptor on GABA-A receptor to cause sedation
- used for short-term treatment of insomnia

63

diphenhydramine

antihistamine with anticholinergic effects

64

ramelteon

melatonin agonist used for insomnia

65

buspirone

- partial 5-HT-1A agonist used for augmentation of GAD
- especially useful in alcoholics who cannot take benzos

66

hydroxyzine

short acting antihistamine and anticholinergic effects used for anxiety

67

In psychiatry, B blockers are used for:

- panic attacks
- performance anxiety
- akathisia

68

D-amphetamine

stimulant used for ADHD - watch BP, weight loss, insomnia, tic exacerbation, decreased seizure threshold

69

methylphenidate

stimulant used for ADHD - watch BP, weight loss, insomnia, tic exacerbation, decreased seizure threshold

70

atomoxetine

stimulant (inhibits NE, DA reuptake) used in ADHD

71

modafinil

stimulant used in narcolepsy

72

donepezil

AChesterase inh used in dementia

73

galantamine

AChesterase inh used in dementia

74

rivastigmine

AChesterase inh used in dementia

75

memantine

NMDA glutamate antagonist used in dementia to be used WITH AChesterase inh

76

ECT should be used for:

- refractory depression (esp with psychotic features)
- catatonia
- acute mania

77

light therapy is used to treat:

MDD with seasonal pattern