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Psych Drugs Flashcards

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1
Q

fluoxetine

A

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

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2
Q

sertraline

A

SSRI - used for depression

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3
Q

paroxetine

A

SSRI - used for depression

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4
Q

fluvoxamine

A

SSRI - used for OCD

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5
Q

citalopram

A

SSRI - used for depression

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6
Q

escitalopram

A

SSRI - used for depression and GAD

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7
Q

venlafaxine

A

SNRI - used for depression, GAD, neuropathic pain

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8
Q

duloxetine

A

SNRI - used for depression, neuropathic pain, fibromyalgia

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9
Q

buproprion

A

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

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10
Q

trazodone

A

used in MDD, insomnia - no sexual side effects

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11
Q

mirtazapine

A

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

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12
Q

amitriptyline

A

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

TCAs prevent reuptake of NE and serotonin.

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13
Q

imipramine

A

tertiary amine (TCA) - enuresis, panic disorder

TCAs prevent reuptake of NE and serotonin.

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14
Q

clomipramine

A

tertiary amine (TCA) - OCD

TCAs prevent reuptake of NE and serotonin.

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15
Q

doxepin

A

tertiary amine (TCA) - chronic pain, insomnia

TCAs prevent reuptake of NE and serotonin.

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16
Q

nortriptyline

A

secondary amine (TCA) - chronic pain

TCAs prevent reuptake of NE and serotonin.

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17
Q

desipramine

A

secondary amine (TCA)

TCAs prevent reuptake of NE and serotonin.

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18
Q

common SSRI SEs

A
  • GI upset
  • insomnia
  • HA
  • anorexia –> weight loss
  • sexual dysfunction
  • akathisia-like restlessness
  • serotonin syndrome - fever, diaphoresis, tachycardia, hypertension, delirium, hyperreflexia
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19
Q

common SNRI SEs

A
  • same as SSRI

- due to NE, hypertension, dry mouth, constipation

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20
Q

trazodone SEs

A

orthostatic hypotension, arrhythmias, priapism

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21
Q

mirtazapine SEs

A

sedation, weight gain

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22
Q

common TCA SEs

A
  • anticholinergic - dry mouth, constipation, urinary retention, blurred vision, tachycardia
  • antihistaminergic - sedation, weight gain
  • antiadrenergic - orthostatic hypotension, reflex tachycardia, arrhythmias
  • serotonergic - sexual SEs like SSRIs
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23
Q

phenelzine

A

MAO-I - refractory depression and anxiety

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

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24
Q

tranylcypromine

A

MAO-I - refractory depression and anxiety

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

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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
57
lorazepam
int benzo used to treat panic attacks, alcohol/benzo/barb withdrawal
58
oxazepam
int benzo used to treat alcohol/benzo/barb withdrawal
59
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

Pharmacology (22 decks)

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