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USMLE Step 1 > Psych Drugs > Flashcards

Psych Drugs Flashcards

(77 cards)

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1
Q

Rx for Alcohol Withdrawal

A

Benzodiazpines

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2
Q

Tx: Anxiety

A

SSRIs, SNRIs, buspirone

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3
Q

Tx for ADHD

A

Methylphenidate, amphetimines

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4
Q

Tx for Bipolar Disorder

A

“Mood stabilizers” (e.g. lithium, valproic acid, carbamazepine), atypical antipsychotics

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5
Q

Tx for Bulimia

A

SSRIs

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6
Q

Tx for Depression

A

SSRIs, SNRIs, TCAs, buspirone, mirtazapine (especially with insomnia)

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7
Q

Tx for OCD

A

SSRIs, clomipramine

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8
Q

Tx for Panic Disorder

A

SSRIs, venlafaxine, benzodiazepines

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9
Q

Tx for PTSD

A

SSRIs

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10
Q

Tx for PTSD

A

SSRIs

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11
Q

Tx for Schizophrenia

A

Antipsychotics

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12
Q

Tx for Social Phobia

A

SSRIs

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13
Q

Tx for Tourette’s Syndrome

A

Antipsychotics (e.g haloperidol)

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14
Q

CNS Stimulants

A

Methylphenidate, Dextroamphetamine, Methamphetamine

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15
Q

CNS Stimulants (methylphenidate, dextroamphetamine, methamphetamine): Mechanism

A

Increase catecholamines at synaptic cleft, especially NE and dopamine

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16
Q

CNS Stimulants (methylphenidate, dextroamphetamine, methamphetamine): Clinical Use

A

ADHD, narcolepsy, appetite control

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17
Q

Antipsychotics (typical)

A

Haloperidol, Trifluoperazine, Fluphenazine, Thioridazine, Chlorpromazine,

Haloperidol + (“-azines”)

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18
Q

Typical Antipsychotics (“-azines”+ haloperidol) : Mechanism

A

Block D2 receptors (increase cAMP)

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19
Q

High potency typical antipsychotics

A

Trifluoperazine, Fluphenazine, Haloperidol

Try to Flying High
* associated with extrapyramidal effects

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20
Q

Typical Antipsychotics (“-azines + haloperidol): Clinical Use

A

Schizophrenia (primarily positive symptoms), psychosis, acute mania, Tourette’s syndrome

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21
Q

Low potency antipsychotics

A

Chlopromazine, Thioridazine

(Cheating Leaves are low)
* associated with non-neurological side effects (anti-cholinergic, antihistamine, and alpha-1 blockade)

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22
Q

Typical antipsychotics (“-azines”+ haloperidol): Toxicity

A

Highly lipid soluble and stored in body fats; thus very slow to be removed from body

Endocrine side effects (e.g. dopamine receptor antagonism –> hyperprolactinemia –> galactorrhea)

Side effects arising from muscarinic blockage (dry mouth, constipation); alpha-1 blockade (hypotension) and histamine (sedation) receptors

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23
Q

Extrapyramidal effects associated with which typical antipsychotics?

A

Trifluoperazine, Fluphenazine, Haloperidol

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24
Q

Specific side effect for Chlorpromazine (typical antipsychotics)?

A

Corneal deposits

“C”hlorpromazine – “C”orneal deposits

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25
Specific side effect for Thioridazine (typical antipsychotic)?
retinal deposits "T"hioridazine - re"T"inal deposits
26
Haloperidol side effects
Neuroleptic Malignant Syndrome, tardive dyskinesia
27
Evolution of EPS side effects
4 HOUR acute dystonia (muscle spasm, stiffness, oculogyric crisis) 4 DAY akathisia (restlessness) 4 WEEK bradykinesia (parkisonism) 4 MONTH tardive dyskinesia
28
Neuroleptic Malignant Syndrome
Associated with typical antipsychotics | Rigidity, myoglobinuria, autonomic instability, hyperpyrexia
29
Tx for Neuroleptic Malignant Syndrome
Dantrolene, D2 agonists (e.g. bromocriptine)
30
Tardive dyskinesia
Stereotypic oral-facial movements as a result of long-term antipsychotic use. Often irreversible
31
Mneumonic for NMS symptoms
``` Think "FEVERS" F-ever E-ncephalopathy V-itals unstable E-levated enzymes R-igidity of muscles ```
32
Atypical antipsychotics
Olanzapine, Clozapine, Quetiapine, Risperidone, Apiprazole, Ziprasidone
33
Atypical antipsychotics: Mechanism
Not completely understood. Varied effects on 5-HT2, dopamine, alpha and H1 receptors
34
Atypical antipsychotics: Clinical Use
Schizophrenia - both positive and negative symptoms. Also used for bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette's syndrome
35
Atypical antipsychotics: Toxicity
Fewer extrapyramidal and anticholinergic side effects than traditional antipsychotics
36
Side effects for Olanzapine/Clozapine
May cause significant weight gain
37
Side effects for clozapine
May cause agranulocytosis (requires weekly WBC monitoring) and seizure
38
Side effect for Ziprasidone
May prolong the QT interval
39
Lithium: Mechanism
Not established; possible related to inhibition of phosphoinositol cascade
40
Lithium: Clinical Use
Mood stabilizer for bipolar disorder; blocks relapse and acute maniac events. Also SIADH.
41
Mneumonic for Lithium
``` LMNOP L-ithium side effects M-ovements N-ephrogenic diabetes insipidus O- HypOthyroidism (constipation, dry skin, hair loss, weight gain) P-regnancy problems ```
42
Lithium Toxicity
Tremor, sedation, edema, heart block, hypothyroidism, polyuria (ADH antagonist causing nephrogenic diabetes insipidus), teratogenesis
43
Teratogenic effects for lithium
Fetal cardiac defects - Ebstein's anomaly (atrialized right ventricle) - Malformation of great vessels
44
Excretion of Lithium
Almost excreted exclusively by the kidneys; most is reabsorbed at the proximal convoluted tubules following Na reabsorption
45
Buspirone: Mechanism
Stimulates 5-HT1A receptors
46
Buspirone: Clinical Use
Generalized anxiety disorder. Does not cause sedation, addiction, or tolerance. Takes 1-2 weeks to take effect. Does not interact with alcohol (vs. barbituates, benzodiazepines)
47
SSRIs
Fluoxetine, Paroxetine, Sertaline, Citalopram "Fl"ashbacks "Par"alyze "Se"nior "Cit"izens
48
SSRIs: Mechanism
Serotonin-specific reuptake inhibitors
49
SSRIs: Clinical Use
Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD *It normally takes 4-8 weeks for antidepressants to have an effect"
50
SSRIs: Toxicity
Fewer than TCAs, GI distress, sexual dysfunction (anorgasmia and decreased libido) * When combined with SNRIs, MOA inhibitors - drugs that can raise serotonin levels can cause serotonin syndrome)
51
Serotonin syndrome
Combination of drugs that raise serotonin levels (e.g. SSRIs, MOAis, SNRIs) - can cause hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures
52
Treatment for SSRI Toxicity
Cyproheptadine (5-HT2 receptor antagonist)
53
SNRIs
Venlafaxine, duloxetine
54
SNRIs: Mechanism
Inhibit serotonin and NE reuptake
55
SNRIs: Clinical Use
Depression. Venlafaxine is also used in generalized anxiety and panic disorder
56
Aside from depression, duloxetine is used to treat what?
Duloxetine is indicated for diabetic peripheral neuropathy. It has greater effect on NE.
57
SNRIs: Toxicity
Increase in BP in most common; Also stimulant effects, sedation, nausea
58
Tricyclic Antidepressants:
Amitriptyline, Nortriptyline, Imipramine, Desipramine, Clomipramine, Doxepin, Amoxapine (Except for doxepin, amoxapine, TCAs end in "-yline" and "-mine")
59
TCAs ("-iptyline" and "-amine"): Mechanism
Block reuptake of NE and serotonin
60
TCAs ("-iptyline" and "-amine"): Clinical Use
Major depression. Bedwetting (imipramine), OCD (clomipramine), fibromyalgia
61
TCAs (-itpyline and -amine): Toxicity
Sedation, alpha-1 blocking effects including postural hypotension and atropine/anti-cholinergic side effects (tachycardia, urinary retention, dry mouth). Tertiary TCAs (amitiptyline) have more anticholinegic effects than secondary TCAs (nortryptilline) have.
62
Desmipramine: Side effects
Is less sedating than other TCAs and has higher seizure threshold
63
TCAs Toxicity (Mneumonic)
"Tri-C's"- "C"onvulsions, "C"omas, "C"ardiotoxicity (arrhythmias), Also respiratory depression, hyperpyrexia. Confusion and hallucinations in elderly due to anticholinergic effects (use nortriptyline)
64
Treatment for TCA toxicity
Sodium bicarbonate for cardiotoxicity
65
Monoamine Oxidates (MAO) inhibitors
Trancyclopromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor). "MAO" "T"akes "P"ride "I"n "S"hanghai
66
MAO Inhibitors
Non-selective MAO inhibition increases levels of amine neurotransmitters (NE, serotonin, dopamine)
67
MAO Inhibitors: Clinical Use
Atypical depression, anxiety, hypochrondriasis
68
MAO Inhibitors: Toxicity
Hypertensive crisis (most notably with ingestion of tyramine, which is found in many foods such as wine and cheese) CNS Stimulation Contrainidicated with SSRIs, SNRIs, TCAs, St. John's Wort, Meripirine, Dextromethorphan - to precent serotonin syndrome
69
Atypical antidepressants
Buproprion, Mirtazapine, Maprotiline, Trazodone
70
Bupropion: Clinical Use
Also used | for smoking cessation. Increases NE and dopamine via unknown mechanism
71
Bupropion: Toxicity
``` Stimulant effects (tachycardia, insomnia) headache, seizure in bulimic patients. No sexual side effects ```
72
Mirtazapine: Mechanism
A-2 antagonist (increase release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist
73
Mirtazapine: Toxicity
Sedation (which may be desirable in depressed patients with insomnia), increased appetite, weight gain (which may desirable in elderly or anorexic patients), dry mouth
74
Maprotiline
Blocks NE reuptake
75
Maprotilline: Toxicity
Sedation, Orthostatic Hypotension
76
Trazodone: Mechanism
Primarily inhibits serotonin reuptake. Primarly used for insomnia, as high doses are needed for antidepressant effects
77
Trazodone: Toxicity
Sedation, nausea, priapism, postural hypotension Called trazo"bone"due to male-specific side effects

USMLE Step 1 (34 decks)

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