Psych Pharm 2 Flashcards Preview

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Flashcards in Psych Pharm 2 Deck (27)
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1
Q

Methylphenidate, amphetamines

A
  • Cause increase in NE and DA release
  • Used to treat ADHD (Targets frontal lobe secretion and function)
  • Also can be used to supress apetite for a short time and can be used in narcolepsy
2
Q

Neuroleptics

A
  • D2 blockers. D2 is Gi therefore blocking will increase cAMP and function
  • Used for psychosis, acute mania, tourettes
  • Significant side effect profile
  • High potency: Haloperidol, trifluoropirazine, fluphenalzine
  • Low potency: Chlorpromazine, Thioridazine
3
Q

Non Extrapyramidal Side effects

A
  • Have alpha 1, muscarinin, and histamine blocking leading to dry mouth, hypotension, cardiac arrythmias
  • Also block D2 receptors in prolactin cells of AP leading to prolactinemia
  • Very high volume of distrubution
4
Q

Pyramindal Symptoms

A
  • Blockage of D2 receptor leads to increase in DA receptor number and sesitivity
  • at first dose, 4 hours leads to dystonia, torticollis, oculogyric crisis (upward devation of eyes caused by spasmotic contraction), Treat with benztropine (Ach blocker)
  • withing a week (4 days) onset of akasthesia or restlessness from increase in receptor sensitivity
  • At four weeks there is bradykinesia and pseudoparkinsonism
  • At 4 months there can be permanent increase in receptor number and sensitivity leading to tardive dyskinesia (often seen with steretyped lip smacking)
5
Q

Neuroleptic malignant syndrome

A

Massive rigidity and rhabdomyolyisis leading to myoglobinria. Also hyperthermia and autonomic instability
-Tx: Bromocriptine, a dopamine agonist and dantrolene (block Ca channels)

6
Q

Haloperidol, fluphenaline,trifluoreprazine

A

-Increased extrapuramidal side effect risk

7
Q

Chlorpromazine, Thioridazine

A
  • Decreased extrapyramidal symptoms, but incresed AchR blocker symtoms
  • Chlorpromazine also has corneal deposits
  • Thioridzaine has retinal deposits
8
Q

Atypical Antpsychotics

A
  • Mechanism unclear, decreased or absent extrapyramidal symptoms
  • Major side effect is weight gain
9
Q

Cloazapine

A

-Agranulocytosis, need WBC checked frequently

10
Q

Olanzapine

A

-Wieght gain

11
Q

Ziprisadone, risperadone, apiprazole etc

A

-Atypical Antipsychotics

12
Q

Lithium

A
  • Decreases G protein signalling??? Leads to mood stabilization
  • Give before SSRI in patients with mania or may precipitate suicide
  • Purey excreted by kidney, and resorbed with Na
  • S/E: Hypothyroidism, Ebsteins anomaly, Nephrogenic DI, tremors, seizures
13
Q

Busprione

A
  • Partial 5HT agonist

- Used to treat generalized anxiety and has a very mild side effect profile with limited drug drug interactions

14
Q

SSRI

A
  • Inhibit Seretonin Reuptake
  • First line in a number of diseases
  • Depression, PTSD, Anxiety, OCD, Bulemia, Panic
  • S/E: Sexual dysfunction (can use buproprion)
  • Seretonin syndrome
15
Q

Seretonin Syndrome

A
  • Elevated seretonin, generally seen when there is increased seretonin from a number of drugs on board with an MAOI
  • Siezures, Hypertension, flushing, myoclonus, hyperthermia
16
Q

Cyprophetadine

A

-Seretonin Antagonist, used to treat seretonin syndrome

17
Q

Drugs that are SSRI

A

-Fluoxetine, paroxetine, sertaline, citalopram

18
Q

SNRI

A

Venlafaxine, duloxetine

-Most common is increased BP (increase NE)

19
Q

Venlafaxine

A
  • Anxiety

- pani disorders

20
Q

Duloxetine

A

-Can be used to treat diabetic peripheral neuropathy

21
Q

TCA

A
  • Block the reputake of seretonin and NE, can have seretonin syndrome or hypertensive crisis
  • CCC due to blocking of cholinergic effects, and alpha effects. Cardiotox (Torsades), Convulsions, Coma
  • Other indications, but most are replaced by SSRI
  • Strong anticholinergic effects (urinary retension, dry mouth, confusion and hallucinations (especially in elderly)
  • Treat overdose with NaHCO3 to alkalanize the urine and increase clearance
  • Can also be incdicated for bedwetting, OCD, and fibromylagia
22
Q

TCA Drugs

A
  • End in ine/line except doxepin

- Amitryptaline, nortryptaline, imipramine, despiramine, clomimpramine, doxepin, amoxapine

23
Q

MAOI

A
  • MAO degrades caetacholamines, increase Caethacholamines
  • Used to treat atyical depression, anxiety, hypochondriasis
  • Selegeline is specific for MAOB and is used to decrease DA degredation in parkinsons
  • phenylzine, tranlycipromine, isocarbazoxide
  • Hypertensive Crisis with tyramine (leads to increased release of NE and 5HT from cleft)
  • Seretonin syndrome with any drug or herb that will increased sretonin
24
Q

Buprorion

A
  • Mechanism unkown, but increase NE and 5HT
  • Used to treat depression and has minimal sexual side effects
  • Can also be used in smoking cessation
25
Q

Mirtazapine

A
  • Centrally acting alpha 2 antagonist and also has seretonin antagonism activity
  • Causes weight gain and sedation
  • Use in anorexic patients and in depressed patients with insomnia
26
Q

Maprotiline

A

-sepecific for NE reuptake blockage

27
Q

Trazadone

A
  • Main indication is to treat insomnia and pain associated with insomnia
  • Blocks seretonin reuptake and also blocks alpha 1
  • Causes priaprism and hypoyension