Flashcards in Psych Pharm Deck (76)
Drugs for ADHD
Drugs for Alcohol withdrawal
Drugs for anxiety
SSRIs, SNRIs, buspirone
Drugs for bipolar
mood stabilizers: lithium, valproic acid, carbamazepine
Drugs for bulimia
Drugs for depression
SSRIs, SNRIs, TCAs, buproprion, mirtazapine (esp with insomnia)
Drugs for OCD
Drugs for panic d/o
SSRIs, venlafaxine, benzodiazepines
Drugs for PTSD
Drugs for schizophrenia
Drugs for social phobias
drugs for tourette syndrome
antipsychotics (haloperidol, risperidone)
methyl phenidate, desctroamphetamine, methamphetamine, phentermine
CNS stimulant MOA
inc. catecholamines (NE and DA esp) at synaptic cleft
CNS stimulant use
ADHD, narcolepsy, appetite control
haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine
block D2 receptors and increase cAMP
which anti psychotics have high potency
trifluoperazine, fluphenazine, haloperidol
which antipsychotics have low potency
what side effects do you experience with high potency antipsychotics?
neurological (extrapyramidal SEs)
SE of low potency anti-psychotics
anticholinergic, antihistamine and a1 blockade effects
SE of chlorpromazine
SE of thioridazine
SE of haloperidol
NMS and tardive dyskinesia
clinical uses of antipsychotics
schizophrenia, psychosis, acute mania, tourettes
antipsychotics: lipid or water soluble?
highly lipid soluble
extrapyramidal side effects of antipsychotics? Treatment?
benstropine or diphenhydramine
Endocrine SE of antipsychotics
DA antagonism leads to hyperprolactinemia and galactorrhea
SE of antipsychotics?
EPS - dyskinesia
endocrine - DA antag --> hyperprolactinemia, galactorrhea
muscarinic block --> dry mouth, constipation
a1 block --> hypotension
histamine block --> sedation
What is the evolution of EPS SE?
4hr: acute dystonia
4 day: akathisia (restless)
4 week: bradykinesia
4 month: tardive dyskinesa
What is neuroleptic malignant syndrome?
Fever, Encephalopathy, Vitals unstable, Enzymes increase, Rigidity of muscles
How do you treat NMS
dantroline, D2 agonists (bromocriptine)
what is tardive dyskinesia?
oral facial movements from long term antipsychotic use
What are the atypical antipsychotics?
olanzapine, clozapine, quetiapine, risperidone, aripiprazole
MOA of atypical antipsychotics?
unknown, varied 5HT2, DA, alpha and H1 R effects
what are the clinical uses of atypical antipsychotics?
schizophrenia, bipolar, OCD, anxiety, depression, mania, tourettes
what are the SE of olanzapine
what are the SE of clozapine
what are the SE of risperidone
increased prolactin causing decreased GnRH, LH and FSH
what are the SE of ziprasidone
MOA of lithium
not established, maybe IP3 cascade
clinical use of lithium
mood stabilizer for bipolar, blocks relapse and acute manic events, SIADH
SE of lithium
tremor,sedation, edema, heart block, hypothyroid, polyuria, teratogenic
How is lithium excreted
renally and reabsorved at PCT
MOA of buspirone
clinical uses of buspirone
GAD (need 1 to 2 weeks), not sedative, addictive. Can take with EtOH
What are the SSRIs?
fluoxetine, paroxetine, sertraline, citalopram
MOA of SSRIs
5HT specific reuptake inhibitors
clinical uses of SSRIs
depression, GAD, Panic d/o, OCD, bulimia, social phobias, PTSD. Takes 4 - 8 weeks
what are the SE of SSRIs?
GI distress, sexual dysfunction.
what is serotonin syndrome?
increased 5HT can lead to hyperthermia, confusion, myoclonus, cardiovascular collapse, dlushing, diarrhea and seizures
how do you treat serotonin syndrome?
cyproheptadine which is a 5HT2 receptor antagonist
what are the SNRIs
MOA of SNRIs
5HT and NE reuptake inhibitors
clinical use of SNRIs
depression, GAD, panic d/o, duloxetine also for diabetic peripheral neuropathy
what are the SE of SNRIs
increased BP, stimulant effects, sedation, nausea
what are the TCAs?
amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
MOA of TCAs
block reuptake of NE and 5HT
clinical uses of TCAs
major depression, OCD (clomipramine), fibromyalgia
what are the SE of TCAs?
a1 blocking (postural hypoTN
atropine like effects (tachycardia, urinary retention, dry mouth)
convulsions, coma, cardiotoxicity, respiratory depression, hyperpyrexia, confusion
which TCA has more anticholinergic effects?
amitriptyline in comparison to nortriptyline
what are the SE of desipramine?
less sedating than other TCAs but higher seizure incidence
tranylcypromine, phenelzine, isocarboxazid, selegiline
MOA of MAO inhibitors
increase NE, 5HT, and DA
clinical uses of MAO inhibitors
atypical depression, anxiety, hypochondriasis
SE of MAO inhibitors
hypertensive crisis (ingestion of tyramine: wine and cheese)
With what drugs are MAO inhibitors contraindicated and why?
SSRIs, TCAs, St. John's wort., meperidine, and dextromethorphan b/c of serotonin syndrome
clinical use of buproprion
MOA of buproprion
unknown, but increase NE and DA
SE of buproprion
stimulant: tachycardia, insomnia
seizure in bulimics
MOA of mirtazapine
a2 antagonist --> increase release of NE and 5HT
potent 5HT2 and 5HT3 receptor antagonist
SE of mirtazapine
sedation, increased appetite, weight gain, dry mouth
what are the atypical antidepressants?
bupropiion, mirtazapine, trazodone
MOA of trazadone
block 5HT2 and a1 receptors
clinical uses of trazadone
insomnia, high dose needed for antidepressent effects