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Psych Pharm Flashcards

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1
Q

Drugs for ADHD

A

Methylphenidate

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2
Q

Drugs for Alcohol withdrawal

A

benzos

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3
Q

Drugs for anxiety

A

SSRIs, SNRIs, buspirone

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4
Q

Drugs for bipolar

A

mood stabilizers: lithium, valproic acid, carbamazepine

atypical antipsychotics

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5
Q

Drugs for bulimia

A

SSRIs

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6
Q

Drugs for depression

A

SSRIs, SNRIs, TCAs, buproprion, mirtazapine (esp with insomnia)

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7
Q

Drugs for OCD

A

SSRIs, clomipramine

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8
Q

Drugs for panic d/o

A

SSRIs, venlafaxine, benzodiazepines

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9
Q

Drugs for PTSD

A

SSRIs

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10
Q

Drugs for schizophrenia

A

antipsychotics

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11
Q

Drugs for social phobias

A

SSRIs, beta-blockers

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12
Q

drugs for tourette syndrome

A

antipsychotics (haloperidol, risperidone)

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13
Q

CNS stimulants

A

methyl phenidate, desctroamphetamine, methamphetamine, phentermine

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14
Q

CNS stimulant MOA

A

inc. catecholamines (NE and DA esp) at synaptic cleft

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15
Q

CNS stimulant use

A

ADHD, narcolepsy, appetite control

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16
Q

Antipsychotics/ neuroleptics

A

haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine

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17
Q

Antipsychotic MOA

A

block D2 receptors and increase cAMP

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18
Q

which anti psychotics have high potency

A

trifluoperazine, fluphenazine, haloperidol

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19
Q

which antipsychotics have low potency

A

chlorpromazine, thiridazine

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20
Q

what side effects do you experience with high potency antipsychotics?

A

neurological (extrapyramidal SEs)

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21
Q

SE of low potency anti-psychotics

A

anticholinergic, antihistamine and a1 blockade effects

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22
Q

SE of chlorpromazine

A

corneal deposits

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23
Q

SE of thioridazine

A

retinal deposits

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24
Q

SE of haloperidol

A

NMS and tardive dyskinesia

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25
clinical uses of antipsychotics
schizophrenia, psychosis, acute mania, tourettes
26
antipsychotics: lipid or water soluble?
highly lipid soluble
27
extrapyramidal side effects of antipsychotics? Treatment?
dyskinesia | benstropine or diphenhydramine
28
Endocrine SE of antipsychotics
DA antagonism leads to hyperprolactinemia and galactorrhea
29
SE of antipsychotics?
EPS - dyskinesia endocrine - DA antag --> hyperprolactinemia, galactorrhea muscarinic block --> dry mouth, constipation a1 block --> hypotension histamine block --> sedation NMS tardive dyskinesia
30
What is the evolution of EPS SE?
4hr: acute dystonia 4 day: akathisia (restless) 4 week: bradykinesia 4 month: tardive dyskinesa
31
What is neuroleptic malignant syndrome?
Fever, Encephalopathy, Vitals unstable, Enzymes increase, Rigidity of muscles
32
How do you treat NMS
dantroline, D2 agonists (bromocriptine)
33
what is tardive dyskinesia?
oral facial movements from long term antipsychotic use
34
What are the atypical antipsychotics?
olanzapine, clozapine, quetiapine, risperidone, aripiprazole
35
MOA of atypical antipsychotics?
unknown, varied 5HT2, DA, alpha and H1 R effects
36
what are the clinical uses of atypical antipsychotics?
schizophrenia, bipolar, OCD, anxiety, depression, mania, tourettes
37
what are the SE of olanzapine
weight gain
38
what are the SE of clozapine
weight gain | agranulocytosis
39
what are the SE of risperidone
increased prolactin causing decreased GnRH, LH and FSH
40
what are the SE of ziprasidone
prolonged QT
41
MOA of lithium
not established, maybe IP3 cascade
42
clinical use of lithium
mood stabilizer for bipolar, blocks relapse and acute manic events, SIADH
43
SE of lithium
tremor,sedation, edema, heart block, hypothyroid, polyuria, teratogenic
44
How is lithium excreted
renally and reabsorved at PCT
45
MOA of buspirone
stimulates 5HT1A
46
clinical uses of buspirone
GAD (need 1 to 2 weeks), not sedative, addictive. Can take with EtOH
47
What are the SSRIs?
fluoxetine, paroxetine, sertraline, citalopram
48
MOA of SSRIs
5HT specific reuptake inhibitors
49
clinical uses of SSRIs
depression, GAD, Panic d/o, OCD, bulimia, social phobias, PTSD. Takes 4 - 8 weeks
50
what are the SE of SSRIs?
GI distress, sexual dysfunction.
51
what is serotonin syndrome?
increased 5HT can lead to hyperthermia, confusion, myoclonus, cardiovascular collapse, dlushing, diarrhea and seizures
52
how do you treat serotonin syndrome?
cyproheptadine which is a 5HT2 receptor antagonist
53
what are the SNRIs
venlafaxine, duloxetine
54
MOA of SNRIs
5HT and NE reuptake inhibitors
55
clinical use of SNRIs
depression, GAD, panic d/o, duloxetine also for diabetic peripheral neuropathy
56
what are the SE of SNRIs
increased BP, stimulant effects, sedation, nausea
57
what are the TCAs?
amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
58
MOA of TCAs
block reuptake of NE and 5HT
59
clinical uses of TCAs
major depression, OCD (clomipramine), fibromyalgia
60
what are the SE of TCAs?
sedation a1 blocking (postural hypoTN atropine like effects (tachycardia, urinary retention, dry mouth) convulsions, coma, cardiotoxicity, respiratory depression, hyperpyrexia, confusion
61
which TCA has more anticholinergic effects?
amitriptyline in comparison to nortriptyline
62
what are the SE of desipramine?
less sedating than other TCAs but higher seizure incidence
63
MAO inhibitors
tranylcypromine, phenelzine, isocarboxazid, selegiline
64
MOA of MAO inhibitors
increase NE, 5HT, and DA
65
clinical uses of MAO inhibitors
atypical depression, anxiety, hypochondriasis
66
SE of MAO inhibitors
``` hypertensive crisis (ingestion of tyramine: wine and cheese) CNS stimulation ```
67
With what drugs are MAO inhibitors contraindicated and why?
SSRIs, TCAs, St. John's wort., meperidine, and dextromethorphan b/c of serotonin syndrome
68
clinical use of buproprion
smoking cessation
69
MOA of buproprion
unknown, but increase NE and DA
70
SE of buproprion
stimulant: tachycardia, insomnia headache seizure in bulimics
71
MOA of mirtazapine
a2 antagonist --> increase release of NE and 5HT | potent 5HT2 and 5HT3 receptor antagonist
72
SE of mirtazapine
sedation, increased appetite, weight gain, dry mouth
73
what are the atypical antidepressants?
bupropiion, mirtazapine, trazodone
74
MOA of trazadone
block 5HT2 and a1 receptors
75
clinical uses of trazadone
insomnia, high dose needed for antidepressent effects
76
SE of trazadone
sedation, nausea, priapism, postural hypotension

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