Psychiatric Agents Flashcards
(42 cards)
1
Q
antipsychotics action
A
blocks D2 (dopamine) receptors
2
Q
three subcategories of phenothiazines
A
- aliphatic
- piperazine
- piperidine
3
Q
aliphatic phenothiazines side effects (4)
A
- strong sedative effect
- decreases blood pressure
- causes moderate EPS
- orthostatic hypotension
4
Q
piperazine phenothiazines side effects (4)
A
- low sedative effect
- little effect on blood pressure
- greater EPS than other phenothiazines
- strong antiemetic effect (effective against nausea/vomiting)
5
Q
piperidine phenothiazines side effects (4)
A
- strong sedative effect
- causes few EPS
- low-moderate effect on blood pressure
- can cause life-threatening dysrhythmia
6
Q
why do typical antipsychotics have increased incidence of EPS?
A
they have a stronger affinity for D2 receptors
7
Q
nonphenothiazines side effect
A
prolongs QT segment - can cause arrhythmia
8
Q
antipsychotics adverse reactions (7)
A
- extrapyramidal syndrome (EPS): pseudoparkinsonism, acute dystonia, akathisia, tardive dyskinesia
- neuroleptic malignant syndrome (NMS)
- orthostatic hypotension
9
Q
pseudoparkinsonism symptoms (7)
A
- stooped posture
- masklike face
- rigidity
- tremors at rest
- shuffling gait
- pill-rolling hand motion
- bradykinesia
10
Q
acute dystonia symptoms (4)
A
- muscle spasms of face, tongue, neck, back
- facial grimacing
- involuntary upward eye movement
- laryngeal spasms
11
Q
akathisia symptoms (4)
A
- trouble standing still
- restless
- pacing the floor
- feet is in constant motion
12
Q
tardive dyskinesia symptoms (4)
A
- protrusion and rolling of tongue
- sucking and smacking movements of lips
- chewing motion
- involuntary movement of body and extremities
13
Q
acute dystonia treatment (2)
A
- anticholinergics - benztropine (Cogentin)
- anti-parkinsonism drugs - benzodiazepines/Lorazepam (Ativan)
14
Q
akathisia treatment (2)
A
- Benzodiazepines - lorazepam (Ativan)
- beta blockers - propranolol (Inderal)
15
Q
tardive dyskinesia treatment (5)
A
- benzodiazepines
- calcium channel blockers
- beta blockers
- high doses of vitamin E may be helpful
- (anticholinergics may have little effect)
16
Q
neuroleptic malignant syndrome symptoms (10)
A
- sudden high fever
- muscle rigidity
- altered metal status
- BP fluctuations
- tachycardia
- dysrhythmia
- seizures
- rhabdomyolysis (skeletal muscle destruction)
- respiratory failure
- coma
17
Q
neuroleptic malignant syndrome treatment (4)
A
- immediate withdrawal of antipsychotics
- adequate hydration
- hypothermic blankets
- medications: antipyretics, benzodiazepines, muscle relaxants
18
Q
how long does it take antipsychotics to take effects?
A
3-6 weeks
19
Q
do not combine antipsychotics with (3):
A
- alcohol
- narcotics
- CNS depressants
20
Q
Lorazepam
A
- trade: Ativan
- a benzodiazepine, anxiolytic
21
Q
lorazepam uses (4)
A
- anxiolytics
- anticonvulsants
- sedative-hypnotics
- pre-op drugs
22
Q
lorazepam withdrawal symptoms (5)
A
- agitation
- muscle tremors
- cramps
- nausea
- sweating
23
Q
lorazepam action
A
- enhances gamma-aminobutyrate (GABA) effects – inhibitory neurotransmitter within the CNS
- binds to specific benzodiazepine receptors → postsynaptic receptor becomes more sensitive to GABA → inhibition of rapid neurotransmission → decreases signs and symptoms of anxiety
24
Q
lorazepam side effects (8)
A
- drowsiness, dizziness
- weakness
- confusion
- blurred vision
- anorexia
- sleep disturbance
- restlessness
- hallucinations
25
lorazepam adverse reactions
hyper/hypotension
26
types of antidepressants (4)
- tricyclics (TCAs)
- selective serotonin reuptake inhibitors (SSRIs)
- atypical antidepressants
- monoamine oxidase inhibitors (MAOIs)
27
tricyclics (TCAs) action
blocks uptake/reuptake (removal of) norepinephrine and serotonin
28
tricyclics (TCAs) uses
major depression
29
tricyclics (TCAs) side effects (9)
- sedation
- dizziness
- blurred vision
- dry mouth and eyes
- urinary retention
- constipation
- weight gain
- GI distress
- sexual dysfunction
30
tricyclics (TCAs) side adverse reactions (4)
- orthostatic hypotension
- dysrhythmia
- EPS
- blood dyscrasias
31
tricyclics (TCAs) also block (2):
histamine and anticholinergic receptors
32
tricyclics (TCAs) cause increased sedation and anticholinergic effects when taken with (2):
phenothiazines and haloperidol
33
SSRIs action
blocks reuptake of serotonin and enhance transmission
34
SSRIs uses (3)
- MAIN: major depressive disorders
| - also used for anxiety disorders and migraines
35
SSRIs compared to TCAs
- more commonly used
- more costly
- less side effects
36
SSRIs side effects (8)
- dry mouth
- blurred vision
- insomnia
- nervousness
- headache
- nausea, anorexia, diarrhea
- suicidal ideation
- sexual dysfunction
37
SSRIs herbal interactions (2)
- feverfew
| - St. John's wort
38
Fluoxetine
- trade: Prozac
| - an SSRI antidepressant
39
MAOIs action
- inactivates norepinephrine, dopamine, epinephrine, and serotonin
- nonselective: inhibit both MAO-A and B → increases levels of neurotransmitters which relieves symptoms of depression
40
MAOIs use
- mild, reactive, and atypical depression
| - when unresponsive to TCAs, atypicals
41
hypertensive crisis is caused by taking MAOIs with what?
- CNS stimulants/ sympathomimetics
| - tyramine foods
42
tyramine food examples
cheese, bananas, raisins, pickled foods, red wine, beer, cream, yogurt, chocolate, coffee, Italian green beans, liver, yeast, soy sauce
