Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Behavioral Sciences > Psychiatric Pharmacology > Flashcards

Psychiatric Pharmacology Flashcards

(70 cards)

Start Studying
1
Q

Cyclic Antidepressants drugs

A
  • Amitriptyline
  • Nortriptyline
  • Imipramine
  • Desipramine
  • Clomipramine
  • Doxepin
  • Amoxapine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Haloperidol vs Chlorpromazine

Potency, EP symptoms, Anticholinergic effects

A
  • Haloperidol: high potency, high EPS, and low anticholinergic
  • Chlorpromazine: low potency, low EPS, and high anticholinergic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Carbamazepine and Valproic acid

Uses

A
  • Epilepsy
  • Acute mania
  • Rapid cycling bipolar disorder
  • Impulse control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Atomoxetine common uses

A

ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anti-psychotics mechanism of action

A
  • Dopamine blockage at post-synaptic receptors
  • Alpha-adrenergic blockade
  • Anticholinergic action by blocking muscarinic receptors
  • Blocks both NE and serotonin re-uptake
  • Blocks histamine receptors
    Note: All typicals block dopamine D2 receptors. Most Atypicals are D2 antagonists (except aripiprazole is D2 partial agonist) with varied effects on 5-HT2, dopamine, alpha and H1-receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bupropion mechanism of action

A

Increases NE and dopamine via unknown mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CNS stimulants common uses

A
  • ADHD
  • Narcolepsy
  • Appetite control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Selective Serotonin Re-uptake Inhibitors (SSRIs) mechanism of action

A

Specific re-uptake inhibition of serotonin (5-HT), normally take 4-8 weeks to have an effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lithium Adverse effects

A
  • Tremor, thirst, anorexia and GI distress commonly occur at therapeutic levels
  • Life threatening seizures and coma
  • Polyuria and polydipsia
  • Edema
  • Acne
  • Benign leukocytosis
  • Hypothyroidism with goiter (decreased TSH effect and inhibition of 5’-deiodinase)
  • Nephrotoxicity (Thiazide increases toxicity)
  • Nephrogenic Diabetes Insipidus (DI) (decreased ADH effect)
  • Teratogenic (Ebstein anomaly of tricuspid valve)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Benzodiazepines

Uses

A
  • Anxiety
  • Acute and chronic alcohol withdrawal
  • Convulsions
  • Insomnia
  • Restless leg
  • Akathisia
  • Panic disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Selective Serotonin Re-uptake Inhibitors (SSRIs) dugs

A
  • Fluoxetine
  • Paroxetine
  • Sertraline
  • Citalopram
  • Fluvoxamine (approved for OCD)
  • Escitalopram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Onset of EPS

A
  • Hours to days: Acute dystonia (muscle spasm, stiffness, oculogyric crisis)
  • Days to months: Akathisia (restlessness) and Parkinsonism (bradykinesia)
  • Months to years: TD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Serotonin-Norepinephrine Re-uptake Inhibitors (SNRIs) Adverse effects

A
  • Increased blood pressure (most common)
  • Stimulant effects
  • Sedation
  • Nausea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Tardive Dyskinesia (TD) 
(Causes, Predisposing factors, Treatment)
A
  • Supersensitivity of post-synaptic dopamine receptors
  • Older patients, long-term Rx, smoking and DM
  • No Rx, focus on prevention: pimozide or loxapine has less chance of inducing TD, clozapine not associated with it at all
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clozapine

Specific Adverse effects

A
  • Agranulocytosis (weekly WBC count should be done)
  • Increased salivation (“wet pillow” syndrome)
  • Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mirtazapine mechanism of action

A
  • Alpha-2 adrenergic antagonist (Stimulates NE and 5-HT release
  • Blocks 5-HT2, 5-HT3 and H1 receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Trazodone mechanism of action

A
  • 5-HT receptor antagonist (5-HT2)
  • Alpha-1 adrenergic and H1 receptors blocker
  • Weakly inhibits 5-HT re-uptake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CNS stimulants mechanism of action

A

Increase catecholamines in the synaptic cleft, especially NE and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Monoamine oxidase inhibitors (MAOIs) drugs

A
  • Tranylcypromine
  • Phenelzine
  • Isocarboxazid
  • Selegiline (selective MAOb inhibitor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Typical vs Atypical anti-psychotics

A
  • Typical blocks dopamine, while atypical blocks both dopamine and serotonin
  • Typical treats mostly positive symptoms, while atypical treats positive and negative symptoms
  • Typical has more side effects, while atypical has fewer side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Chlorpromazine

Specific Adverse effects

A

Corneal deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Risperidone

Specific Adverse effects

A
  • Highest in raising prolactin levels

- Highest risk of movement disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serotonin-Norepinephrine Re-uptake Inhibitors (SNRIs) Common uses

A
  • Depression
  • Generalized anxiety disorder
  • Diabetic neuropathy
  • Venlafaxine for social anxiety disorder, panic disorder, PTSD and OCD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Quetiapine

Specific Adverse effects

A

Lowest risk of movement side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Atomoxetine adverse effects
- Nausea - Xerostomia (dry mouth) - Decreased appetite - Insomnia - Fatigue - Headache - Cough
26
Chlorpromazine and Thioridazine vs Haloperidol and Fluphenazine (M block and Sedation)
- Chlorpromazine and Thioridazine high M block and sedation | - Haloperidol and Fluphenazine low in M block and sedation
27
Electroconvulsive Therapy (ECT) Important Notes
- Its not a first line treatment but should be considered for * Highly suicidal patients * Depressed pregnant patients - Improvement associated with large increase in slow wave (delta) activity in the prefrontal area; greater increase = greater recovery
28
Extrapyramidal (EP) reactions Treatment
- Benztropine - Trihexyphenidyl - Diphenhydramine - Benzodiazepines
29
Cyclic Antidepressants Adverse effects
- Anti-cholinergic effects: nortriptyline has less effects than amitriptyline - CNS effects: drowsiness, insomnia and agitation, disorientation and confusion, headache and fine tremor - Cardiovascular: most common in elderly and include tachycardia, orthostatic hypotension, and lethal arrhythmias in overdose - Sexual: * Men: impotence and testicular swelling * Women: anorgasmia and breast enlargement (treat with cyproheptadine[5-HT2 receptor antagonist]) - Metabolic: changes in blood sugar levels
30
Mirtazapine adverse effects
- Somnolence - Increased appetite - Weight gain - Dry mouth
31
Selective Serotonin Re-uptake Inhibitors (SSRIs) Common uses
- Depression - Generalized anxiety disorder - Panic disorder - OCD - Bulimia - Social anxiety disorder - PTSD - Premature ejaculation - Premenstrual dysphoric disorder
32
Anti-psychotics neurologic adverse effects
- Anticholinergic effects (especially in elderly): dry mouth, blurry vision, constipation, urinary retention and delirium. Also tachycardia and decreased seizure threshold - CNS effects from H1 receptors blockage: weight gain, sedation, and impaired memory - Extrapyramidal (EP) reactions due to decreasd dopamine - Tardive dyskinesia (TD): tongue protrusion, tremors and spasms of the neck, body and limbs. rarely before 3 to 6 month (1 month if older than 60)
33
Extrapyramidal (EP) reactions names and timeline
- Dystonic reactions (jerky movements, trouble speaking): 1 week (younger at more risk) - Akinesia: 2 weeks - Rigidity: 3 weeks - Tremors: 6 weeks - Akathisia: 10 weeks - Pisa and Rabbit syndromes: 18+ weeks
34
CNS stimulants drugs
- Methylphenidate - Dextroamphetamine - Methamphetamine
35
Selective Serotonin Re-uptake Inhibitors (SSRIs) Adverse effects
- Anorgasmia and delayed orgasm in 15-20% of patients - Anxiety and agitation - Bruxism - Weight loss - SIADH
36
Cyclic Antidepressants Common uses
- Major depression - OCD (clomipramine) - Phobic and panic anxiety states - Peripheral neuropathy - Chronic pain with or without depression - Enuresis - Migraine prophylaxis
37
Buspirone common uses
Generalized anxiety disorder
38
Lithium Mechanism of action
Prevents recycling of inositol (PIP2) by blocking inositol monophosphate (second messenger) which leads to decrease cAMP
39
Cyclic Antidepressants Toxicity
3 Cs - Convulsions - Coma - Cardiotoxicity (arrhythmia due to Na+ channel inhibition) treat with NaHCO3 to prevent arrhythmia
40
Cyclic Antidepressants interactions and cautions
- Hypertensive crisis with MAO inhibitors - Serotonin syndrome with SSRIs, MAO inhibitors, and meperidine (pethidine) - Prevent antihypertensive action of alpha-2 agonists - Potentiate effects of alcohol - Manic episodes induced in 50% of bipolars - Avoid during the first trimester of pregnancy
41
Cyclic Antidepressants mechanism of action
- Blocking re-uptake of serotonin and NE | - Blocking of alpha-1 adrenergic and muscarinic receptors
42
Monoamine oxidase inhibitors (MAOIs) Interactions
- Hypertensive crisis with SSRIs, TCAs, St. John's wort, meperidine, dextromethorphan (used to prevent serotonin syndrome), alpha-1 agonists and levodopa. Also with tyramine containing foods: aged cheese, dried fish, sauerkraur, sausage, chocolate, avocado and red wine (the safe foods are cottage cheese and white wine). Rx: stop the medications and give phentolamine or chlorpromazine. Wait 2 weeks after stopping MAO inhibitors before starting serotonergic drugs or stopping dietary restrictions - Serotonin syndrome with SSRIs, TCAs and meperidine
43
Varenicline mechanism of action
Partial agonist of nicotinic receptors
44
Anti-psychotics common uses
- Psychotic symptoms: hallucinations, alteration of affect, ideas of reference, delusions, etc. (schizophrenia and bipolar disorder) - Tourette's syndrome - Movement disorder: Huntington's, hemiballism - OCD - Nausea and vomiting (drug and radiation induced) - Intractable hiccups - Pruritis
45
Trazodone adverse effects
- Priapism - Cardiac arrythmias - Sedation - Postural hypotension
46
Selective Serotonin Re-uptake Inhibitors (SSRIs) Toxicity and interactions
- Serotonin syndrome - With MAO inhibitors, meperidine and TCAs - Most inhibit cytochrome P450 (especially fluvoxamine and fluoxetine) - Increased levels of benzodiazepines in treatment of anxiety disorder - Citalopram is safer for interaction
47
Thioridazine | Specific Adverse effects
- Cardiotoxicity (torsades "quinidine-like") - Retinitis pigmentosa (retinal deposits) - Retrograde ejaculation
48
Varenicline adverse effects
Sleep disturbances
49
Anti-psychotics non-neurologic adverse effects
- Cardiovascular: orthostatic hypotension (do not use epinephrine; lowers blood pressure further) - Particular taste (also dental cavities) - Vomiting: common with long term use especially among smokers - Sexual effects: due to elevated prolactin * Men: decreased libido, inhibition of ejaculation, retrograde ejaculation and gynecomastia * Women: breast enlargement and lactation, changes in libido, and dysmenorrhea - Altered bodily response to temperature
50
Monoamine oxidase inhibitors (MAOIs) Common uses
- Atypical depression | - Anxiety
51
Monoamine oxidase inhibitors (MAOIs) mechanism of action
Inhibit MAOa and MAOb (enzymes that metabolizes serotonin, epinephrine and NE)
52
Typical or First generation anti-psychotics
- Chlorpromazine - Thioridazine - Fluphenazine - Haloperidol - Trifluoperazine (high potency)
53
Electroconvulsive Therapy (ECT) Mechanism of action and uses
- Electricity is passed from frontal cortex to the striatum, usually requires 5-10 treatments. and only relative C/I is increased intracranial pressure. 90% show immediate improvement - Uses: depression, schizoaffective disorder, and bipolar disorder
54
Olanzapine | Specific Adverse effects
Highest incidence of diabetes, weight gain and increase cholesterol
55
Buspirone mechanism of action
Stimulates 5-HT1a receptors
56
Neuroleptic Malignant Syndrome (NMS) | Diagnosis and Treatment
- Fever, encephalopathy, vitals unstable, Increased enzymes and rigidity of muscles with myoglobinuria - Dantrolene and bromocriptine (D2 agonist)
57
Atypical or Second generation anti-psychotics
- -pines: Clozapine, Olanzapine, Quetiapine, Asenapine - -dones: Risperidone, Ziprasidone, Lurasidone, Iloperidone, Paliperidone - Others: Aripiprazole
58
Trazodone common uses
- Depression - Insomnia - Erectile dysfunctio
59
Atomoxetine mechanism of action
Selective NE re-uptake inhibitor
60
Ziprasidone | Specific Adverse effects
Prolongs QT interval
61
Buspirone adverse effects
- Dizziness - Headache - Somnolence - Premature ejaculation
62
Varenicline common uses
Smoking cessation
63
Bupropion adverse effects
- Increased risk of seizures (anorexic/bulimic patients) - Appetite suppressant - Agitation - Insomnia - Headache
64
Lithium Common uses
- Long-term control and prophylaxis of bipolar disorder, migraine cluster headache and chronic aggression - Combined with TCAs for resistant depression
65
Atypical anti-psychotics which one is highest in alpha block and which one in sedation
- Alpha block is clozapine | - Sedation is risperidone
66
Haloperidol | Specific Adverse effects
Most likely cause of neuroleptic malignant syndrome (NMS) and TD
67
Cyclic Antidepressants Withdrawal
- Akathisia, dyskinesia, anxiety, sweating, dizziness, vomiting, cholinergic rebound, and depression rebound - After prolonged use, withdraw gradually
68
Serotonin-Norepinephrine Re-uptake Inhibitors (SNRIs) drugs
- Venlafaxine - Desvenlafaxine - Duloxetine - Levomilnacipran - Milnacipran
69
Bupropion common uses
- Depression | - Smoking cessation
70
Serotonin-Norepinephrine Re-uptake Inhibitors (SNRIs) Mechanism of action
Inhibit 5-HT and NE re-uptake

Behavioral Sciences (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions