Psychiatry Flashcards

Question

Methylphenidate, dextroampheatmine, metamphetamine, phentermine

Answer 1

MOA: increase catecholamines at the synaptic cleft, especially NE and dopamine Treat: ADHD, narcolepsy, appetite control

Answer 2

Atypical antidperessant MOA: increase NE and dopamine by inhibiting presynpatic uptake Clinical: atypical depression and smoking cessation, migraines, depression in bipolar, adult ADHD Toxicity: stimulant effects (tacchycardia, insomnia), headache, nausea DON'T USE IN PATIENTS WITH EATING DISORDERS, EPILEPSY, OR ALCOHOL ABUSE DUE TO INCREASE RISK OF SEIZURES and psychosis or on MAOI No sexual side effects!!!

Answer 3

MOA: blocks 5Ht2 and alpha1 adrenergic receptors Clinical: primarily insomnia, high doses needed for antidepressant Toxicity: sedation, nausea, priapism (constant boner), postural hypotension, hepatotoxicity, dizziness, orthostatsis, cardiac arrhythmias

Answer 4

Atypical antipsychotic- MOA: Dopamine and serotonin antagonist Clinical: Schizophrenia positive and negative symptoms, Bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome Toxicity: fewer EPS and anticholinergic side effects than traditional antipsychotics May prolong QT interval should obtain ECGs Less metabolic side effects

Answer 5

reslessnes and agiation Treatment: B-Blocker

Answer 6

MOA: Blocks reuptake of monoamines Intoxication: impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death (coronary artery vasospasm), stroke, intracranial hemorrhage, seizures, sympathetic stimulation-tachycardia Treatment: benzodiazepines Withdrawal: hypersomonlence, malaise, severe psychological craving, depression/suicidality, increased appetite, psychomotor retardation, MI (increased demand and decreased perfusion)

Answer 7

Atypical antipsychotic MOA: Dopamine and Serotonin antagonists Fast acting Clinical: Schizophrenia positive and negative symptoms Bipolar disorder OCD, anxiety disorder, depression, mania, Tourette syndrome/tics toxicity: fewer EPS and anticholinergic side effects than traditional antipsychotics (however most likely atypical antipsychotic to cause EPS) Increases prolactin leading to lactation and gynecomastia Decreases GnRH, LH and FSH causing irregular menstruation and fertility issues

Answer 8

MOA: reinforces effects of nicotine that lead to dependene through partial agonistic acitivity on a4B2 nicotinic acetylcholin recpetor in CNS Decreases symptoms of withdrawal and attenuating rewards

Answer 9

Atypical antipsychotics MOA: Dopamine and serotonin antagonist Acts on D4 receptors Clinical: schizophrenia positive and negative symptoms (treatment resistant Schizo) Toxicity: NO EPS and anticholinergic side effects than traditional antipsychotics (least likely atypical antipsychotic to cause EPS) weight gain AGRANULOCYTOSIS-requires weekly WBC monitoring Seizures MYOCARDITIS

Answer 10

Intoxication: perceptual distortion (visual auditory), visual hallucinations, depersonalization, anxiety, paranoia, psychosis, possible flashback

Answer 11

MOA: Increase levels of amine NTs-NE, 5HT, and dopamine Takes 2 weeks to re synthesize MAO- watch for serotonin syndrome-wait two weeks to switch to (fluoxetine 5 weeks), 2 weeks to come off Clinical: atypical depression, anxiety, hypochondriasis Toxicity: hypertensive crisis (ingestion of tyramine-wine and cheese), CNS stimulation, edema, orthostasis, weight gain, sexual, headache Treat with phentolamine Contraindicated: SSRIs, TCAs, St. John's wort, meperidine, and dextromehtorphan-prevents serotonin syndrome

Answer 12

intoxication: Low safety margin, marked respiratory depression CYP450 Inducers Treatment: symptom management-assist respiration, increase BP Withdrawal: delirium, life threatening cardiovascular collapse

Answer 13

Produced painless seizure in anesthetized patient Treatment for major depressive disorder refractory to other treatments or pregnant women with depression Or when immediate response is necessary (suicide) Depression with psychotic features and Catatonia are also indications AE: disorientation, temporary headache, and partial anterograde/retrograde amnesia fully resolving in 6 months

Answer 14

Goal is to resolve unconscious conflicts by bringing repressed experiences and feelings into awareness Insight oriented Patients: under the age of 40, not psychotic, intelligent, in stable relationships and function daily Useful in: Cluster C, Anxiety Disorders, OCD, Problems coping with life events, anorexia nervosa, sexual disorders, dysthymic disorder Focus: unconscious conflicts cause symptoms, explore positive relationships, break down defense mechanisms , talk about problems

Answer 15

Helping patients change behaviors that contribute to their symptoms Extinguishes maladaptive behaviors by replacing htem with healthy alternatives Classical and operant conditioning flooding: phobic disorders Systemic desensitization: phobic disorders Aversion therapy: paraphilias, substance abuse Token economy: showering, shaving Biofeedback: migraines, agoraphobia, fecal incontinence, tension headache, asthma, hypertension, chronic pain

Answer 16

MOA:Serotonin reuptake inhibitors CYP450 inhibitor Lots of drug interactions Clinical: ONLY OCD Toxicity: Nausea and vomiting more common GI distress, sexual dysfunction, serotonin syndrome, nausea, diarrhea, anxiety, insomnia (vivid dreams), headaches, restlessness, seizures (low risk) can elevate levels of neuroleptics increasing side effects Watch with cough supprsesant for sserotonin syndrome

Answer 17

Combines cognitive therapy and behavior therapy patient learns how behaviors is influenced by thoughts used in: depression, anxiety, and substance abuse

Answer 18

Seen with high potency traditional anti-psychotics (haloperidol and trifluoperazine) and risperidone

Answer 19

Caused by builldup of stored catecholamines (NE) MAOIs + foods with tyramine (red wine, cheese, chicken liver, cured meats) or plus sympathomimetics Treat with: Phentolamine

Answer 20

Sustained contraction of muscles of neck, tongue, eyes, diaphragm within days High potency traditional antipsychotics (haloperidol and trifluoperazine) Treat with: benedryl/cogentin

Answer 21

Patients with similar problem or pathology meet together with a therapist for group sessions Treat: substance abuse, adjustment disorder, eating disorder and personality disorders Advantages: patients get immediate feedback and support from peers and may gain insight Universilization: patient is not alone in their suffering Group cohesion: group working towards same goal

Answer 22

Masklike face, cogwheel rigidiity, pill rolling tremor Occur with high potency traditonal antipsychotics (haloperidiol and trifluoperazine) Happens within months Treat with benztropine

Answer 23

Corrects faulty assumptions and negative feelings that exacerbate psychiatric symptoms Treats: depression and anxiety paranoid personality disorder, OCD, somatoform disorder, and eating disorders

Answer 24

Choreoatetoid muscle movements usually of mouth and tongue Occur after years of antipsychotic use particularly high potency traditional antipsychotics (haloperidol, trifluoperazine) Can be irreversible Treat with benztropine

Answer 25

Fever, tachycardia, hypertension, tremor, elevated CPK, lead pipe rigidity, leukocytosis, Can be caused by all antipsychotics after short or long time (increased risk with high potency traditional antipsychotics-haloperidol and trifluoperazine) Treatment: stop drug, benedryl, dantrolene/bromocriptine/amantadine

Answer 26

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) also for pain Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 27

MOA:Serotonin reuptake inhibitors Used commonly due to low incidence of side effects which resolve with time, no food restrictions, much safer in overdose CYP450 inhibitor Clinical: depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD, IBS, migraines, autsim Toxicity: Fewer side effects than TCAs highest risk of GI distress (N/V/D), sedation sexual dysfunction, serotonin syndrome, nausea, diarrhea, anxiety, weight loss, insomnia (vivid dreams), headaches, restlessness, seizures (low risk) can elevate levels of neuroleptics increasing side effects Watch with cough supprsesant for sserotonin syndrome

Answer 28

dizziness, headaches, nausea, insomnia and malaise May need to be tapered

Answer 29

MOA:Serotonin reuptake inhibitors-stimulant Used commonly due to low incidence of side effects which resolve with time, no food restrictions, much safer in overdose CYP450 inhibitor Short half life can lead to withdrawal phenomena Clinical: depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD, IBS, migraines, autsim Toxicity: Fewer side effects than TCAs GI distress, sexual dysfunction, serotonin syndrome, nausea, diarrhea, anxiety, More anticholinergic SE: sedation, constipation, weight gain, headaches, restlessness, seizures (low risk) can elevate levels of neuroleptics increasing side effects Worse for sexual sdie efects and weight gain Late night sedation Several Drug interactions Watch with cough supprsesant for sserotonin syndrome

Answer 30

Diminishes self destructive behaviors and hospitalizations Incorporates cognitive and supportive techniques, improve emotion and regulation, distress tolerance, mindful awareness Treats: Borderline personality disorder, self injury

Answer 31

MOA:Serotonin reuptake inhibitors Used commonly due to low incidence of side effects which resolve with time, no food restrictions, much safer in overdose Clinical: depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD, IBS, migraines, autsim Toxicity: Fewer side effects than TCAs LEAST Sexual side effects GI distress, sexual dysfunction, serotonin syndrome, nausea, diarrhea, anxiety, insomnia (vivid dreams), headaches, restlessness, seizures (low risk) can elevate levels of neuroleptics increasing side effects Can increase QTc interveal FEWEST Drug interactions Watch with cough supprsesant for sserotonin syndrome

Answer 32

SNRI MOA: inhibit 5-HT and NE reuptake Clinical: depression, generalized anxiety and panic disorders, fibromylagia, diabetic neuropathy, female stress incontinence Depression WITH PAIN Toxicity: increase BP, stimulant effects, sedation, nausea, vomiting, diarrhea

Answer 33

SNRI MOA: inhibit 5-HT and NE reuptake Clinical: depression, generalized anxiety and panic disorders, fibromylagia, diabetic neuropathy, female stress incontinence Depression WITH PAIN Toxicity: increase BP, stimulant effects, sedation, nausea, vomiting, diarrhea, hepatatoxicity, bleeding

Answer 34

SNRI MOA: inhibit 5-HT and NE reuptake Clinical: Only fibromyalgia Toxicity: increase BP, stimulant effects, sedation, nausea, vomiting, diarrhea

Answer 35

MOA: blocks 5Ht2 and alpha1 adrenergic receptors Clinical: primarily insomnia, high doses needed for antidepressant Toxicity: sedation, nausea, postural hypotension, hepatotoxicity, dizziness, orthostatsis Liver failure-black box warning

Answer 36

SNRI MOA: inhibit 5-HT and NE reuptake Clinical: depression with pain Toxicity: increase BP, stimulant effects, sedation, nausea, vomiting, diarrhea

Answer 37

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) OCD-clomipramine Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QRS prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 38

MOA:Serotonin reuptake inhibitors Much like citalopram but more expensive! Used commonly due to low incidence of side effects which resolve with time, no food restrictions, much safer in overdose Clinical: depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD, IBS, migraines, autsim Toxicity: Fewer side effects than TCAs LEAST Sexual side effects GI distress, sexual dysfunction, serotonin syndrome, nausea, diarrhea, anxiety, insomnia (vivid dreams), headaches, restlessness, seizures (low risk) can elevate levels of neuroleptics increasing side effects Fewest Drug interactions Watch with cough supprsesant for sserotonin syndrome

Answer 39

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) also enuresis and pain Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 40

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) Also for enuresis Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 41

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 42

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 43

MOA: Increase levels of amine NTs-NE, 5HT, and dopamine Takes 2 weeks to re synthesize MAO- watch for serotonin syndrome-wait two weeks to switch to (fluoxetine 5 weeks), 2 weeks to come off Clinical: atypical depression, anxiety, hypochondriasis Toxicity: hypertensive crisis (ingestion of tyramine-wine and cheese), CNS stimulation, edema, orthostasis, weight gain, sexual, headache Treat with phentolamine Contraindicated: SSRIs, TCAs, St. John's wort, meperidine, and dextromehtorphan-prevents serotonin syndrome

Answer 44

MOA: Increase levels of amine NTs-NE, 5HT, and dopamine Takes 2 weeks to re synthesize MAO- watch for serotonin syndrome-wait two weeks to switch to (fluoxetine 5 weeks), 2 weeks to come off Clinical: atypical depression, anxiety, hypochondriasis Toxicity: hypertensive crisis (ingestion of tyramine-wine and cheese), CNS stimulation, edema, orthostasis, weight gain, sexual, headache Treat with phentolamine Contraindicated: SSRIs, TCAs, St. John's wort, meperidine, and dextromehtorphan-prevents serotonin syndrome

Answer 45

MOA: increases GABA by increasing frequency of Cl- channel opening Intermediate acting Uses: seizures, insomnia, GAD, Alcohol withdrawal PANIC ATTACKS Lethal with alcohol Toxicity: dependence, additive CNS depression with alcohol, less respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly), decreased memory and concentration LESS DROWSINESS SEVERE WITHDRAWAL SYMPTOMS AND HIGHER ADDICTIVE POTENTIAL Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 46

a2 agonists | Used for opioid detoxification, tourrettes/tics

Answer 47

Used for panic attacks, social phobia, akathesia | Helps with sweating and tachycardia

Answer 48

Cholinesterase inhibitor | slows progression of Alzheimers

Answer 49

For sleep Not a BDZ But binds to same receptor No addiction and no withdrawal

Answer 50

MOA: increases GABA by increasing frequency of Cl- channel opening Short acting Uses: seizures, insomnia, GAD, Alcohol withdrawal PANIC ATTACKS Lethal with alcohol Toxicity: dependence, additive CNS depression with alcohol, less respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly), decreased memory and concentration LESS DROWSINESS SEVERE WITHDRAWAL SYMPTOMS AND HIGHER ADDICTIVE POTENTIAL Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 51

For: relationship conflicts, life role transitions, grief Focus current relationships and conflicts

Answer 52

NMDA antagonist | Used in alzheimers

Answer 53

MOA: block dopamine receptors (increase cAMP) Low potency Clinical: Schizophrenia positive symptoms, psychosis, acute mania, AND HUNTINGTONS Toxicity: EPS-acute dystonia (sustained muscle contractions), akathisia (restlessness-treat with Beta blockers), Parkinsonism (tremor rigidity, bradykinesia-treat with anticholinergics (benztropine or diphenyhydramine) , increased LFTs, seizures galactorrhea Neuroleptic malignant syndrome: rigidity, myoglobinuria, autonomic instability, hyperpyrexia, Treat with dantrolene, D2 agonists (brmocriptine) Tardive dyskinesia: sterotpic oral-facial movements, lip smacking, chroathetoid movements

Answer 54

MOA: block dopamine receptors (increase cAMP) Low potency Clinical: Schizophrenia positive symptoms, psychosis, acute mania, AND HUNTINGTONS Toxicity: EPS-acute dystonia (sustained muscle contractions), akathisia (restlessness-treat with Beta blockers), Parkinsonism (tremor rigidity, bradykinesia-treat with anticholinergics (benztropine or diphenyhydramine) , increased LFTs, seizures BLUE SKIN, CORNEAL DEPOSITS galactorrhea Neuroleptic malignant syndrome: rigidity, myoglobinuria, autonomic instability, hyperpyrexia, Treat with dantrolene, D2 agonists (brmocriptine) Tardive dyskinesia: sterotpic oral-facial movements, lip smacking, chroathetoid movements

Answer 55

MOA: Facilitate GABA by increasing frequency of Cl- channel opening Decreases REM sleep Clinical: anxiety, spasticity, status epilepticus (diazepam), detoxification from alcohol delirum tremens, general anesthetic (amnesia muscle relaxation), hypnotic (insomnia) GOOD FOR ALCOHOL WITHDRAWAL, PRESURGERY ANXIETY Diazepam and chlrodizepoxide are first line treatment for seizures assoicated with alcohol withdrawal Toxicity: Less dependence (due to slower clearance), Higher daytime drowsiness (increased chance of falls), additive CNS ddepression effects with alcohol, less risk of respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly) decreased memory and concentration Avoid with alcohol, barbituates, neuroleptics and 1st gen antihistamines Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 56

For: lower functioning patient, psychotic, cognitively impaired, acute life crisis Focus: reinforce coping skills, build up adaptive defense mechanisms

Answer 57

blocks Na-voltage gated channels, increases GABA used for bipolar rapid cycling, mixed episodes Side effects: increased LFTs, teratogenic, hyponatremia, aplastic anemia

Answer 58

No acute use, used for mood stabilization Side effects: rash, cytopenias, multi-organ hypersensivity

Answer 59

MOA: increases GABA by increasing frequency of Cl- channel opening Short acting Uses: seizures, insomnia, GAD, Alcohol withdrawal Lethal with alcohol Toxicity: dependence, additive CNS depression with alcohol, less respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly), decreased memory and concentration LESS DROWSINESS SEVERE WITHDRAWAL SYMPTOMS AND HIGHER ADDICTIVE POTENTIAL Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 60

MOA: increases GABA by increasing frequency of Cl- channel opening Short acting Uses: seizures, GAD, Alcohol withdrawal INSOMNIA Lethal with alcohol Toxicity: dependence, additive CNS depression with alcohol, less respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly), decreased memory and concentration LESS DROWSINESS SEVERE WITHDRAWAL SYMPTOMS AND HIGHER ADDICTIVE POTENTIAL Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 61

MOA: Facilitate GABA by increasing frequency of Cl- channel opening Decreases REM sleep Clinical: anxiety, spasticity, status epilepticus (diazepam), detoxification from alcohol delirum tremens, general anesthetic (amnesia muscle relaxation), hypnotic (insomnia) GOOD FOR ALCOHOL WITHDRAWAL, PRESURGERY ANXIETY Diazepam and chlrodizepoxide are first line treatment for seizures assoicated with alcohol withdrawal Toxicity: Less dependence (due to slower clearance), Higher daytime drowsiness (increased chance of falls), additive CNS ddepression effects with alcohol, less risk of respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly) decreased memory and concentration Avoid with alcohol, barbituates, neuroleptics and 1st gen antihistamines Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 62

Increases GABA Used: bipolar disorder, alcohol dependenc, psychosis, agression, rapid cycling bipolar Side effects: teratogenic, hepatotoxic, thrombocytopenia, nausea, sedation, alopecia, pancreatitis

Answer 63

MOA: Facilitate GABA by increasing frequency of Cl- channel opening Decreases REM sleep Clinical: anxiety, spasticity, status epilepticus (diazepam), detoxification from alcohol delirum tremens, general anesthetic (amnesia muscle relaxation), hypnotic (insomnia) Diazepam and chlrodizepoxide are first line treatment for seizures assoicated with alcohol withdrawal Toxicity: Less dependence (due to slower clearance), Higher daytime drowsiness (increased chance of falls), additive CNS ddepression effects with alcohol, less risk of respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly) decreased memory and concentration Avoid with alcohol, barbituates, neuroleptics and 1st gen antihistamines Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 64

Cholinesterase inhibitor | Slows progression of Alzheimers

Answer 65

For sleep Not a BDZ But binds to same receptor No addiction and no withdrawal

Answer 66

Used in substance abuse Address ambivalence to change, non judgmental, enhance motivation to change

Answer 67

MOA: Facilitate GABA by increasing frequency of Cl- channel opening Decreases REM sleep Clinical: anxiety, spasticity, status epilepticus (diazepam), detoxification from alcohol delirum tremens, general anesthetic (amnesia muscle relaxation), hypnotic (insomnia) GOOD FOR ALCOHOL WITHDRAWAL, PRESURGERY ANXIETY Diazepam and chlrodizepoxide are first line treatment for seizures assoicated with alcohol withdrawal Toxicity: Less dependence (due to slower clearance), Higher daytime drowsiness (increased chance of falls), additive CNS ddepression effects with alcohol, less risk of respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly) decreased memory and concentration Avoid with alcohol, barbituates, neuroleptics and 1st gen antihistamines Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Answer 68

MOA: block reuptake of NE and 5HT Also block Na channels, Ach channels, alpha adrenergic, block histamine Clinical: major depression, fibromyalgia, painful diabetic neuropahty (insomnia with depression) LEAST SIDE EFFECTS, LEAST SEDATING Toxicity: Sedation alpha blocking: postural hypotension Anticholinergic: dry mouth, tachycardia, urinary retention, Confusion and hallucinations in elderly, hyperthermia, dilated pupils Na block: cardiotoxcity leads to death treat with NaHCO3, QT prolongation and cardiac dysrhthymias NaHCO3 can correct QRS prolongation, reverse hypotension and treat ventricular dysrhthymias Tri-Cs: convulsion, coma, cardiotoxicity Respiratory depression, hyperpyrexia (high fever) CAUTION in BPH

Answer 69

For: prominent physical symptoms that accompany psych symptoms Focus: improve awareness and control over physiological reactions Lower stress levels Integrate mind and body

Answer 70

MOA: Facilitate GABA by increasing frequency of Cl- channel opening Decreases REM sleep Clinical: anxiety, spasticity, status epilepticus (diazepam), detoxification from alcohol delirum tremens, general anesthetic (amnesia muscle relaxation), hypnotic (insomnia) Diazepam and chlrodizepoxide are first line treatment for seizures assoicated with alcohol withdrawal Toxicity: Less dependence (due to slower clearance), Higher daytime drowsiness (increased chance of falls), additive CNS ddepression effects with alcohol, less risk of respiratory depression and coma than barbiturates, sedation impairs coordination and balance (avoid in elderly) decreased memory and concentration Avoid with alcohol, barbituates, neuroleptics and 1st gen antihistamines Treat overdose with flumazenil (competitive antagonist at GABA benzodiazepine receptor)

Psychiatry Flashcards

(94 cards)