psychiatry Flashcards Preview

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Flashcards in psychiatry Deck (22):
1

Typical antipsychotics mechanism

Haloperidol, trifluoperazine, fluphenazine, thioridizine, chlorpromazine. D2 antagonists. Increase intracellular cAMP. Used for schizophrenia, psychosis, mania, tourettes.

2

High potency antipsychotics

Trifluoperadine, fluphenazine, haloperidol- Have lots of eps symptoms

3

Low potency antipsychotics

clorpromazine, thioridazine,. Have a lot of non-neurologic side effects like anticholinergic, antihistaminergic, a1 blockade

4

Toxicity of typical antipsychotics

Highly lipid soluble and stored in body fat so slow to be removed from system. Extrapyramidal side effects like dyskinesias. Endocrine side effects (hyperprolactinemia, menstrual arrest).

Dry mouth, constipation, hypotension, sedation

5

How to treat EPS of antipsychotics

Benztropine or diphenhydramine

6

Neuroleptic malignant syndrome and treatment

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia Treat with dantrolene or bromocriptine (d2 agonist).

Fever, encephalopathy, unstable vitals, increased inzymes, muscle rigity.

7

Tardive dyskinesia

Sterotypic oral facial movements as a result of lerg term antipsychotic use. Potentially irreversible

8

Atypical antipsychotics

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone.

Mechanism not completely understood. Varied effects on 5ht dopamine, alpha and histamine receptors

9

Atypical antipsychotics side effects

Fewer EPS and anticholineric side effects.

Olanzapine causes weight gain
Clozapine causes agranulocytosis and seizures
Risperidone can increaes prolactin.

Ziprasidone can prolong the QT interval.

10

Lithium

Used for bipolar, blocks relapse and used for acute panic events. Can be used for SIADH.

11

Lithium toxicity

Tremor, nephrogenic DI, hypothyroidism, ebstein's abnormality.

12

Buspirone

Stimulates 5HT1a receptors used for anxiety no sedation. Takes 1-2 weeks to work. Don't interact with alcohol.

13

Serotonin syndrome

Hyperthermia, confusion, myoclonus, diarrhea. Treat with cyprohepatidine

14

Cyproheptadine

5HT2 receptor antagonist used to treat serotonin syndrome.

15

SNRI

Venlafaxine, duloxetine. Used for depression, GAD/panic disorders, diabetic peripheral neuropathy. Increase in BP common, also some stimulant effects.

16

TCA

Amytriptyline, nortryptaline, imipramine, desipramine, clomipramine, amoxapine. Block reuptake of NE and serotonin. used for fibromyalgia. Sedation, a1 blocking effects like hypotension, anticholinergic side effects,

17

Clomipramine

Used for OCD

18

Which TCA have more anticholinergic effects?

Tertiary (amitripyaline)

19

Desipramine

less sedation but can cause serizures.

20

TCA toxicity

Convulsions, coma, cardiotoxity. Treat with NAHCO3 for arrythmias.

21

MAOI causing serotonin syndrome

SSRIs TCA st johns wort, meperidine, dxm

22

Buproprion

Increase NE and DA. simtulant, no sexual side effects. Can cause seizures in bulemia patients. No sexual side effects.