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Pharmacology > Psychiatry Drugs > Flashcards

Psychiatry Drugs Flashcards

1
Q

Typical Antipsychotics Overview (“Ant-Tie Psychiatrist”)

A

Indication: schizophrenia (“sketchy fern”), psychosis, acute mania, Tourette syndrome (“torn rat”).

Mechanism: D2 receptor antagonist (“block guy blocking doberman).

Properties: lipid soluable (“lips”, long half life).

Side Effects: galactorrhea; see high and low potency drugs.

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2
Q

High Potency Antipsychotics (“High Pot Ant-Tie Psychiatrist”)

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Drugs: trifluorperazine (“truffle-purse”); fluphenazine (“fluffy-nazi”); haloperidol (“halo-poodle”).

Side Effects: neurologic EPS symptoms (“X-pyramid”) including dystonia (“dice-stone”, muscle spasm), akathisia (restlessness), parkinsonism (“park-in-sun garage”, bradykinesia), and tardive dykinesia (“tar-dive disc-kite”, oral-facial movements).

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3
Q

Haloperidol (“Halo-Poodle”)

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Class: high-potency antipsychotic (“high pot ant-tie psychiatrist”).

Side Effects: EPS symptoms (“X-pyramid).

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4
Q

Fluphenazine (“Fluffy-Nazi”)

A

Class: high-potency antipsychotic (“high pot ant-tie psychiatrist”).

Side Effects: EPS symptoms (“X-pyramid).

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5
Q

Trifluoperazine (“Truffle-Purse”)

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Class: high-potency antipsychotic (“high pot ant-tie psychiatrist”).

Side Effects: EPS symptoms (“X-pyramid).

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6
Q

Low Potency Antipsychotics (“Low Pot Ant-Tie Psychiatrist”)

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Drugs: chlorpromazine (“color-pro”); thioridizine (“thor-diasy”).

Side Effects: non-neurologic symtoms including anticholinergic (“ant-tie cola”, dry mouth and costipation), antihistamine (sedation), and alpha-1 blockade (“anti-tie-afro-1-wand”, hypotension).

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7
Q

Chlorpromazine (“Color-Pro”)

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Class: low potency antipsychotic (“low pot ant-tie psychiatrist”).

Side Effects: corneal deposits (“corn-eyes”); non-neurologic symtoms.

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8
Q

Thioridazine (“Thor-Diasy”)

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Class: low potency antipsychotic (“low pot ant-tie psychiatrist”).

Side Effects: retinal deposits (“red-tin”); non-neurologic symtoms.

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9
Q

Atypical Antipsychotics (“A-Tipi Ant-Tie Psychiatrist”)

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Drugs: olanzapine; clozapine; quetiapine; rispiridone; aripiprazole; ziprasidone.

Indication: schizophrenia (“stetchy-fern”, both positive and negative symptoms); bipolar disorder; OCD; anxiety disorder; depression; mania; Tourette syndrome.

Mechanism: unknown; effects upon 5-HT2, dopamine, alpha, and H1 receptors.

Side Effects: fewer EPS (“X-pyramid falling off cliff”) and anticholinergic (“ant-tie-cola falling off cliff”) symptoms than traditional antipsychotics.

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10
Q

Olanzapine

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Class: atypical antipsychotic.

Side effects: weight gain (“up-arrow scale”)

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11
Q

Clozapine

A

Class: atypical antipsychotic.

Side effects: weight gain (“up-arrow scale”); agranulocytosis (“a-granny-side-toe”); siezure (“Caesar”).

MOST EFFECTIVE DRUG, BUT MANY SIDE EFFECTS!

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12
Q

Quetiapine

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Class: atypical antipsychotic.

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13
Q

Risperidone

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Class: atypical antipsychotic.

Side effects: hyperprolactinemia and subsequent effects.

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14
Q

Aripiprazole

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Class: atypical antipsychotic.

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15
Q

Ziprasidone

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Class: atypical antipsychotic.

Side effects: long QT (“stretched QT-heart”).

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16
Q

Lithium (“Lithium Battery”)

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Indication: mood stabilization (“mood-mask stabalized”) in bipolar disorder (“bi-polar bear”); SIADH.

Mechanism: unknown (“question-mark mechanism”).

Side Effects: tremor (“trimmer”); hypothyroidism (“hippo-thigh-droid”); nephrogenic DI (“kidney with dyed beads and sippy cup”); teratogen (“pregnant woman with caution tape”) = Ebstein enomaly (“Einstein heart”); heart block (“block in heart”); sedation; edema.

Elimination: KIDNEYS; contraindicated in renal failure; increased serum lithium in dehydration and salt-wasting diuretics; decreased serum lithium in increased salt intake.

NARROW THERAPEUTIC WINDOW!

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17
Q

Buspirone (“Bus-Piranha”)

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Mechanism: 5-HT1 agonist (“turning on 5-HT1 silver tonic receptors”); causes release of dopamine (“doberman on bus”) and norepinephrine (“north-epi-pen on bus”).

Indication: generalized anxiety disorder (“general with anxiety-bag”).

Side effects: very few (“low side-FX sign”); does not interact with alcohol (“martini ignored”, vs. barbiturates and benzos).

Other: takes 1-2 weeks to take effect.

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18
Q

SSRIs (“Selective Silver-Tonic Reuptake Tube with Inhibiting Chains”)

A

Drugs: fluoxetine (“flute-ox”); paroxetine (“pear-rockets”); sertraline (“search-light”); escitalopram (“Easter-ram”).

Mechanism: 5-HT specific reuptake inhibitors.

Indication: depression (“depressed emo playing claw machine”); gereralized anxiety disorder (“emo using anxiety-bag and general on search light”); panic disorder; OCD; bulimia; social phobias; PTSD.

Side effects: sexual dysfunction (“limp weiner in bun”); serotonin syndrome (“silver-tonic savage”); can initially cause anxiety; can cause mania in biopolar patients; do not combine fluoxetine or paroxetine with tamoxifen; escitalopram can cause long QT.

Other: can take 4-8 weeks to have effect.

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19
Q

Serotonin Syndrome (“Silver-Tonic Savage”)

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Cause: use of SSRI along with MAO-I, SNRI, TCA or linezolid.

Signs/symptoms: hyperthermia; confusion; myoclonus; CV collapse; flushing; diarrhea; seizures.

Treatment: cyrpoheptadine (“zipper-head”)

20
Q

SNRIs (“Silver-Tonic and North-Epi-Pen Reuptake Tube with Inhibiting Chains in SNRI Factory”)

A

Drugs: venlafaxine (“vanilla-fax”); duloxetine (“doll-ox”).

Mechanism: inhibits 5-HT and NE reuptake.

Indication: depression (“depressed emo working at factory”); generalized anxiety and panic disorders (“manager with anxiety bag and panic button”, venlafaxine); diabetic peripheral neuropathy (“dyed-bead pancrease with wavy-nerve-arms”; duloxetine).

Side effects: hypertension (“hiker-BP escaping from factory”); insomnia (“woman with eyes taped open”); decreased libido (“down-arrow libido-limbo guy escaping”); nausua (“woman vomitting”); sedation.

21
Q

Venlafaxine (“Vanilla-Fax”)

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Class: SNRI.

Indication: depression (“depressed emo”); generalized anxiety and panic disorder (“manager with anxiety bag and panic button”).

22
Q

Duloxetine (“Doll-Ox”)

A

Class: SNRI.

Indication: depression (“depressed emo”); diabetic peripheral neuropathy (“dyed-bead pancrease with wavy-neuron arms being saved by doll-ox”).

23
Q

TCAs (“Tricycle Ant-Tie Depressed Emo”)

A

Drugs (think about “tiling” for -iptyline and “ramen” for -ipramine): amitriptyline (“amish-trip-tiling”); nortriptyline (“north-trip-tiling”); imipramine (“i-map-ramen”); desipramine (“daisy-ramen”); clomipramine (“clam-map-ramen”); doxepin; amoxapine.

Mechanism: blocks reuptake of NE and 5-HT (“block in north-epi-pen and silver-tonic reuptake tube”).

Indication: major depression (“major-league depressed emo”); bed wetting (“bed with urine beneath i-map-ramen bowl”); fibromyalgia (“Fabio with mayo-algae causing the amish-trip-tiling”).

Side effects: anti-histamine (“ant-tie historian”); alpha-1 blocker (“block man with 1-wand blocking triceratops receptor”, postural hypertension); anticholinergic (“ant-tie-cola dumping cola on CNS brain); CNS effects (“attacked CNS brain”, sedation, siezure); respiratory depression; hyperpyrexia; **Tri-Cs **(“triceratops”) = convulsions (“Converse sneakers”), coma (“comb in brain”), cardiotoxicity (“toxic green heart”, arrhythmias, treat with NaHCO3).

24
Q

Amitriptyline (“Amish-Trip-Tiling”)

A

Class: TCA (“tricycle ant-tie depressed emo”).

Indication: depression; fibromyalgia (“fabio-mayo-algae”); chronic pain.

Side effects: more anticholinergic symptoms.

25
Q

Nortriptyline (“North-Trip-Tiling”)

A

Class: TCA (“tricycle ant-tie depressed emo”).

Indication: depression.

Side effects: less anticholinergic symptoms.

26
Q

Imipramine (“I-Map-Ramen”)

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Class: TCA (“tricycle ant-tie depressed emo”).

Indication: bed wetting (“urine on bed coming out of i-map-ramen pot”).

27
Q

Desipramine (“Daisy-Ramen”)

A

Class: TCA (“tricycle ant-tie depressed emo”).

Indication: depression.

Other: less sedating; narrow therapeutic window.

28
Q

Clomipramine (“Clam-Map-Ramen”)

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Class: TCA (“tricycle ant-tie depressed emo”).

Indication: OCD.

29
Q

MAO-Inhibitors (“Mao with Inhibiting Chains”)

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Drugs (“take pride in shanghai”): tranylcypromine (“train-zipper”); phenelzine (“funnel-Z on train”); isocarboxazid (“ice-car-box”); selegiline (“sledge-lion smashing ice-car-box”).

Mechanism: increases levels of amines NE, 5-HT, and dopamine (“up-arrow A-mines from emo’s hand”).

Indication: atypical depression (“A-tipi with emo”); anxiety; hypochondriasis.

Side effects: hypertensive crisis (“hiker-BP crying”); hypertensive crisis precipitated by eating tyramine containing foods such as wine and cheese (“wine and cheese party with Mao in caution tape”); serotonin syndrome when combined with SSRIs (“silver-tonic savage pulling table cloth while eating silver-tonic pills”).

Medication Contraindications: SSRIs, TCAs, St. John’s wort, meperidine and dextromethorphan.

30
Q

Tranylcypromine (“Train-Zipper”)

A

Class: MAO-I (“Mao in inhibiting chains”).

31
Q

Phenelzine (“Funnel-Z”)

A

Class: MAO-I (“Mao in inhibiting chains”).

32
Q

Isocarboxazid (“Ice-Car-Box”)

A

Class: MAO-I (“Mao in inhibiting chains”).

33
Q

Selegiline (“Sledge-Lion”)

A

Class: MAO-I (“Mao in inhibiting chains”).

34
Q

Buproprion (“Butt-propane”)

A

Class: atypical antidepressant (“emo smoking cigarette”).

Mechanism: unknown; increases NE (“north-epi-pen exploding upward”) and dopamine (“doberman exploding upward”).

Indication: depression (“emo”), especially if SSRI caused sexual dysfunction; smoking cessation (“emo smoking cigarette and no smoking sign”).

Side effects: stimulant side effects (“Caesar with red bull can”) including tachycardia and insomnia; seizure (“Caesar”) in bulimic patients.

35
Q

Mirtazapine (“Martha-Pine”)

A

Class: alpha-2 blocker (“afro-tutu block guy”).

Mechanism: increase release of NE and 5-HT via alpha-2 blockade; 5-HT receptor antagonist (“ant-toga blocking 5-HT receptor from Marth pouring silver tonic”).

Indication: depression (“fat depressed emo”).

Side effects: sedation (“sedating dart in emo”); increased appetite and weight gain (“fat emo sitting on up-arrow scale”); increase serum cholesterol (“emo eating burger”); dry mouth.

36
Q

Trazodone (“Tarzan-Bone”)

A

Class: atypical antidepressant.

Mechanism: 5-HT reuptake inhibitor (“inhibiting chains on silver-tonic reuptake tube”); block 5-HT and alpha-1 receptors.

Indication: insomnia (“Jane with eyes taped open”); depression.

Side effects: sedation (“sedation dart”); priapism (“Tarzan pitching a tent”, traza-bone); orthostatic hypertension (“oar-hippo-BP”).

37
Q

Benzodiazepines (“Benz-Dice”)

A

Drugs (think about “Z-Pam Anderson” for -zepam and “Z-lamb” for -zolam): diazepam; lorazepam; triazolam; temazepam; oxazepam; midazolam; chlordiazepoxide; alprazolam.

Mechanism: facilitate GABA action by increasing the frequency of chloride channel opening (“up-arrow revolving door on chloride-dispenser channel”).

Indication: anxiety (“pregnant woman with axiety bag”); spasticity; status epilecticus (“statue-Caesar”, first line); detoxification (“D-tux”, especially DTs); night terrors and sleep walking; induction of general anesthesia (“A-nest induction-duck”); insomnia.

Side effects: decreased REM sleep (“down-arrow sleeping rum bottle”); CNS depression (“deflated CNS-brain”); dependence (“dependence ball-and-chain on CNS-brain”); treat overdose with flumazenil (“flute-mace-nail”), a competative antagonist at GABA receptor.

38
Q

Short Acting Benzodiazepines (“Benz-Dice”)

A

Drugs: triazolam; oxazepam; midazolam.

Properties: higher addictive potential; decreased daytime fatigue and impaired judgement compared to long acting.

39
Q

Donepezil (“Donut-Puzzle”)

A

Class: acetylcholinesterase inhibitor (“a-seagull-cola-nest with inhibiting chains”).

Indication: Alzheimer’s disease (“old-timer clock being lead home by puzzle pieces”, slows decline in cognition and functional independence).

Side effects: nausua/vomitting (“seagull vomitting”); dizziness (“dizzy seagull”); insomnia; bradycardia.

40
Q

Memantine (“Mummy-Tin”)

A

Class: NMDA receptor antagonist (“NMDA receptor ant-toga”).

Mechanism: slows intracellular calcium influx and attenuates exictotoxic neuronal damage (“mummy-tin’s wrapping blocking excited-x-nerves”).

Indication: Alzheimer’s disease (“mummy-tin leading the old-timer home with his wrapping”).

Side effects: confusion (“Confucious”); hallucinations (“Halloween hallucination pumpkin”); dizziness (“dizzy-eyed pumpkin”)

41
Q

Methylphenidate (“Metal-Pheonix”)

A

Class: CNS stimulant (“CNS-brain with red bull can”)

Mechanism: increases catecholamines in synaptic cleft (“cat-cola in synaptic cleft”); increases NE and dopamine (“up-arrow north-epi-pen and doberman”).

Indications: ADHD (“AD-HeaD guy with multiple heads”).

Side effects: potential for abuse (“guy abusing red bull”); decreased appitite; decreased sleep; weight loss; growth retardation; tics; irritability; “zombie-like”; sudden death and cardiac toxicity (rare).

42
Q

Atomoxetine

A

Class: NE-reuptake inhibitor.

Indication: ADHD in youth and adults.

Advantages: single daily dosing; not a controlled substance.

Side effects: GI upset; loss of appitite; erectile dysfunction; insomnia; liver toxicity (rare).

43
Q

Fluoxetine (“Flute-Ox”)

A

Class: SSRI (“selective silver-tonic reuptake-tube with inhibiting chains”).

Notes: long half-life; do not combine with tamoxifin; appears safe in pregnancy.

44
Q

Sertraline (“Search-Light”)

A

Class: SSRI (“selective silver-tonic reuptake-tube with inhibiting chains”).

Notes: causes diarrhea.

45
Q

Paroxetine (“Pear-Rocket”)

A

Class: SSRI (“selective silver-tonic reuptake-tube with inhibiting chains”).

Notes: short half-life; do not combine with tamoxifen.

46
Q

Citalopram/Escitalopram (“Easter-Ram”)

A

Class: SSRI (“selective silver-tonic reuptake-tube with inhibiting chains”).

Notes: can cause long-QT at high doses.

Pharmacology (17 decks)

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