Psychopharm Flashcards
(528 cards)
1
Q
What are the two forms of lithium, and what are they the first-line treatment for?
A
Lithium carbonate and lithium citrate are the front-line treatment for bipolar disorder.
2
Q
Clinically, why is it important to ask about ALL medications and changes in medications, not just psychiatric medications?
A
Because some medications, like hypertension and rheumatoid arthritis medications, can have psychological side effects.
3
Q
What does sodium pentothal cause?
A
Unconsciousness
4
Q
What is the risk of metabolism impairment when it comes to psychopharm?
A
Drug toxicity (poisoning due to high levels of the drug in the body because it can’t be metabolized correctly) and/or severe side effects
5
Q
What does Greek descent have to do with psychopharm?
A
Some people of Greek descent metabolize drugs very quickly, which means they’d see minimal symptom improvement at very high doses.
6
Q
What are five drugs that contain significant levels of caffeine, and why is that relevant?
A
Excedrin (pain reliever), Midol (pain reliever), Cafergot (migraines), Fiorinal (tension headaches), Fioricet (tension headaches).
These mimic symptoms of anxiety and panic disorders.
7
Q
What drug do you need to inquire about in someone with acne and depression/suicidal ideation?
A
Isotretinoin (Accutane) - can cause depression and SI
8
Q
What are the two types of drugs used to treat seasonal affective disorder?
A
SSRIs and MAO inhibitors
9
Q
How long do most antidepressants take to work?
A
2-4 weeks
10
Q
What are 7 drugs that can induce mania?
A
Amphetamines
Tricyclic antidepressants
SAM-e (osteoarthritis meds and OTC depression meds)
Antihypertensives
Prednisone (corticosteroid)
Anticholinergics (benztropine and trihexyphenidyl)
Levothyroxine (thyroid medication)
11
Q
If you’re treating bipolar disorder with an antidepressant, what else do you need to do?
A
Pair it with a mood stabilizing drug (antipsychotic) to avoid inducing mania
12
Q
Does bipolar disorder respond better to therapy or medication?
A
Medication, by a lot
13
Q
What is the one specific phobia that responds well to medication therapy, and why?
A
Social phobias, due to medications’ ability to mediate parts of our brain that activate to avoid rejection and abandonment
14
Q
What are 4 non-obvious drugs that can cause anxiety?
A
Steroids, asthma medications, nasal decongestants, and appetite suppressants
15
Q
Why is the locus coeruleus relevant for medication treatment for anxiety disorders?
A
Dysregulation here is thought to be a primary biological cause of anxiety disorders
16
Q
Why do some people with anxiety disorders self-medicate with opiates?
A
Opiates bind to the inhibitory receptors on the locus coeruleus, which acts as a natural brake and prevents the locus coeruleus from firing activation signals to the limbic system
17
Q
What two conditions is gabapentin used to treat?
A
Seizure disorders and anxiety disorders
18
Q
If propranolol (Inderal) is taken before a stressful event like a speech, what is its dosage?
A
10-80mg
19
Q
What type of drug is propranolol?
A
Beta blocker
20
Q
What do beta blockers do?
A
Prevent increased cardiac action (like a rapid heartrate) and reduce blood pressure
21
Q
Are benzodiazepines addictive?
A
Yes, if used for more than a few weeks.
22
Q
Why is medication treatment contraindicated in neurotic anxiety?
A
Medication can further block awareness of the underlying psychological conflict
23
Q
What percentage of patients have a relapse of panic disorder symptoms if they stop medication?
A
70%
24
Q
What are the two classes of medications used to treat panic disorder?
A
Benzodiazepines and antidepressants (specifically MAOIs)
25
What is the one antidepressant that should never be used to treat panic disorder and why?
Bupropion (Zyban and Wellbutrin), because it has been shown to exacerbate panic attacks
26
What is the symptom relapse rate for OCD if clients stop taking their medication?
95%
27
What is the only psychotherapy effective at treating OCD?
Exposure therapy (75-80% success rate after 25 sessions)
28
What is the % difference in dosing rate for OCD compared to depression?
OCD dosing rates are 50-100% higher - meaning they need more to see an effect
29
What drugs are most effective at treating OCD?
Antidepressants
30
What do 5-HT antidepressants do?
Increase the level of serotonin in the brain
31
What is the relapse rate for schizophrenia symptoms, with and without medication treatment?
70% relapse if they stop meds, 30-40% relapse even on meds
32
True or false: patients who have been psychotic longer prior to medication treatment have a poorer treatment response.
True
33
Why are Parkinson's medications sometimes used for schizophrenia?
To treat the extrapyramidal (movement-based) symptoms of schizophrenia
34
True or false: beta blockers are sometimes used for schizophrenia because they reduce akathisia.
True.
(Akathisia is an inability to sit still, and it is a common side effect of antipsychotics)
35
How long is the minimum recommended course of treatment for antipsychotics?
6 months
36
What drugs are best suited to treat hyperarousal in PTSD patients and why?
Antidepressants because they can inhibit hypersensitive norepinephrine receptors that cause hyperarousal
37
True or false: treatment with clonidine (Catapres and Kapvay) and beta-blockers immediately following a traumatic event may prevent brain damage from excessive adrenaline levels.
False. They may prevent brain damage due to excessive cortisol and glutamate levels.
38
What is the recommended antidepressant treatment length for PTSD?
9-12 months
39
What is the problem with treating PTSD with high doses of benzodiazepines and antipsychotics?
They may chemically induce a state similar to dissociation and prevent the person from accessing and working through the underlying trauma.
40
Are benzodiazepines an appropriate treatment for borderline personality disorder and why/why not?
No, because borderline patients are at high risk for dependency and abuse.
41
Should the antidepressant bupropion (Zyban and Wellbutrin) be used in borderline personality disordered patients and why/why not?
No, because bupropion is a dopamine agonist and may exacerbate psychotic symptoms.
42
Which types of antidepressants are at high risk for toxicity in overdose?
Tricyclic antidepressants and MAO inhibitors
43
What is the street name for phencyclidine?
PCP (stimulant)
44
What is the one commonly abused drug type that does not cause withdrawal symptoms or persisting symptoms following cessation of use?
Hallucinogens, specifically PCP
45
What commonly abused drug does not cause anxiety?
Opioids
46
What are the only two commonly abused drugs that cause dementia and amensia?
Alcohol and sedative-hypnotics (like benzos)
47
What is the brand name for disulfiram?
Antabuse
48
What is the generic name for Antabuse?
Disulfiram
49
What does disulfiram (Antabuse) do, and what is the appropriate dosing for it?
Encourages alcohol abstinence by causing nausea and vomiting when the person drinks alcohol. Dosage is 250-500mg daily.
50
What two drugs can reduce alcohol cravings post-detox?
Naltrexone and acamprosate (Campral)
51
What is the generic name for Campral?
Acamprosate
52
What is the brand name for acamprosate?
Campral
53
What can you give someone to reduce their alcohol intoxication?
Multivitamins, specifically those with thiamine and folate
54
What neurotransmitter system is highly activated during stimulant intoxication?
Dopamine
(Therefore, antipsychotics can reduce acute intoxication)
55
What is the brand name for propoxyphene?
Darvon
56
What is the generic name for Darvon?
Propoxyphene
57
What type of drug is propoxyphene (Darvon)?
Opioid
58
What is the brand name for meperidine?
Demerol
59
What is the generic name for Demerol?
Meperidine
60
What type of drug is meperidine (Demerol)?
Opioid
61
What is the brand name for pentazocine?
Talwin
62
What is the generic name for Talwin?
Pentazocine
63
What type of drug is pentazocine (Talwin)?
Opioid
64
What is the brand name for hydromorphone?
Dilaudid
65
What is the generic name for Dilaudid?
Hydromorphone
66
What type of drug is hydromorphone (Dilaudid)?
Opioid
67
What are the 2 brand names for oxycodone?
Percodan and Oxycontin
68
What is the generic name for Percodan and Oxycontin?
Oxycodone
69
What type of drug is oxycodone (Percodan and Oxycontin)?
Opioid
70
What are the 2 brand names for hydrocodone?
Vicodin and Damason-P
71
What is the generic name for Vicodin and Damason-P?
Hydrocodone
72
What type of drug is hydrocodone (Vicodin and Damason-P)?
Opioid
73
What is the chemical name for lysergic acid diethylamide?
LSD (hallucinogen)
74
What type of drug is mescaline?
Hallucinogen
75
How long does it usually take for the body to flush itself of hallucinogens?
12-24 hours
76
What substance addiction can bupropion (Zyban and Wellbutrin) be used to treat?
Nicotine addiction
77
What are the brand names for bupropion?
Zyban and Wellbutrin
78
What is the generic name for Zyban?
Bupropion
79
What is the brand name for varenidine?
Chantix
80
What is the generic name for Chantix?
Varenidine
81
What is varenidine (Chantix) used to treat?
Nicotine addiction
82
True or false: tranquilizers like Xanax, Ativan, and Valium, as well as sleeping pills, improve sleep.
False. They lead to poor sleep because they reduce the amount of time in deep sleep.i
83
Do decongestants improve or hinder sleep, and why?
Hinder, because many contain pseudoepinepherine
84
What type of medications are Sonata, Lunesta, Rozerem, and Ambien?
Sleeping pills (the good ones that don't reduce deep sleep)
85
What type of medication is Atarax?
Antihistamine
86
What is the brand name for zolpidem?
Ambien
87
What is the generic name for Ambien?
Zolpidem
88
What is the brand name for zaleplon?
Sonata
89
What is the generic name for Sonata?
Zaleplon
90
What is the brand name for eszopiclone?
Lunesta
91
What is the generic name for Lunesta?
Eszopiclone
92
What is the brand name for ramelteon?
Rozerem
93
What is the generic name for Rozerem?
Ramelteon
94
What is a common side effect of sleeping pills?
Amnesia/doing things you don't remember
95
What is the brand name for triazolam?
Halcion
96
What is the generic name for Halcion?
Triazolam
97
What two sleeping pills are most associated with amnesia?
Triazolam (Halcion) and zolpidem (Ambien)
98
What is the only sleeping pill that is not habit-forming?
Ramelteon (Rozerem)
99
What are the brand names for trazodone?
Desyrel and Oleptro
100
What is the generic name for Desyrel?
Trazodone
101
What is the brand name for quetiapine?
Seroquel
102
What is the generic name for Seroquel?
Quetiapine
103
What is the brand name for mirtazapine?
Remeron
104
What is the generic name for Remeron?
Mirtazapine
105
What type of drug is mirtazapine (Remeron)?
Sedating antidepressant (SNRI)
106
What does mirtazapine (Remeron) treat, and what is its dosage?
Depression and insomnia, 7.5-15mg for insomnia
107
What is the brand name for flurazepam?
Dalmane
108
What is the generic name for Dalmane?
Flurazepam
109
What does flurazepam (Dalmane) treat, and what is its dosage?
Insomnia, 15-60mg/day
110
What is the brand name for temazepam?
Restoril
111
What is the generic name for Restoril?
Temazepam
112
When temazepam (Restoril) is used to treat insomnia, what is its dosage?
15-30mg/day
113
When triazolam (Halcion) is used to treat insomnia, what is its dosage?
Insomnia, 0.25-0.5mg/day
114
What is the brand name for estazolam?
Prosom
115
What is the generic name for Prosom?
Estazolam
116
What does estazolam (Prosom) treat, and what is its dosage?
Insomnia and anxiety, 1-2mg/day
117
What is the brand name for quazepam?
Doral
118
What is the generic name for Doral?
Quazepam
119
What does quazepam (Doral) treat, and what is its dosage?
Insomnia, 7.5-15mg/day
120
What does zolpidem (Ambien) treat, and what is its dosage?
Insomnia and anxiety, 5-12.5mg/day
121
What does zaleplon (Sonata) treat, and what is its dosage?
Insomnia and anxiety, 5-10mg/day
122
What does eszopiclone (Lunesta) treat, and what is its dosage?
Insomnia and anxiety, 1-3mg/day
123
What does ramelteon (Rozerem) treat, and what is its dosage?
Initial insomnia, 4-16mg/day
124
What is the brand name for survorexant?
Belsomra
125
What is the generic name for Belsomra?
Survorexant
126
What does survorexant (Belsomra) treat, and what is its dosage?
Insomnia and anxiety, 10-20mg/day
127
What dosage of melatonin is appropriate to treat insomnia?
0.5mg/day
128
What dosage of diphenhydramine (Benadryl) is appropriate to treat insomnia?
25-100mg/day (1-4 pills)
129
When used to treat insomnia, what is the dosage for trazodone (Desyrel)?
25-100mg/day
130
What is the brand name for doxepin?
Silenor
131
What is the generic name for Silenor?
Doxepin
132
When used to treat insomnia, what is the dosage of doxepin (Silenor)?
3-6mg/day
133
Is sleep hygiene or medication most effective at treating insomnia?
Sleep hygiene
134
What three types of drugs can treat restless leg syndrome?
Dopamine agonists, benzodiazepines, and anticonvulsants
135
What two types of drugs can exacerbate restless leg syndrome?
Antihistamines and serotonergic antidepressants
136
What do haloperidol and pimozide treat?
Tourette Syndrome
137
What is the one and only drug that might help treat anorexia, and why?
Naltrexone (opiate agonist), because it mimics the endorphin high that results from fasting
138
What is the generic name for Wellbutrin?
Bupropion
139
Whar type of medication best treats bulimia?
SSRI antidepressants
140
Should bupropion (Zyban and Wellbutrin) be used to treat eating disorders, and why/why not?
No, because it increases risk of convulsions.
141
What is the brand name for topiramtate?
Topamax
142
What is the generic name for Topamax?
Topiramate
143
What type of drug is topiramate (Topamax), and what is it sometimes used to treat?
It is an anticonvulsant sometimes used to treat bulimia.
144
What is the street name for anoretic agents?
Diet pills
145
What is the brand name for lisdexamfetamine?
Vyvanse
146
What is the generic name for Vyvanse?
Lisdexamfetamine
147
What type of drug is lisdexamfetamine (Vyvanse), and what is it used to treat?
It is a psychostimulant that treats binge-eating disorder and ADHD.
148
What are 4 common side effects of lisdexamfetamine (Vyvanse)?
Dry mouth, insomnia, reduced appetite, and increased heart rate
149
What class of drug is used to treat dementia?
Acetylcholinesterase inhibitors
As the brain ages, there is a reduction in the level of the neurotransmitter acetylcholine, and this drug prevents the catalyzation of acetylcholine.
150
What are 3 examples of acetylcholinesterase inhibitors?
Rivastigmine, donepezil, and galantamine
151
What are brand names for phentermine?
Fastin and Ionamin
152
What is the generic name for Fastin and Ionamin?
Phentermine
153
What is phentermine (Fastin and Ionamin) used to treat?
Obesity
154
What should phentermine (Fastin and Ionamin) never be taken with?
SSRI antidepressants
155
What is the brand name for sibutramine?
Meridia
156
What is the generic name for Meridia?
Sibutramine
157
What does sibutramine (Meridia) treat?
Obesity
158
What do Orlistat, Contrave, and Qsymia treat?
Obesity
159
What is the brand name for lorcaserin?
Belviq
160
What is the generic name for Belviq?
Lorcaserin
161
What does lorcaserin (Belviq) treat?
Obesity
162
What class of medication is best for treating chronic pain?
Cyclic antidepressants
163
Dopamine, norepinephrine, and serotonin are examples of what?
Catecholamines
164
How does a monoamine oxidase inhibitor work?
Stops the function of monoamine oxidase, which breaks down catecholamines like dopamine and serotonin
165
What is the brand name for amitriptyline?
Elavil
166
What is the generic name for Elavil?
Amitriptyline
167
What is the brand name for clomipramine?
Anafranil
168
What is the generic name for Anafranil?
Clomipramine
169
What is the brand name for desipramine?
Norpramin
170
What is the generic name for Norpramin?
Desipramine
171
What is the brand name for imipramine?
Tofranil
172
What is the generic name for Tofranil?
Imipramine
173
What are the brand names for nortriptyline?
Pamelor and Aventyl
174
What is the generic name for Pamelor and Aventyl?
Nortriptyline
175
What are the three categories of side effects for tricyclic antidepressants?
Anticholinergic (things dry out), adrenergic (sweating, orthostatic hypotension, and sexual dysfunction), and antihistaminic (sedation and weight gain)
176
True or false: tricyclic antidepressants are difficult to overdose on.
False. They are very toxic.
177
Which two tricyclic antidepressants generally have the worst side effects?
Amitriptyline (Elavil) and doxepin (Silenor)
178
What is the brand name for fluoxetine?
Prozac
179
What is the generic name for Prozac?
Fluoxetine
180
What is the brand name for citalopram?
Celexa
181
What is the generic name for Celexa?
Citalopram
182
What is the brand name for escitalopram?
Lexapro
183
What is the generic name for Lexapro?
Escitalopram
184
What is the brand name for fluvoxamine?
Luvox
185
What is the generic name for Luvox?
Fluvoxamine
186
What is the brand name for paroxetine?
Paxil
187
What is the generic name for Paxil?
Paroxetine
188
What is the brand name for sertraline?
Zoloft
189
What is the generic name for Zoloft?
Sertraline
190
What type of antidepressant is amitriptyline (Elavil)?
Tricyclic
191
What type of antidepressant is clomipramine (Anafranil)?
Tricyclic
192
What type of antidepressant is despiramine (Norpramin)?
Tricyclic
193
What type of antidepressant is doxepin (Silenor)?
Tricyclic
194
What type of antidepressant is imipramine (Tofranil)?
Tricyclic
195
What type of antidepressant is nortriptyline (Pamelor and Aventyl)?
Tricyclic
196
What type of antidepressant is trazodone (Oleptro)?
Tricyclic
197
What type of antidepressant is fluoxetine (Prozac)?
SSRI
198
What type of antidepressant is citalopram (Celexa)?
SSRI
199
What type of antidepressant is escitalopram (Lexapro)?
SSRI
200
What type of antidepressant is fluvoxamine (Luvox)?
SSRI
201
What type of antidepressant is paroxetine (Paxil)?
SSRI
202
What type of antidepressant is sertaline (Zoloft)?
SSRI
203
Do tricyclic antidepressants or SSRIs have more side effects?
Tricyclics
204
What might happen after a few months of treatment with SSRIs, and what do you do about it?
Patients may develop a syndrome that mimics depression. They should add bupropion (Wellbutrin) or a stimulant.
205
What is the brand name for venlafaxine?
Effexor
206
What is the generic name for Effexor?
Venlafaxine
207
What is the brand name for desvenlafaxine?
Pristiq
208
What is the generic name for Pristiq?
Desvenlafaxine
209
What is the brand name for duloxetine?
Cymbalta
210
What is the generic name for Cymbalta?
Duloxetine
211
What is the brand name for levomilnacipran?
Fetzima
212
What is the generic name for Fetzima?
Levomilnacipran
213
What type of antidepressant is venlafaxine (Effexor)?
SNRI
214
What type of antidepressant is desvenlafaxine (Pristiq)?
SNRI
215
What type of antidepressant is duloxetine (Cymbalta)?
SNRI
216
What type of antidepressant is levomilnacipran (Fetzima)?
SNRI
217
Are SNRIs or SSRIs better at treating depression?
SNRIs, but they have more side effects than SSRIs
218
What is the brand name for atomoxetine?
Strattera
219
What is the generic name for Strattera?
Atomoxetine
220
What type of drug is atomoxetine (Strattera)?
NRI (norepinephrine reuptake inhibitor)
221
What is the brand name for reboxetine?
Vestra
222
What is the generic name for Vestra?
Reboxetine
223
What type of antidepressant is reboxetine (Vestra)?
NRI (norepinephrine reuptake inhibitor)
224
What is the brand name for nefazodone?
Serzone
225
What is the generic name for Serzone?
Nefazodone
226
What type of antidepressant is nefazodone (Serzone)?
Atypical
227
What is the spelled-out version of SNRI?
Serotonin and norepinephrine reuptake inhibitor
228
What should nefazodone (Serzone) never be used with?
Xanax
229
What is the brand name for buspirone?
BuSpar
230
What is the generic name for BuSpar?
Buspirone
231
What does buspirone (BuSpar) treat, and what is its dosage?
Anxiety, 10-40mg/day
232
What is the brand name for vilazodone?
Viibryd
233
What is the generic name for Viibryd?
Vilazodone
234
What type of antidepressant is vilazodone (Viibryd)?
Atypical
235
What is the brand name for vortioxetine?
Trintellix
236
What is the generic name for Trintellix?
Vortioxetine
237
What type of antidepressant is vortioxetine (Trintellix)?
Atypical
238
What food interactions increase the risk of a hypertensive crisis with MAOIs?
Foods high in tyramine, like fish, sausage, Italian meats, bananas, beef bouillon, and sauerkraut
239
What is the riskiest side effect of MAOIs?
Hypertensive crisis
240
What drug interactions increase the risk of a hypertensive crisis with MAOIs?
Stimulants, including decongestants and psychostimulants
241
What is the brand name for phenelzine?
Nardil
242
What is the generic name for Nardil?
Phenelzine
243
What is the brand name for tranylcypromine?
Parnate
244
What is the generic name for Parnate?
Tranylcypromine
245
What type of antidepressant is tranylcypromine (Parnate)?
MAOI
246
What type of antidepressant is phenelzine (Nardil)?
MAOI
247
What are the brand names for selegiline?
Deprenyl and Ensam (patch)
248
What is the generic name for Deprenyl and Ensam?
Selegiline
249
What comorbid physical and psychological conditions does selegiline (Deprenyl and Ensam) treat?
Parkinson's and depression
250
What type of antidepressant is selegiline (Deprenyl and Ensam)?
MAOI
251
What type of antidepressant is meclobemide?
MAOI
252
What is the brand name for troamphetamine?
Dexedrine
253
What is the generic name for Dexedrine?
Troamphetamine
254
What is the brand name for methylphenidate?
Ritalin
255
What is the generic name for Ritalin?
Methylphenidate
256
What type of drug is troamphetamine (Dexedrine)?
Stimulant
257
What type of drug is methylphenidate (Ritalin)?
Stimulant
258
What are stimulants like methylphenidate (Ritalin) and troamphetamine (Dexedrine) sometimes used to treat and why?
Depression, because they promote the release of catecholamines
259
Do people need to be on antidepressants for life?
Not usually, unless they have another episode of depression after the first course of treatment, then yes.
260
How long does it normally take for someone to develop physiological tolerance to antidepressant side effects?
1-2 weeks
261
What is the standard dose for the antidepressant amitriptyline (Elavil)?
75-300mg/day
262
What is the standard dose for the antidepressant clomipramine (Anafranil)?
75-200mg/day
263
What is the standard dose for the antidepressant desipramine (Norpramin)?
75-300mg/day
264
What is the standard dose for the antidepressant imipramine (Tofranil)?
75-300mg/day
265
What is the standard dose for the antidepressant nortriptyline (Pamelor and Aventyl)?
50-150mg/day
266
What is the standard dose for trazodone (Oleptro) when treating depression?
150-400mg/day
267
What is the standard dose for the antidepressant citalopram (Celexa)?
10-40mg/day
268
What is the standard dose for the antidepressant escitalopram (Lexapro)?
5-20mg/day
269
What is the standard dose for the antidepressant fluoxetine (Prozac)?
20-80mg/day
270
What is the standard dose for the antidepressant fluvomaxine (Luvox)?
50-300mg/day
271
What is the standard dose for the antidepressant paroxetine (Paxil)?
20-60mg/day
272
What is the standard dose for the antidepressant sertraline (Zoloft)?
50-200mg/day
273
What is the standard dose for the antidepressant atomoxetine (Strattera)?
60-120mg/day
274
What is the standard dose for the antidepressant bupropion (Wellbutrin)?
150-400mg/day
275
What is the standard dose for the antidepressant desvenlafaxine (Pristiq)?
50-400mg/day
276
What is the standard dose for the antidepressant duloxetine (Cymbalta)?
20-100mg/day
277
What is the standard dose for the antidepressant levomilnacipran (Fetzima)?
40-120mg/day
278
What is the standard dose for the antidepressant mirtazapine (Remeron)?
15-45mg/day
279
What is the standard dose for the antidepressant nefazodone (Serzone)?
100-600mg/day
280
What is the standard dose for the antidepressant venlafaxine (Effexor)?
75-350mg/day
281
What is the standard dose for the antidepressant vilazodone (Viibryd)?
10-40mg/day
282
What is the standard dose for the antidepressant vortioxetine (Trintellix)?
10-20mg/day
283
What is the standard dose for the antidepressant phenelzine (Nardil)?
30-90mg/day
284
What is the standard dose for the antidepressant selegiline (Ensam)?
6-12mg/day
285
What is the standard dose for the antidepressant tranylcypromine (Parnate)?
20-60mg/day
286
Why is family psychopharmacology relevant when it comes to medication selection?
If a family member responded to the medication, it's more likely this patient will, too.
287
True or false: people need to continue antidepressants for 9-12 months, even after symptoms go away, to ensure complete remission.
True
288
In terms of antidepressant side effects, what is activation?
Anxiety symptoms that occur within the first few hours of starting an antidepressant or increasing dosage
289
In terms of antidepressant side effects, what is switching?
A manic state, usually one that occurs a few weeks after starting an antidepressant or increasing dosage
290
What is a common misconception about taking medications that must be overcome to ensure compliance?
Considering the need for medications a "moral weakness" (meaning they weren't strong enough to overcome mental illness on their own)
291
What does St. John's wart treat, and what is its dosage?
Depression, 900-1800mg/day
292
What prescription drugs should St. John's wart not be taken with?
Any, including other antidepressants
293
What is the spelled-out name for the drug SAM-e?
S-adenosyl-methionine
294
What is SAM-e used to treat, and what is its dosage?
Depression, 400-1600mg/day
295
What mental illness can omega-3 fatty acids be used to treat, and at what dose?
Depression, 1-9g/day
296
True or false: it is safe to mix MAOIs and other types of antidepressants.
False.
297
How long does it take to see symptom reduction in bipolar disorder with lithium?
5-14 days, with full stabilization taking months
298
What does it mean when people say that lithium has as narrow therapeutic window?
The difference in dosage between the therapeutic dose and the toxic dose is very small.
299
What is the lithium dosage for someone in an acute manic state with bipolar disorder?
1200-1400mg/day
300
What is the maintenance lithium dose for someone with bipolar disorder?
600-1800mg/day
301
What organ's impairment is most likely to lead to toxic lithium buildup?
Kidneys (renal system)
302
What are 6 signs of lithium toxicity?
GI symptoms
Worsening of tremors
Confusion
Stupor
Slurred speech
Seizure
303
What are the brand names for carbamazepine?
Tegretol and Equetro
304
What is the generic name for Tegretol?
Carbamazepine
305
What is the brand name for divalproex?
Depakote
306
What is the generic name for Depakote?
Divalproex
307
What is the brand name for lamotrigine?
Lamictal
308
What is the generic name for Lamictal?
Lamotrigine
309
What is the generic name for Equetro?
Carbamazepine
310
What type of drug is carbamazepine (Equetro and Tegretol)?
Anticonvulsant
311
What type of drug is divalproex (Depakote)?
Anticonvulsant
312
What type of drug is lamotrigine (Lamictal)?
Anticonvulsant
313
What does carbamazepine (Tegretol and Equetro) treat, and what is its dosage?
Bipolar disorder, 600-1600mg/day
314
What does lamotrigine (Lamictal) treat, and what is its dosage?
Bipolar disorder, 50-300mg/day
315
What does divalproex (Depakote) treat, and what is its dosage?
Bipolar disorder, 750-1500mg/day
316
What two symptoms are indicative of carbamazepine (Equetro and Tegretol) toxicity?
Neurological and cardiac malfunctions
317
What two symptoms are indicative of divalproex (Depakote) toxicity?
Somnolence and coma
318
What symptom is indicative of lamotrigine (Lamictal) toxicity?
Rashes, including Stevens-Johnson syndrome (red, hive-y rash)
319
What is the brand name for oxcarbazepine?
Trileptal
320
What is the generic name for Trileptal?
Oxcarbazepine
321
What does oxcarbazepine (Trileptal) treat, and what type of drug is it?
It is an anticonvulsant that treats bipolar disorder.
322
What are the 2 concerns with giving a bipolar patient an antidepressant?
Inducing a manic episode and increasing the speed of cycling
323
Which 2 classes of antidepressants are preferred for bipolar patients?
SSRIs and bupropion (Wellbutrin)
324
How long do bipolar patients need to stay on their medication?
For life
325
What is the brand name for diazepam?
Valium
326
What is the brand name for chlorodiazepoxide?
Librium
327
What is the brand name for clonazepam?
Klonopin
328
What is the brand name for lorazepam?
Ativan
329
What is the brand name for alprazolam?
Xanax
330
What is the brand name for midazolam?
Versed
331
What is the generic name for Valium?
Diazepam
332
What is the generic name for Librium?
Chlorodiazepoxide
333
What is the generic name for Klonopin?
Clonazepam
334
What is the generic name for Ativan?
Lorazepam
335
What is the generic name for Xanax?
Alprazolam
336
What is the generic name for Versed?
Midazolam
337
What type of drug is diazepam (Valium)?
Benzodiazepine
338
What type of drug is chlorodiazepoxide (Librium)?
Benzodiazepine
339
What type of drug is clonazepam (Klonopin)?
Benzodiazepine
340
What type of drug is temazepam (Restoril)?
Benzodiazepine
341
What type of drug is lorazepam (Ativan)?
Benzodiazepine
342
What type of drug is alprazolam (Xanax)?
Benzodiazepine
343
What type of drug is triazolam (Halcion)?
Benzodiazepine
344
What type of drug is midazolam (Versed)?
Benzodiazepine
345
What does diazepam (Valium) treat, and what is its dosage?
Anxiety, 4-40mg/day
346
What does chlorodiazepoxide (Librium) treat, and what is its dosage?
Anxiety, 15-100mg/day
347
What does clonazepam (Klonopin)treat, and what is its dosage?
Anxiety, 1-8mg/day
348
What does temazepam (Restoril) treat, and what is its dosage?
Anxiety, 15-60mg/day
349
What does lorazepam (Ativan) treat, and what is its dosage?
Anxiety, 1.5-6mg/day
350
What does alprazolam (Xanax) treat, and what is its dosage?
Anxiety, 0.5-6mg/day
351
What does triazolam (Halciun) treat, and what is its dosage?
Anxiety, 0.125-0.5mg/day
352
What does midazolam (Versed) treat, and how is it delivered?
Anxiety, pre-measured injectable
353
What are the brand names for hydroxyzine?
Atarax and Vistaril
354
What is the generic name for Atarax and Vistaril?
Hydroxyzine
355
What does hydroxyzine (Atarax and Vistaril) treat, and what is its dosage?
Anxiety, 30-200mg/day
356
In addition to insomnia, what does diphenhydramine (Benadryl) treat, and what is its dosage?
Anxiety, 75-200mg/day (3-8 pills)
357
What is the brand name for propranolol?
Inderal
358
What is the generic name for Inderal?
Propranolol
359
What does propranolol (Inderal) treat, and what is its dosage?
Anxiety, 20-160mg/day
360
What is the brand name for atenolol?
Tenormin
361
What is the generic name for Tenormin?
Atenolol
362
What type of drug is atenolol (Tenormin)?
Beta blocker
363
What does atenolol (Tenormin) treat, and what is its dosage?
Anxiety, 25-100mg/day
364
What are the brand names for clonidine?
Kapvay and Catapres
365
What is the generic name for Kapvay and Catapres?
Clonidine
366
When used to treat anxiety, what is the dosage for clonidine (Kapvay and Catapres)?
0.2-0.9mg/day
367
When used to treat ADHD, what is the dosage for clonidine (Kapvay and Catapres)?
0.15-0.4mg/day
368
When used to treat anxiety, what is the dosage of doxepin (Silenor)?
3-25mg/day
369
What is the brand name for prazosin?
Minipress
370
What is the generic name for Minipress?
Prazosin
371
What does prazosin (Minipress) treat, and what is its dosage?
Anxiety and PTSD, 10-20mg/day
372
Can someone die from benzodiazepine withdrawal?
Yes
373
How long does it take to safely wean someone off benzodiazepines without encountering withdrawal symptoms?
A very long time. Don't decrease dosage by more than 5-10% per week.
374
What is the risk of combining alcohol and anxiety medications, especially benzodiazepines?
They can have an additive depressive effect (they're both downers), and therefore people can have respiratory depression or even become comatose.
375
What are neuroleptics?
First-generation antipsychotics
376
What two antipsychotic medications are most likely to cause sedation?
Chlorpromazine (Thorazine) and clozapine (Clozaril)
377
What three antipsychotic medications are most likely to cause extrapyramidal effects?
Fluphenazine (Prolixin), haloperidol (Haldol), and pimozide (Orap)
378
What two antipsychotic medications are most likely to cause anticholinergic effects?
Chlorpromazine (Thorazine) and clozapine (Clozaril)
379
Do first- or second-generation antipsychotics have more side effects?
First-generation antipsychotics
380
What two antipsychotic medications are most likely to cause metabolic effects?
Clozapine (Clozaril) and olanzapine (Zyprexa)
381
What is rapid neuroleptization?
The use of high doses of antipsychotic medications
382
Do most patients with schizophrenia need to be treated for life?
No. They can discontinue medications 1 year after symptom remission.
383
What is the brand name for chlorpromazine?
Thorazine
384
What is the brand name for fluphenazine?
Prolixin
385
What is the brand name for haloperidol?
Haldol
386
What is the brand name for loxapine?
Loxitane
387
What is the brand name for perphenazine?
Trilafon
388
What is the brand name for pimozide?
Orap
389
What is the brand name for aripiprazole?
Abilify
390
What is the brand name for asenapine?
Saphris
391
What is the brand name for brexpiprazole?
Rexulti
392
What is the brand name for cariprazine?
Vraylar
393
What is the brand name for clozapine?
Clozaril
394
What is the brand name for iloperidone?
Fanapt
395
What is the brand name for lurasidone?
Latuda
396
What is the brand name for olanzapine?
Zyprexa
397
What is the brand name for paliperidone?
Invega
398
What is the brand name for risperidone?
Risperidal
399
What is the brand name for ziprasidone?
Geodon
400
What is the generic name for Thorazine?
Chlorpromazine
401
What is the generic name for Prolixin?
Fluphenazine
402
What is the generic name for Haldol?
Haloperidol
403
What is the generic name for Loxitane?
Loxapine
404
What is the generic name for Trilafon?
Perphenazine
405
What is the generic name for Orap?
Pimozide
406
What is the generic name for Ability?
Aripiprazole
407
What is the generic name for Saphris?
Asenapine
408
What is the generic name for Rexulti?
Brexpiprazole
409
What is the generic name for Vraylar?
Cariprazine
410
What is the generic name for Clozaril?
Clozapine
411
What is the generic name for Fanapt?
Iloperidone
412
What is the generic name for Latuda?
Lurasidone
413
What is the generic name for Zyprexa?
Olanzapine
414
What is the generic name for Invega?
Paliperidone
415
What is the generic name for Risperdal?
Risperidone
416
What is the generic name for Geodon?
Ziprasidone
417
What type of medication is chlorpromazine (Thorazine)?
First-generation antipsychotic
418
What type of medication is fluphenazine (Prolixin)?
First-generation antipsychotic
419
What type of medication is loxapine (Loxitane)?
First-generation antipsychotic
420
What type of medication is perphenazine (Trilafon)?
First-generation antipsychotic
421
What type of medication is pimozide (Orap)?
First-generation antipsychotic
422
What type of medication is aripiprazole (Abilify)?
Second-generation antipsychotic
423
What type of medication is asenapine (Saphris)?
Second-generation antipsychotic
424
What type of medication is brexpiprazole (Rexulti)?
Second-generation antipsychotic
425
What type of medication is cariprazine (Vraylar)?
Second-generation antipsychotic
426
What type of medication is clozapine (Clozaril)?
Second-generation antipsychotic
427
What type of medication is iloperidone (Fanapt)?
Second-generation antipsychotic
428
What type of medication is lurasidone (Latuda)?
Second-generation antipsychotic
429
What type of medication is olanzapine (Zyprexa)?
Second-generation antipsychotic
430
What type of medication is paliperidone (Invega)?
Second-generation antipsychotic
431
What type of medication is quetiapine (Seroquel)?
Second-generation antipsychotic
432
What type of medication is risperidone (Risperdal)?
Second-generation antipsychotic
433
What type of medication is ziprasidone (Geodon)?
Second-generation antipsychotic
434
What is the appropriate dosage for chlorpromazine (Thorazine)?
50-1500mg/day
435
What is the appropriate dosage for fluphenazine (Prolixin)?
3-45mg/day
436
What is the appropriate dosage for haloperidol (Haldol)?
2-40mg/day
437
What is the appropriate dosage for perphenazine (Trilafon)?
8-60mg/day
438
What is the appropriate dosage for loxapine (Loxitane)?
50-250mg/day
439
What is the appropriate dosage for pimozide (Orap)?
1-10mg/day
440
What is the appropriate dosage for aripiprazole (Abilify)?
10-30mg/day
441
What is the appropriate dosage for asenapine (Saphris)?
5-20mg/day
442
What is the appropriate dosage for brexpiprazole (Rexulti)?
0.5-4mg/day
443
What is the appropriate dosage for cariprazine (Vraylar)?
1.5-6mg/day
444
What is the appropriate dosage for clozapine (Clozaril)?
300-900mg/day
445
What is the appropriate dosage for iloperidone (Fanapt)?
12-24mg/day
446
What is the appropriate dosage for lurasidone (Latuda)?
40-80mg/day
447
What is the appropriate dosage for olanzapine (Zyprexa)?
5-20mg/day
448
What is the appropriate dosage for paliperidone (Invega)?
3-12mg/day
449
What is the appropriate dosage for quetiapine (Seroquel)?
300-750mg/day
450
What is the appropriate dosage for risperidone (Risperdal)?
4-16mg/day
451
What is the appropriate dosage for ziprasidone (Geodon)?
40-160mg/day
452
True or false: there are medications that can be taken to reduce the Parkinson's-like and anticholinergic side effects of antipsychotic medications?
True.
453
What is the brand name for thioridazine?
Mellaril
454
What is the generic name for Mellaril?
Thioridazine
455
What type of medication is thioridazine (Mellaril)?
First-generation antipsychotic
456
What is the appropriate dosage for thioridazine (Mellaril)?
150-800mg/day
457
What is the brand name for trifluoperazine?
Stelazine
458
What is the generic name for Stelazine?
Trifluoperazine
459
What type of medication is trifluoperazine (Stelazine)?
First-generation antipsychotic
460
What is the appropriate dosage for trifluoperazine (Stelazine)?
10-40mg/day
461
What is folic acid used to treat, and what is its dosage?
Mood disorders, 400-500mg/day
462
What is ginkgo biloba used to treat, and what is its dosage?
Cognitive impairment (like memory loss), 30-240mg/day
463
What is yohimbine used to treat, and what adverse psychological effects might it cause?
It is used to treat erectile dysfunction, but it causes anxiety.
464
What is kava kava used to treat?
Anxiety
465
What form of ketamine is FDA-approved for the treatment of treatment-resistant depression?
Esketamine (injectable)
466
What is the chemical name for MDMA?
3,4-methylenedioxymethamphetamine
467
How can you mitigate the discontinuation side effects from psychiatric medications?
Slowly decrease the dose over multiple months instead of going cold turkey
468
What is the only common psychiatric disorder that usually requires lifelong medication?
Bipolar disorder
469
How does dosing in pre-pubescent children relate to adult dosing, and why?
It's generally the same because young children have a very high drug metabolism rate.
470
Why might children who are stable on a medication experience increased side effects when they enter puberty?
In puberty, children's drug metabolism slows down significantly, so side effects may increase.
471
What is an off-label drug?
A drug that is not approved by the FDA
472
What 3 types of stimulants are used to treat ADHD?
Methyphenidates, dextroamphetamines, and amphetamines
473
What is the brand name for dextroamphetamine?
Dexedrine
474
What is the generic name for Dexedrine?
Dextroamphetamine
475
What type of drug is dextroamphetamine (Dexedrine)?
Stimulant
476
What does dextroamphetamine (Dexedrine) treat, and what is its dosage?
ADHD, 5-40mg/day
477
When used to treat ADHD, what is the appropriate dosage for lisdexamphetamine (Vyvanse)?
30-70mg/day
478
What is the brand name for dexmethylphenidate?
Focalin
479
What is the generic name for Focalin?
Dexmethylphenidate
480
What does dexmethylphenidate (Focalin) treat, and what is its dosage?
ADHD, 5-20mg/day
481
What class of stimulant is Adderall?
Amphetamine
482
What does Adderall treat, and what is its dosage?
ADHD, 5-40mg/day
483
What class of stimulant is Ritalin?
Methylphenidate
484
What does Ritalin treat, and what is its dosage?
ADHD, 10-60mg/day
485
Metadate and Methylin are brand names for what drug?
Methylphenidates
486
Metadate and Methylin treat what, and what is their dosage?
ADHD, 10-60mg/day
487
What are the brand names for guanfacine?
Tenex and Intuniv
488
What is the generic name for Intuniv and Tenex?
Guanfacine
489
What does guanfacine (Intuniv and Tenex) treat, and what is its dosage?
ADHD, 0.25-1mg/day
490
What two antidepressants can be used to treat ADHD?
Bupropion (Wellbutrin) and atomoxetine (Strattera)
491
Is sadness or irritability more common in youth with depression?
Irritability
492
Do antidepressants increase suicidality in youth?
They increase suicidal ideation and actions, but not actual suicides.
493
True or false: most children with bipolar mania can be treated with one mood stabilizer.
False. Most need two.
494
What is a notable negative drug interaction for female patients on carbamazepine (Tegretol and Equetro) or oxazepine?
Carbamazepine and oxazepine reduce the body's ability to process birth control pills and can render them ineffective.
495
What class of drugs is best for OCD treatment in youth?
SSRIs
496
What is drug bioavailability?
The amount of the drug that actually reaches systemic circulation (represented as a %)
497
What risks might a patient run if they switch from a brand medication to a generic medication?
A decrease in bioavailability, even at the same dose, because of differences in manufacturing practices
498
What does it mean if a drug has an enteral route of administration?
It involves the GI system (oral and rectal)
499
What does it mean if a drug has a parenteral route of administration?
It does not involve the GI system (IV, IM, inhalation, transdermal, and through the mucous membranes)
500
True or false: most psychiatric drugs do not cross the placenta and affect the fetus.
False. Most drugs do cross the placenta.
501
True or false: some psychiatric medications can cause teratogenesis in fetuses.
True.
502
What is important to consider in geriatric psychopharmacology?
They're often on a lot of drugs, so make sure to be aware of drug-drug interactions and whether psych symptoms are a result of side effects from other drugs or are their own individual diagnosis.
503
Which three benzodiazepines are safest to use in elderly patients?
Oxazepam (Serax), lorazepam (Ativan), and temazepam (Restoril)
504
Which three benzodiazepines are riskiest to use in elderly patients?
Diazepam (Valium), chlordiazepoxide (Librium), and flurazepam (Dalmane)
505
Dosage of elderly patients is often at what percentage of dosage in younger patients?
30-50% that of younger patients
506
What three diagnoses is gabapentin empirically supported to treat?
Social anxiety disorder, panic disorder, and alcohol use disorder
507
What % THC is hemp and CBD?
Less than 0.3%
508
What % THC is hemp and CBD?
Less than 0.3%
509
What % THC is low-dose cannabis (the only type that has been studied for medicinal benefits)?
0.5-3%
510
What % THC is low-dose cannabis (the only type that has been studied for medicinal benefits)?
0.5-3%
511
What % THC can you get in OTC cannabis?
Up to 90%
512
What % THC can you get in OTC cannabis?
Up to 90%
513
What catecholemine does cannabis release?
Dopamine
514
True or false: people do not experience withdrawal symptoms when stopping cannabis use.
False
515
What two forms of cannabis ingestion are more likely to lead to psychosis, and why?
Dabs and vape pens because of how concentrated they are
516
What two forms of cannabis ingestion are more likely to lead to psychosis, and why?
Dabs and vape pens because of how concentrated they are
517
True or false: people with psychotic disorders will often use cannabis to reduce positive symptoms and/or medication side effects, which makes their psychosis worse.
True
518
True or false: people with psychotic disorders will often use cannabis to reduce positive symptoms and/or medication side effects, which makes their psychosis worse.
True
519
What are wax, butter, and shatter?
Cannabis dabs that have up to 99% THC
520
True or false: using high-% THC products leads to tolerance and makes low-% THC products ineffective.
True
521
What is Delta 8, and is it legal?
A psychoactive CBD-derivative
It is federally legal and unregulated (different in some states), as opposed to marijuana which is still federally illegal, because of the 2018 farm bill that legalized hemp.
522
What illegal drug is associated with an increase in early-onset dementia?
Cocaine
523
How long does it take for the effects of cocaine to wear off?
1-2 hours
524
How long does it take for the effects of alcohol to wear off?
1-2 hours
525
How long does it take for the effects of marijuana to wear off?
1-6 hours
526
How long does it take for the effects of ecstasy to wear off?
2-4 hours
527
How long does it take for the effects of meth to wear off?
4-12 hours
528
How long does it take for the effects of LSD/PCP/acid to wear off?
12 hours
