Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Psychiatry > Psychopharm > Flashcards

Psychopharm Flashcards

(69 cards)

Start Studying
1
Q

What are the HAM side effects? What classes have them (2)?

A

H- antiHistamine- sedation weight gain
A- antiAdrenergic- hypotension
M-antiMuscarinic- dry mouth, blurred vision, urinary retention
Classes- TCAs (imipramine, amitriptyline, doxepin, etc) and low potency antipsychotics (clozapine, olanzapine, risperidone, quetiapine, etc)

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

What is serotonin syndrome? What are some drugs that cause it?

A

Too much serotonin causing neuromuscular (clonus, hyperreflexia), autonomic instability (increased BP, HR, temp), cognitive (AMS), and and GI distress
SSRIs and one of the following- MAOIs, tramadol, triptans, MDMA, cocaine, etc)

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

What is the treatment for extrapyramidal side effects of neuroleptics?

A

Benzotropine- anticholinergic

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

What are the extrapyramidal side effects? What drugs cause them? How long until they can be seen?

A

Parkinson like symptoms, akthisia (treat with propanolol), dystonia
Occurs with typical antipsychotics (haloperidol, fluphenazine, chlorpromazine, etc)
Can occur within days

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

What lass of drugs can cause hyperprolactinemia?

A

Typical antipsychotics AND risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Neuroleptic malignant syndrome? Treatment?

A

Looks like serotonin syndrome without GI distress
Autonomic instability, “lead pipe” rigidity, AMS
Check CPK levels
Treat with cooling blankets and dantrolene

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

What disorders are only treated by SSRIs? (6)

A 
OCD
Pre-menstrual dysphoric disorder
PTSD
Social Anxiety long term
Premature Ejaculation
Hot Flashes (specifically Paroxetine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What typically causes “brain zaps”, anxiety, irritability, dizziness, and headaches?

A

Serotonin rapid discontinuation

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

What class of drugs can treat fibromyalgia, chronic back pain due to OA, and neuropathic pain

A

SNRIs, specifically duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What % of patients will respond to antidepressants?

A

30-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the black box warning for SSRIs?

A

Increased suicidal thinking and behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
What makes the following SSRIs special?
Fluoxetine
Sertraline
Paroxetine
Fluvoxamine
Citalopram
Escitalopram
A

Fluoxetine- longest half life no need to taper
Sertraline- highest risk for GI side effects
Paroxetine- short half life, more anticholinergic side effects (sedation, constipation)
Fluvoxamine- only approved for OCD
Citalopram- no CYP effects
Escitalopram- no CYP effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pneumonic for SSRI side effects?

A

Sex
Stomach
Restlessness
Insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
What is special about the following SNRIs?
Duloxetine
Venlafaxine
Desvenlafaxine
Savella
A

Duloxetine- used for fibromyalgia or neuropathic pain, contraindicated in liver disease
Venlafaxine- can increase BP
Desvenlafaxine- metabolite of venlafaxine
Savella- none, used for fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is buproprion MOA, uses, side effects, special facts?

A

MOA- NE and dopa reuptake inhibitors
Uses- depression, smoking cessation, ADHD and obesity (causes weight LOSS) are off label
Side effects- lowers seizure threshold, headache, insomnia
Contraindicated in people with eating disorders
NO SEXUAL side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is vilazodone MOA, uses, side effects?

A

SSRI and partial serotonin 1a agonist
Used for depression
Side effects similar to SSRIs- diarrhea and nausea are common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is trazodone and nefazodone MOA, uses, side effects?

A

MOA- serotonin antagonist and reuptake inhibitor
Uses- refractory depression and insomina
Side effects- dizziness, orthostatics, sedation, and priapism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the black box warning for nefazodone?

A

Liver failure

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

What is mirtazapine MOA, uses, side effects?

A

MOA- alpha 2 agonist, SNRI, and serotonin antagonist
Uses- refractory depression, good for elderly as helps with sleep or patients who need to gain weight
Side effects- WEIGHT GAIN, sedation, dizziness, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment of TCA overdose?

A

Sodium Bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the side effects of TCAs (7)? Which of these can be used as advantages (4)?

A

Anti-histamine
Anti-adrenergic
Anti-muscarinic
Cardiotoxicity- get EKG!
Convulsions
Coma
LETHAL IN OVERDOSE- assess suicide risk
Urinary retention- use imipramine to treat enuresis
Sedation- doxepin used to treat insomnia
Anti-histamine- doxepin used to treat itching
IBS, neuropathic pain, migraines- use amytriptyline to treat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q 
What makes these TCAs special? MOA of TCAs?
Amitriptyline
Imipramine
Clomipramine
Doxepin
Nortriptyline
Desipramine
Amoxapine
Trimipramine
Protryptiline
A 
MOA- inhibits reuptake of 5HT and NE
Amitriptyline- used for IBS, migraines
Imipramine- used in enuresis, IM form
Clomipramine- used in OCD
Doxepin- used for insomnia and itching
Nortriptyline- less orthostatics
Desipramine- least anticholinergic, less sedation
Amoxapine- similar side effects of antipsychotics
Trimipramine- none
Protryptiline- none
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the dosing and treatment strategies for antidepressants?

A

Start low and titrate as tolerated
At least 6 weeks at maximum dose if no side effects seen
Then switch to other classes
Then augmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Phenelzine, Tranylcypromne, Isocarboxazid, selegiline- MOA, uses, side effects, anything special?

A

MAOIs- prevent the break down of NE, 5HT, dopa, and tyramine
Used for atypical or refractory depression
Major side effect profile- serotonin syndrome with SSRIs, hypertensive crisis and many more
Selegiline has a patch that can avoid hypertensive crisis via certain foods- does not affect MAO in the gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are three things to monitor when prescribing lithium?
Creatinine, lithium and thyroid levels
26
What does potency mean when discussing antipsychotics?
Action on dopamine receptors
27
Which typical antipsychotics are considered low potency and how are they special (3)?
Chlorpromazine, mesoridazine, and Thioridazine Have lower affinity for dopamine, more anticholinergic and antihistaminic side effects, less EPS side effects Chlorpromazine- photosensitivity, can treat hiccups Thioridazine- associated with retinitis pgimentosa Mesoridazine
28
What are the midpotency typical antipsychotics and how are they special (4)?
Loxapine, Thiothixene, trifluoperazine, perphenazine Have midrange properties for affinity and side effects Loxapine- high risk of seizure Thiothixene- can cause ocular pigment changes Trifluoperazine- can reduce anxiety Perphenazine- can treat nausea and vomiting in pregnant women
29
Other typical antipsychotics to know and why (1)?
Molindone- described as both typical and atypical, causes weight loss
30
What are the high potency typical antipsychotics and how are they special (3)?
Haloperidol, Fluphenazine, Pimozide Highest affinity for dopamine receptors, more EPS side effects, greatest risk for tardive dyskinesia, less anticholinergic and antihistaminic effects
31
What two drugs have been shown to decrease risk of suicide?
Lithium and clozapine
32
What class of drugs cause metabolic syndrome?
Atypical antipsychotics
33
Which atypical antipsychotics are FDA approved for Depression?
Quetiapine
34
Which atypical antipsychotics are FDA approved for maintenance of bipolar disorder?
Quetiapine, olanzapine, aripiprazole, ziprasidone
35
Which atypical antipsychotics are FDA approved depression as augmentation with at least one other drug?
Aripiprazole
36
Which brain pathway is responsible for positive schizophrenia symptoms?
Mesolimbic
37
Which brain pathway is responsible for negative schizophrenia symptoms?
Mesocortical
38
``` What makes the following atypical antipsychotics special? MOA of atypicals? Clozapine Risperidone Quetiapine Olanzapine Ziprasidone Aripiprazole Paliperidone Asenapine Iloperidone Lurasidone ```
MOA- 5HT2A and D2 receptors blockade Clozapine- more efficacious than any other antipsychotic, can cause agranulocytosis or myocarditis, orthostatics Risperidone- hyperprolactinemia, has long acting indictable form Quetiapine- less EPS side effects, more sedation, lots of FDA approvals Olanzapine- lowest discontinuation, weight gain is common Ziprasidone- less weight gain Aripiprazole- less sedating, can be used as adjunct treatment for depression Paliperidone- metabolite of risperidone, long acting forms Asenapine- none Iloperidone- none Lurasidone- none
39
What stimulants are used in narcolepsy, OSA?
Modafanil, Armodafinil
40
What are the stimulants used in ADHD and refractory depression (5)? MOA? Biggest side effect?
Dextroamphetamine, Amphetamine salts, Lis-Dextroamphetamine, Methamphetamine, Methylphenidate Inhibit reuptake of dopamine and NE Major potential for abuse Weight loss, insomnia, and hypertension are other side effects
41
What is the MOA of amphetamines?
Taken up by VMAT causing release of dopamine, NE, and 5HT
42
What are some side effects of Methylphenidate?
Leukopenia, anemia, increased LFTs, weight loss, insomnia | Stimulant used for AHDHD
43
What is atomoxetine MOA, uses, side effects?
Presynaptic NE transporter inhibitor Used for ADHD Side effects- LESS appetite suppression and insomnia
44
What is Guanfacine and C ionidine MOA, uses, side effects?
MOA- alpha 2 agonist, located in prefrontal cortex leading to increased attention Uses- ADHD, HTN, anxiety, Tics, withdrawal of alcohol, opioids Side effects- abdominal pain, constipation, dry mouth, headaches
45
What is the difference between methadone and buprenorphine?
Methadone is just an agonist while buprenorphine is an agonist and antagonist Buprenorphine is more efficacious- has longer duration of action
46
What is acamprosate MOA, uses, side effects?
MOA- reduces excitatory glutamate and increases GABA Used for alcohol dependance GI side effects common Can be used in liver failure as not hepatically metabolized
47
What is Naltrexone MOA, uses, and side effects?
MOA- blocks mu opioid receptor preventing alcohol from binding Uses- alcohol dependance Side effects- n/v, eosinophilic PNA, hepatocellular injury
48
What is disulfiram MOA, uses?
MOA- inhibits aldehyde dehydrogenase that causes nausea, vomiting, diaphoresis, flushing, and dyspnea when alcohol is consumed Used for alcohol dependance
49
What alpha 2 agonist can be used for ADHD?
Clonidine
50
What mood stabilizer typically causes SJS? (2)
Lamotrigine is most common | Also Carbamazepine
51
What are the side effects of carbamazepine (6)?
SJS, GI distress, CNS effects, HYPONATREMIA, Hepatitis, Teratogenic
52
What should be monitored when giving a patient Valproic Acid/ Depakote?
LFTs!!
53
What mood stabilizer causes fine tremor?
LITHIUM
54
Lithium uses, side effects (7)? Special considerations (2)
Used for acute mania and maintenance of bipolar disorder, also schizoaffective disorder Side effects- Tremor, AMS, diabetes insipidus, ECG changes, weight gain, hypothyroid, Ebstein's anomaly (teratogen) MONITOR BLOOD LEVELS and kidney function, avoid NSAIDs
55
Carbamazepine MOA, uses
Blocks Na channels inhibiting action potentials | Used for mixed episodes and rapid cycling bipolar disorder
56
What are two advantages of oxcarbazepine vs carbamazepine?
Better tolerated | Less risk of rash and hepatic toxicity
57
Two uses for gabapentin other than anticonvulsant?
Anxiety, insomnia
58
Two uses for pregabalin other than anticonvulsant?
GAD, fibromyalgia
59
Topiramate uses, side effects (4)
Used for anxiety and impulse control | Side effects- Weight loss is advantage, metabolic acidosis, kidney stones, COGNITIVE SLOWING
60
Long acting BZDs? (4)
Diazepam, Clonazepam, Flurazepam, Clorazepate,
61
Intermediate acting BZDs? (5)
Alprazolam, Lorazepam, Oxazepam, Temazepam, Chlordiazepoxide
62
Short acting BZDs?
Triazolam, Midazolam
63
Side effects of BZDs (5)
Drowsiness, Amnesia, Decreased coordination, Withdrawal, Respiratory depression
64
Buspirone MOA, uses, side effects?
MOA- 5HT-1A receptor partial agonist Used for GAD Few side effects, low potential for abuse
65
Hydroxyzine MOA, uses, side effects
MOA- antihistamine Uses- Anxiety- quick acting Side effects- sedation, dry mouth, constipation, urinary retension
66
Propanolol uses (2)
Performance anxiety, Akathisia
67
Clonidine MOA, uses (2), side effects (3)?
MOA- alpha 2 agonist Uses- ADHD, anxiety, Side effects- dizziness, orthostatic hypotension, somnolence
68
Zolpidem, Zalelpon, Eszopiclone MOA, uses, side effects (4)
MOA- BZD receptor 1 agonist Uses- insomnia Side effects- GI distress, amnesia, hallucinations, sleepwalking
69
Ramelteon MOA
Melatonin receptor agonist

Psychiatry (2 decks)

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