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Flashcards in Psychopharmacology Deck (76):
1

What dopamine pathway is associated with negative symptoms like social isolation and lack of hygiene?

Mesocortical

2

What dopamine pathway is associated with positive symptoms like delusions?

Mesolimbic

3

What dopamine pathway is associated with extra pyramidal symptoms such as tardive dyskinesia?

Nigostriatal

4

What dopamine pathway is associated with galactorrhea and gynecomastia?

Tubule infundibular

5

What serotonin receptors are responsible for depressive symptoms?

5HT1

6

What serotonin receptors are responsible for decreased libido symptoms?

5HT2

7

What serotonin receptors are responsible for gastrointestinal symptoms?

5HT3/4

8

What populations of patients should not be on antipsychotics?

People with arrhythmias, people with epilepsy

9

What effects do first generation antipsychotics have?

Anti adrenergic, antihistamine, anticholinergic (anti-muscarinic)

10

What is the target if second gen atypicals?

D2 and 5hT

11

What are the potential side effects of clozapine?

Agranulocytosis, seizures, hypotension

12

What is the brand name, type and side effects of quetiapine?

Seraquil, second gen antipsychotic, can cause orthostasis and sedation

13

What class of drug, brand name, side effects to apiprazole?

Partial DA agonist (second generation) abilify,

14

What are the restrictions for MAOI use?

Food restrictions (Tyramine)

15

What are potential side effects of TCA agents?

Fatal in overdoses

16

What are potential uses of SNRIs?

comorbid pain syndrome

17

What is a major advantage of bupropion and what is its mechanism of action?

No associated sexual dysfunction - works by acting on NE and dopamine receptors

18

What are specific effects of mitazapine?

Promotes sleep and appetite

19

What are potential negatives side effects of lithium?

Tremor, weight gain, GI symptoms, Neurotoxicity, thyroid dysfunction, diabetes insipidus, T wave depression

20

What are potential negative side effects of carbamazepine?

Steven Johnson rash, blood dyspraxia

21

What are potential negatives side effects of valproic acid?

Hepatitis, blood dyscrasia

22

What benzos are liver sparing?

Ativan (lorezepam), oxazepam (serax), tamezepam (restoril)

23

What benzos pose a high risk for abuse? What benzos pose a low
Risk? Why?

Xanax - quick onset, short duration, high risk

Clonipin - long onset, long duration,
Low risk

24

What makes second generation antipsychotics different from first gen?

Second gen - lower incidence of extrspyramidal effects but higher incidence of metabolic syndrome

25

What are possible extrapyramidal symptoms that can result?

dystonia, parkinsonism, akathisia

26

What schizophrenia medication is responsible for loss of night vision?

thioidazine

27

What are some common side effects of SSRIs?

sexual dysfunction, GI upset, headache, akathisia

28

What antidepressent should be avoided in patients with an eating disorder?

wellbutrin (buproprion)

29

What mood stabilizer and antipsychotic requires a pretreatment CBC to assess for agranulocytosis?

carbamazepine, clozapine

30

What is a screening test that should be performed for individuals on seroquel?

slit eye lamp exam for cataracts

31

What bipolar drug can cause birth defects?

valproate

32

What is the treatment for a benzodiazepine overdose?

flumenzenil

33

What are the symptoms of serotonin syndrome?

diarrhea, agitation, delirium, myoclonus, seizures

34

What medication has been shown to reduce suicidality in schizophrenics?

clozapine

35

What is the treatment for a MAO-I overdose?

low dose benzos

36

What are the symptoms of serotonin syndrome?

diaphoresis, tachycardia, myoclonic jerks, hyperthermia

37

Which benzodiazepines should be used in the treatment of alcohol withdrawal?

Lorazepam, oxazepam, tamezepam

38

What is a therapeutic level of lithium? What does lithium toxicity look like?

0.5-1; tremor, nausea, diarrhea, ataxia

39

How do you manage symptoms of akinesthia in a patient recently started on an antipsychotic?

prescribe beta blocker

40

What is a common side effect thioridazine?

retinal pigmentation

41

What tests should be performed when prescribing lithium?

electrolytes, thyroid studies, serum Cr BUN

42

How do stimulants affect the tics of tourette's?

exacerbate the tics

43

What drug should never be prescribed with lithium (or at least be super careful)

NSAIDS, HCTZ (increase levels)

44

What are some of the risks of SSRIs in pregnancy?

Persistent pulmonary hypertension

45

What is a risk to the newborn of lithium?

Epstein anomaly

46

What are the symptoms associated with SSRI discontinuation syndrome?

Dizziness, nausea, vomiting, fatigue and lethargy

47

What common medications can interfere with lamotrigine?

OCPs

48

What medication is most effective in the treatment of OCD?

Clomipramine

49

What antidepressent reduces seizure threshold?

wellbutrin

50

What are the risks associated with nefazaodone?

serious liver failure

51

What are the major types of SNRIs on the market?

venlafaxine (effexor) and duloxetine (cymbalta)

52

What kind of drug is trazodone?

serotonin receptor antagonist

53

What are the uses of cymbalta (dulextine)

neuropathic pain and depression

54

What are the side effects associated with lamictal?

SJS

55

How do you treat extrapyramidal side effects?

benzotropine (anti-cholinergic), antihistaminergic (benadryl), amantadine

56

What is the risk of TD if taking typical antipsychotic?

1% ever year

57

What class of drug is mirtazepine and what is it used for?

alpha2 receptor antagonist - used for refractory depression and insomnia

58

What class of drug is wellbutrin

norepinephrine/dopamine reuptake inhibitor

59

What are the antimuscarinic side effects?

blurred vision, weight gain, urinary retention, tachycardia

60

What class of medications is considered particularly effective in treating atypical depression?

MAOIs

61

What meds frequently recommended for panic disorder?

SSRIs, TCAs

62

What meds are frequently recommended for GAD?

SSRIs, venlafaxine

63

What meds are frequently recommended for enuresis?

TCA (imipramine)

64

What are the side effects associated with thorazine? What kind of med is it?

typical antipsychotic - low potency; orthostatic hypotension, nausea, vomiting, bluish skin discoloration

65

What are examples of high potency typical antipsychotic?

haldol, fluphenazine (prolixin)

66

How frequently does TD stay?

50% of cases spontaneously remit, 50% do not!

67

How do you treat anticholinergic side effects?

benzotropine

68

How do you treat extrapyramidal side effects?

benzotropine (anti-cholinergic), antihistaminergic (benadryl), amantadine

69

What is the risk of TD if taking typical antipsychotic?

1% ever year

70

What are some non -benzo hypotics and how do they work?

Zolpidem (ambien), eszopicone (Lunesta) -- > selective benzo receptor binding

Benadryl

Rozerem (selective melatonin agonist)

Non benzy anxiolytics:
-buspar - 5hT partial agonist
-hydroxyzine = antihistamine

71

What is the mechanism of action for Strattera?

presynaptic norepinephrine transporter inhibitor

72

What medications do you need to worry about taking with OCPs?

lamotrigine

73

What atypical antipsychotic truly reduces the risk of extrapyramidal symptoms?

clozapine

74

What typical antipsychotic is especially concerning for patients that have a change in their EKG?

pimozide

75

What medication is optimal for opioid detoxification?

buprenorphine - mixed opioid agonist/antagonist

76

What medication is optimal for treatment of binge eating disorder and bulimia?

topiramate