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Psychopharmacology Flashcards

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1
Q

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

A

Mesocortical

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2
Q

What dopamine pathway is associated with positive symptoms like delusions?

A

Mesolimbic

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3
Q

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

A

Nigostriatal

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4
Q

What dopamine pathway is associated with galactorrhea and gynecomastia?

A

Tubule infundibular

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5
Q

What serotonin receptors are responsible for depressive symptoms?

A

5HT1

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6
Q

What serotonin receptors are responsible for decreased libido symptoms?

A

5HT2

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7
Q

What serotonin receptors are responsible for gastrointestinal symptoms?

A

5HT3/4

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8
Q

What populations of patients should not be on antipsychotics?

A

People with arrhythmias, people with epilepsy

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9
Q

What effects do first generation antipsychotics have?

A

Anti adrenergic, antihistamine, anticholinergic (anti-muscarinic)

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10
Q

What is the target if second gen atypicals?

A

D2 and 5hT

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11
Q

What are the potential side effects of clozapine?

A

Agranulocytosis, seizures, hypotension

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12
Q

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

A

Seraquil, second gen antipsychotic, can cause orthostasis and sedation

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13
Q

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

A

Partial DA agonist (second generation) abilify,

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14
Q

What are the restrictions for MAOI use?

A

Food restrictions (Tyramine)

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15
Q

What are potential side effects of TCA agents?

A

Fatal in overdoses

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16
Q

What are potential uses of SNRIs?

A

comorbid pain syndrome

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17
Q

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

A

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

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18
Q

What are specific effects of mitazapine?

A

Promotes sleep and appetite

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19
Q

What are potential negatives side effects of lithium?

A

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

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20
Q

What are potential negative side effects of carbamazepine?

A

Steven Johnson rash, blood dyspraxia

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21
Q

What are potential negatives side effects of valproic acid?

A

Hepatitis, blood dyscrasia

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22
Q

What benzos are liver sparing?

A

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

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23
Q

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

A

Xanax - quick onset, short duration, high risk

Clonipin - long onset, long duration,
Low risk

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24
Q

What makes second generation antipsychotics different from first gen?

A

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

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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

Psych (17 decks)

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