Psychopharmacology

Question 1

Major classes of psychotropic medications (5)

Answer 1

Antipsychotics, antidepressants, antianxiety agents, mood stabilizers, stimulants

Question 2

Most common Typical or Traditional Antipsychotics (Neuroleptics or Major Tranquilizers)

Answer 2

Thorazine (chlorpromazine)
Prolixin (fluphenazine)
Haldol (haloperidol)

Question 3

Traditional Antipsychotics better at treating ___ sxs of psychosis

Answer 3

Positive- hallucinations, delusions, disorganized thinking

Question 4

Atypical or Novel Antipsychotics

Answer 4

Clorazil (clozapine)
Risperdal (risperidone)
Zyprexa (olanzapine)
Seroquel (quetipine)
Geodon (ziprasidone)
Abilify (ariprazole)

Question 5

Atypical Antipsychotics are equally effective in treating __ and __ sx of schizophrenia. They are often preferred over traditional antipsyh meds because they does not cause ____ ______.

Answer 5

Positive; Negative

Extrapyramidal symptoms

Question 6

Disorders treated with Antipsychotics

Answer 6

Schizophrenia
Delirium
Brief Psychotic Disorder
Tourette's Disorder
Autism/PDD
PTSD
Depression
Delusional Disorder
Some indications for dementia

Question 7

Common side effects of lower potency antipsychotics

Answer 7

Sedation, anticholinergic effects, hypotension, lowers seizure threshold

Question 8

Common side effects of high potency antipsychotics

Answer 8

Extrapyramidal sxs

Question 9

___ ____ is a potential side effect of all traditional antipsychotics

Answer 9

Tardive dyskinesia

Question 10

Anticholinergic Effects

*Hint: Dry everything out or hold it in

Answer 10

Dry mouth
constipation
urinary retention
blurred vision
nasal congestion
confusion
decreased memory

Question 11

Orthostatic hypotension

Answer 11

lightheaded when stand up

Question 12

Treatment of Extrapyramidal Sxs

Answer 12

Anticholinergic agents (Cogentin, Artane)

Question 13

Extrapyramidal Symptoms

Answer 13

Mvmt related sxs
Parkinsonism-shuffling, tremor, mask face, rigidity
Akathisia: dysphoria, agitation, rocking, shifting wt
Dystonia-painful spasms in neck, back, tongue, larynx

Question 14

Tardive dyskinesia

Answer 14

Abnormal movements of the lips, tongue, jaw, limbs, and trunk
generally arises 6 months after tx, plateaus after 3 to 6 yrs

Question 15

Tx of Tardive dyskinesia

Answer 15

Monitoring pts to see if med needs to be changed or dosage reduced
Neuroleptics temporarily reduce sxs

Question 16

The Atypical Antipsychotic with no side effect of tardive dyskinesia

Answer 16

Clozaril (clozapine)

Question 17

What types of medications exacerbate tardive Dyskinesia?

Answer 17

anticholinergic agents

Question 18

Agranulocytosis

Answer 18

Potentially lethal side effect, mostly assoc w/Clozaril (clozapine)
Sudden drop in granulocyte count leading to sore throat & high fever

Question 19

___ is the atypical antipsychotic that is only prescribed when other antipsychotics have failed due to risk of lethal side effect, ___.

Answer 19

Clozaril; agranulocytosis

Question 20

True of False: Antipsychotics can cause addiction and tolerance

Answer 20

False, but there can be withdrawal if a high dosage is stopped suddenly

Question 21

Most Common Tricyclic Antidepressants (TCAs)

*Hint: end w/”amine” or “tyline”

Answer 21

Elavil (amitriptyline)
Anafranil (clomipramine)
Tofranil (imipramine)

Question 22

SSRIs

Answer 22

Prozac (fluoxetine)
Zoloft (sertraline)
Paxil (paroxetine)
Cymbalta (duloxetine)
Strattera (atomoxetine)
Serafem (fluoxetine)
Luvox (fluvoxamine)
Celexa (citalopram)
Lexapro (escitalopram)

Question 23

Monoamine Oxidase Inhibitors (MAOIs)

Answer 23

Inhibit activity of monoamine oxidase
Nardil (phenelzine)
Parnate (tranylcypromine)

Question 24

Mechanism of Action of Antidepressants

Answer 24

Most block reuptake of norepinephrine and/or serotonin

Question 25

Common meds for depression w/sleep problems

Answer 25

Desyrel (trazodone) Sinequan (doxepin) Due to hypnotic effects

Question 26

Common tx for psychotic depression

Answer 26

TCAs combined w/antipsychotic

Question 27

Common tx for inpt, melancholic, geriatric depression

Answer 27

TCAs

Question 28

Common tx for atypical depressions

Answer 28

Treatment resistant depressions, depr w/panic disorder MAOIs SSRIs may eventually be effective too

Question 29

Best tx for mild depression

Answer 29

psychotherapy; placebos equally effective as medication

Question 30

Tricyclics can induce ___ in 10-15% of patients

Answer 30

Mania

Question 31

Common tx for Panic Disorder

Answer 31

Tofranil (imipramine) Paxil (paroxetine) Prozac (fluoxetine)

Question 32

Common tx of OCD

Answer 32

Anafranil (clomipramine) | Prozac & other SSRIs

Question 33

Common tx of Chronic Pain

Answer 33

TCAs Elavil (amitryptiline) Norpramin (desipramine) Sinequan (doxepin)

Question 34

Common tx of bulimia

Answer 34

SSRIs | TCAs (Norpramin, Tofranil)

Question 35

Common tx of premature ejaculation

Answer 35

TCA- Anafranil (clomipramine) | SSRI- Paxil (paroxetine)

Question 36

Side effects of Tricyclics

Answer 36

TCAs can trigger mania in bipolar patients Anticholinergic effects (dry mouth, memory issues, confusion) Sedation Orthostatic hypotension Weight gain Nausea Sexual dysfunction

Question 37

Side effects of SSRIs

Answer 37

``` Headaches Nervousness Restlessness Insomnia GI distress sexual dysfunction ```

Question 38

Side effects of MAOIs

Answer 38

``` Orthostatic hypotension Weight gain Edema Sexual dysfunction Insomnia Tyramine Induced Hypertensive Crisis (must follow strict dietary guidelines to avoid excess tyramine) ```

Question 39

2 Classes of Antidepr that are highly lethal by overdose

Answer 39

TCAs | MAOIs

Question 40

Contraindicators for TCAs

Answer 40

heart conditions High BP seizures

Question 41

what is the most common side effect of antipsychotic medications?

Answer 41

Akathisia