Psycotropics Flashcards
1
Q
SSRI basics
A
Selective serotonin reuptake inhibitors, type of antidepressant (often first given)
2
Q
SSRIs ex
A
-xetine: paroxetine(very common), fluoxetine(very common), sertraline, citalopram, escitalopram, fluvoxamine, vilazodone, vortioxetine
3
Q
SSRIs time to take effect
A
4-6 weeks
4
Q
SSRIs side effects
A
Somnolence, dizziness, headache, insomnia, tremor, weakness, constipation, dry mouth, nausea, pharyngitis, runny nose, urinary retention, abnormal ejaculation
5
Q
Benzodiazepines purpose
A
Anxiety reducing, hypnotic, sedative, anticonvulsant (short term only)
6
Q
Benzodiazepine ex
A
-zepam, -Zolam: diazepam (anxiety and seizures), temazepam (sleep), alprazolam (anxiety and nerves), midazolam (anesthesia), triazolam(sleep) CNS DEPRESSION
7
Q
Benzodiazepines concerns
A
Respiratory depression, risk of addiction
8
Q
CNS stimulants MOA
A
Enhance dopamine transmission to areas of the brain that interpret well being
9
Q
CNS stimulants side effects
A
Agitation, insomnia, headache, dizziness, apprehension, disorientation, hyperactivity, nausea, vomiting, dyspnea, urinary retention, tachycardia, palpitation
10
Q
CNS stimulants concerns
A
High risk of abuse and tolerance
11
Q
Bupropion indications
A
Depression, SAD, smoking cessation
12
Q
Bupropion MOA
A
Increases dopamine and norepinephrine
13
Q
Bupropion side effects
A
Stimulant, seizures
14
Q
SNRIs indications
A
Depressive episodes, depression accompanied by anxiety disorders (GAD, panic, social phobias, PTSD), diabetic peripheral neuropathic pain, fibromyalgia, and chronic muscle pain
15
Q
SNRIs example
A
Duloxetine and venlafaxine, bupropion, tradozone, nefazodone, maprotiline
16
Q
SNRIs side effects general
A
Fatigue, tachycardia, palpitations, change in libido, impotence, skin rash, itching, vasodilation resulting in sweating and excessive sweating
17
Q
TCAs indications and full form
A
Tricyclic antidepressants, for depression, OCD, bipolar, chronic neuropathic pain, depression accompanied by anxiety disorders, enuresis
18
Q
TCAs ex
A
-iptyline or -ipramine: amitriptyline, desipramine, clomipramine, imipramine, nortriptyline + doxepin, amoxapine,
19
Q
TCAs side effects
A
Anticholinergic, 3 C’s convulsion, coma, cardiotoxicity, + constipation and photosensitivity
20
Q
MAOIs full form
A
Monoamine oxidase inhibitors
21
Q
MAOIs indications
A
Depressive episodes
22
Q
MAOIs aren’t for
A
Elderly, pheochromocytoma, liver and kidney disease, cerebrovascular disease, hypertension, history of headaches,
23
Q
MAOIs ex
A
Takes Pride In Shanghai: Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline
24
Q
Aripiprazole indications
A
Schizophrenia, bipolar disorder, depression
25
Aripiprazole side effects
Headache, dizziness, nausea, insomnia, anxiety
26
Aripiprazole facts
Lowest risk of weight gain, lowest risk of drug induced disorders
27
Antipsychotics indication
Tourette’s and schizophrenia, bipolar, agitation and behavioral disorders
28
Antipsychotics MOA
Block dopamine receptors
29
Antipsychotics side effects
Sedation, headache, hypotension, dry mouth, nasal congestion, urticaria, photophobia, photosensitivity, increase in the intensity of the psychotic symptoms, lethargy, hyperactivity, paranoid reactions, agitation, confusion, weight gain, increased cholesterol, triglyceride, and blood sugar levels, neuroleptic malignant syndrome, recidivism
30
Low potency antipsychotics ex and side effects
Chlorpromazine (SE: corneal deposit and cataracts) and thioridazine( SE: corneal deposits and cataracts)
31
High potency antipsychotics ex
Fluphenazine, trifluoperazine, haloperidol
32
High potency antipsychotics side effects
Short term: dystonia, torticolis
| Long term: tardive dyskinesia
33
Atypical antipsychotics indications
Schizophrenia
34
Atypical antipsychotics side effects
Seizures, prolonged QT interval, agranulocytosis
35
Neuroleptic malignant syndrome signs and symptoms
FEVER: fever, encephalopathy, vital signs unstable, elevated enzymes, rigidity of muscles
36
Reverse neuroleptic malignant syndrome by
D2 Agonists (bromocriptine, dantrolene)
37
Haloperidol indications
Migraines and schizophrenia
38
Haloperidol side effects
QT prolongation, weight gain, restlessness, neuroleptic malignant syndrome
39
Haloperidol concerns
Caution in seizure patients
40
Chlorpromazine classification
Low potency antipsychotic
41
Chlorpromazine indication
Schizophrenia and hiccups
42
Chlorpromazine side effects
Corneal deposits, cataracts, hypotension, sedation, neuroendocrine effects
43
Clozapine classification
Atypical antipsychotic
44
Clozapine indication
Schizophrenia, and levodopa induced psychosis
45
Clozapine consideration
Need weekly lab tests
46
Clozapine side effects
Hypersalivation, myocarditis, arangulocytosis
47
Pregablin MOA
GABA analog
48
Pregablin indications
Seizures, neuropathic pain, fibromyalgia
49
Pregablin side effects
Fatigue, angioedema, rhabdomylolysis (breakdown of muscle tissue)
50
Pregablin risks
Dependence potential
51
Risperidone classification
Atypical antipsychotic
52
Risperidone indications
Schizophrenia, bipolar mania, autism associated irritability
53
Risperidone side effects
Prolonged QT, hyperprolactinemia, gynecomastia, amenorrhea
54
Risperidone administration fact
IM= long lasting form
55
Lithium classification
Atypical antipsychotic
56
Lithium indications
Bipolar (mood stabilizer)
57
Lithium restrictions
Not for use during pregnancy (cat
D), allergy to tartrazine, renal or cardiovascular disease, sodium depletion, dehydration in patients taking diuretics, lactation
58
Lithium side effects
Tremors, nausea, vomiting, thirst, polyuria
59
Tardive dyskinesia symptoms
Bizarre facial movements, bizarre tongue, increased extremity movements, stiff neck, dysphagia
60
Tardive dyskinesia solutions
Stop meds, AIMS
61
Cholinesterase inhibitors MOA
Block breakdown of acetylcholine
62
Cholinesterase inhibitors indications
Dementia, Alzheimer’s (early and moderate stages)
63
Cholinesterase inhibitors side effects
Vasodilation, constriction of pupils, slow HR, mucus in respiratory tract, anorexia, nausea, vomiting, diarrhea, dizziness, headache
64
Cholinesterase inhibitors ex
Memantine, galantamine, donepazil, rivastigmine,
65
Barbiturates indications
Seizure treatment and anesthesia
66
Barbiturates MOA
Decrease neuron firing, increase duration of Cl channel opening.
67
Barbiturates SE
Sedation CNS depression, CV depression, respiratory depression, P450 inhibitor
68
Phenobarbital indications
Seizures
69
Phenobarbital side effects
Ataxia, paradoxical excitement
70
Phenobarbital considerations
High abuse potential
71
Zolpidem classification
Non benzodiazepine hypnotic
72
Zolpidem indications
Insomnia
73
Zolpidem MOA
GABA receptor
74
Zolpidem side effects
Ataxia and confusion
75
Zolpidem considerations
Lower chance of dependence
76
Buspirone indication
General anxiety
77
Buspirone MOA
5-HTIA receptors, release dopamine and norepinephrine
78
Buspirone considerations
Little side effects, no alcohol interaction
79
Tradozone indication
Insomnia
80
Tradozone MOA
Alpha blocker: inhibit serotonin reuptake
81
Tradozone side effects
Sedation, priapism, orthostatic hypotension
82
Acetylcholine
Neurotransmitter that sends impulses across the parasympathetic branch of the autonomic nervous system
83
Amyloid plaque
Tangles of protein in nerve tissue
84
Parasympathetic
Pertaining to the part of the autonomic nervous system concerned with conserving body energy
85
Cholinesterase inhibitors contraindications
Pregnancy (cat B), and lactation
86
Cholinesterase inhibitors precautions
Renal disease, bladder obstruction, seizure disorders, sick sinus syndrome, GI bleeding, asthma
87
Cholinesterase inhibitors interactions
Decreased effectiveness of anticholinergics, increased risk of theophylline toxicity, decreased effectiveness of thiazide diuretics, increased risk of GI bleeding with NSAIDs
88
Narcolepsy
Chronic disorder that results in recurrent attacks of drowsiness and sleep during daytime
88
Satiety
Feeling of fullness in the GI system or appetite is satisfied
88
Attention deficit hyperactivity disorder (ADHD)
Disorder characterized by inattention, hyperactivity, and impulsivity
89
Amphetamines use
Drugs used to treat children with ADHD
90
Analeptics use
Stimulate the respiratory center of the brain and cardiovascular system, used with narcolepsy and as an adjuvant treatment for obstructive sleep apnea
91
Anorexiants use
Drugs used to suppress the appetite
92
Amphetamines MOA
Block reuptake of norepinephrine and dopamine
93
Analeptics ex
Modafinil, armodafinil, caffeine, doxapram
94
Analeptics MOA
Bind to dopamine
95
Anorexiants ex
Lorcaserin, benzphetamine, diethylpropion, phendlmetrazine, phentermine,
96
Anorexiants MOA
Act on serotonin receptors and producing a feeling of satiety
97
CNS stimulants use
ADHD, drug induced respiratory depression, postanesthesia respiratory depression without reduction of analgesia, narcolepsy, obstructive sleep apnea, exogenous obesity
98
CNS stimulants contraindications
Convulsive disorders, ventilation disorders (COPD), cardiac problems, severe hypertension, hyperthyroidism, not a depression treatment
99
Anorexiants pregnancy cat
X
100
Amphetamines contraindications
Shouldn’t be taken concurrently or within 14 days of antidepressants, glaucoma
101
Anorexiants contraindications
Concurrently or within 14 days of taking an antidepressant,
102
Armodafinil pregnancy cat
C
103
CNS stimulants precautions
Respiratory illness, real or hepatic impairment, history of substance abuse, pregnant or lactating
104
CNS Stimulants interactions
Anesthetics increase risk of cardiac arrhythmias, theophylline increases risk of hyperactive disorders
105
Modafinil interactions
Decreased effectiveness of oral contraceptives
106
Atomoxetine side effects
Suicidal ideation, especially in children
107
Amphetamines ex
Amphetamine, dexmethylphenidate, dextroamphetamine, lisdexamfetamine, methamphetamine, methylphenidate,
108
Anxiolytics
Drugs used to treat anxiety
109
Ataxia
Unsteady gait, muscular in coordination
110
Gamma-aminobutyric acid (GABA)
A neurotransmitter inhibitor that is involved in the regulation of sleep and anxiety
111
Generalized anxiety disorder (GAD)
Disorder of chronic anxiety, exaggerated worry and tension
112
Post traumatic stress disorder (PTSD)
A mental health condition triggered by a terrifying event
113
Buspirone MOA
Act on the brains serotonin receptors
114
Benzodiazepines MOA
Potential if the effects of GABA
115
Hydroxyzine MOA
Acts on hypothalamus and brainstem reticular formation
116
Anti anxiety use
Isolated episodes of intense anxiety, temporary use for those with severe functional impairment, preanesthetic sedation and muscle relaxation, convulsions, seizures, alcohol withdrawal
117
Anti anxiety side effects
Mild drowsiness or sedation, lightheadedness or dizziness, headache, lethargy, apathy, fatigue, disorientation, anger, restlessness, nausea, constipation, diarrhea, dry mouth, visual disturbances
118
Benzodiazepine withdrawal symptoms
Increased anxiety and panic, fatigue, hypersomnia, nightmares, metallic taste, concentration difficulties, headache, tinnitus, tremors, numbness in extremities, tachycardia, hypertension, nausea, vomiting, diarrhea, fever, sweating, muscle tension, aching, cramps, psychoses, hallucinations, agitation, memory impairment, convulsions
119
Anti anxiety drugs contraindications
Psychoses, acute narrow angle glaucoma, pregnancy (cat D), labor, lactation, coma, shock, low vital signs in patients with acute alcohol intoxication
120
Buspirone contraindications
Grapefruit
121
Diazepam contraindications
Grapefruit
122
Buspirone pregnancy cat
B
123
Hydroxyzine pregnancy cat
C
124
Anti anxiety precautions
Elderly, impaired liver function, impaired kidney function, debilitation
125
Anti anxiety drugs interactions
Alcohol and analgesics increases risk of CNS depression, alcohol also increases risk for convulsions, TCAs and antipsychotics increase risk for sedation and respiratory depression, digoxin increases risk for digitalis toxicity
126
How do benzodiazepines effect elderly
Excreted more slowly p, causing a prolonged effect, if they accumulate, may cause in parease in adverse reactions or toxicity
127
Benzodiazepine antidote
Flumazenil
128
Hypnotic
Drug that induced sleep
129
Sedative
Drug producing a relaxing, calming effect
130
Sedative and hypnotics primary use
Insomnia
131
Criteria for diagnosis for insomnia
Difficulty asleep, waking often and trouble going back to sleep at night, waking too early in the morning, feeling tired upon waking
132
Non benzodiazepines ex
Ezopiclone, and zolpidem, dexmedetomidine, ramelteon, suvorexant, tasimelteon, zalepion,
133
Barbiturates consideration
Used infrequently because of their long half life, which prolongs a sleepy or drowsy feeling
134
Sedatives and hypnotics uses
Insomnia, convulsions or seizures, used as adjuncts for anesthesia, preoperative sedation, conscious sedation
135
Sedatives and hypnotics side effects
Dizziness, drowsiness, headache, nausea
136
Sedatives and hypnotics contraindications
Comatose patients, severe respiratory problems, history of drug and alcohol habitual use, pregnancy, lactation, grapefruit
137
Barbiturates pregnancy cat
D
138
Sedative and hypnotics precautions
Lactation, hepatic or renal impairment, habitual alcohol use, mental health problems
139
Sedatives and hypnotics interactions
Antidepressants, opioid analgesics, antihistamines, phenothiazines, cimetidine, and alcohol all increase sedative effect
140
Zolpidem side effects
Memory loss or amnesia
141
Barbiturates ex
Pentobarbital, secobarbital
142
Bipolar disorder
A mood disorder characterized by severe swings from extreme hyperactivity to depression
143
Dysphoric
Characterized by extreme or exaggerated sadness, anxiety, or unhappiness
144
Endogenous
Pertaining to something that normally occurs or is produced within the organism
145
Mood disorders
A spectrum of conditions that range from severe debilitation to an exhaustive elation
146
Neurohormones
Secreted rather than transmitted neurosubstances
147
Priapism
Painful, persistent erection
148
Serotonin syndrome
Potentially life threatening drug reaction that causes the body to produce too much serotonin
149
Tyramine
Amino acid, commonly found in foods such as cheese and red wine
150
Unipolar depression
Mental disorder of low mood, low self esteem, and loss of interest/pleasure aka major mood disorder
151
Depression symptoms
Feelings of hopelessness or helplessness, diminished interest in activities of life, significant with loss or gain, insomnia or hypersomnia, agitation, restlessness or irritability, fatigue, feelings of worthlessness, excesssive guilt, diminished ability to think or concentrate, indecisiveness, recurrent thoughts of death or suicide
152
SSRIs MOA
Inhibit CNS reuptake of serotonin
153
SSRIs uses
Depressive episodes, anxiety disorders (panic, PTSD, GAD, social phobias), premenstrual dysphoric disorder (PMDD), OCD, bulimia
154
SSRIs contraindications
Pregnancy (cat C),
155
Fluoxetine contraindications
Cisapride, pimozide, carbamazepine
156
Serte aliñe contraindications
Grapefruit
157
SSRI precautions
Type 2 diabetes, cardiac disease, impaired liver or kidney function, suicidal ideation, shouldn’t be switched to an SSRI within 2 weeks of stopping a
MAOI
158
SSRI interactions
Other antidepressants increase risk of toxic effects, cimetidine increases anticholinergic symptoms, NSAIDs increase risk of GI bleeding and decrease effectiveness of the SSRI, lithium increases risk of lithium toxicity
159
SNRIs MOA
Affect neurotransmission of serotonin, norepinephrine, and dopamine
160
SNRIs neuromuscular system side effects
Somnolence, migraine, hypotension, dizziness, lightheadedness, vertigo, blurred vision, photosensitivity, insomnia, nervousness, agitation, tremor
161
SNRIs GI system side effects
Nausea, dry mouth, anorexia, thirst, diarrhea, constipation, bitter taste
162
SNRIs pregnancy cat
C
163
Bupropion pregnancy cat
B
164
Maprotiline pregnancy cat
B
165
Maprotiline classifications
SNRI
166
Maprotiline contraindications
Seizure disorder, during acute phase of a myocardial infarction,
167
Nefazodone contraindications
Cisapride, pimozide, carbamazepine
168
Vilazodone contraindications
Grapefruit
169
Tradozone contraindications
Grapefruit
170
SNRIs precautions
Cardiac disease, renal or hepatic impairment, hyperthyroid disease, suicidal ideation
171
SNRIs interactions
Sedatives, hypnotics, analgesics increase risk for respiratory and CNS depression, warfarin increases risk of bleeding cimetidine increases anticholinergic symptoms, antihypertensives increase risk for hypotension, MAOIs increase risk for hypertensive episodes, severe convulsions and hyperpyretic episodes
172
TCAs MOA
Inhibit reuptake of serotonin or norepinephrine
173
Antidepressants most often used
SSRIs and SNRIs are most frequently prescribed, (more than TCAs and MAOIs)
174
TCAs contraindications
Not given within 14 days of MAOIs, recent myocardial infarction, pregnancy (cat C and D)
175
Doxepin contraindications
Glaucoma, tendency for urinary retention
176
TCAs precautions
Cardiac disease, hepatic or renal impairment, hyperthyroid disease, history of seizure activity, narrow angle glaucoma, increased intraocular pressure, urinary retention, suicidal ideation, elderly
177
TCAs interactions
Sedatives, hypnotics and analgesics increase risk or respiratory and CNS depression, cimetidine increases anticholinergic symptoms, MAOIs increase risk for hypertensive episodes, convulsions and hyperpyretic episodes, adrenergics increase risk for arrhythmias and hypertension
178
MAOIs MOA
Increase in endogenous epinephrine, norepinephrine, dopamine, and serotonin
179
MAOIs side effects
Orthostatic hypotension, dizziness, headache, blurred vision, constipation, dry mouth, nausea, diarrhea, impotence, hypertensive crisis when taken with foods containing tyramine
180
Foods containing tyramine
Aged cheese, sour cream, yogurt, beef, chicken livers, pickled herring, fermented meats, undistilled alcoholic beverages, caffeine, chocolate, avocado, bananas, figs, raisins, sauerkraut, yeast extracts, soy sauce
181
MAOIs precautions
Younger than 16, pregnancy (cat C), lactation, impaired liver function, history of seizures, Parkinsonian symptoms, diabetes, decongestants, hyperthyroidism, suicidal ideation
182
MAOIs interactions
Sedatives, hypnotics, and analgesics increase risk for adverse reaction during surgery, thiazide diuretic increases hypotensive effects, meperidine increases risk for hypertensive episodes, severe convulsions, and hyperpyretic episodes, adrenergics increase risk for cardiac arrhythmias and hypertension, tyramine risks hypertensive crisis, and antitussives cause hypotension, fever, nausea, jerking motions of the leg and coma
183
Lithium interactions
Antacids decrease lithium effectiveness, diuretics and antipsychotics increase risk of lithium toxicity
184
Lithium should be monitored in...
Patients who sweat profusely, experience diarrhea, vomiting, or have an infection or fever causing fluid loss, elderly are at a higher risk for lithium toxicity
185
Arangulocytosis
Decrease or lack of granulocytes (type of white blood cell)
186
Alogia
Inability to finish a sentence when communicating
187
Anhedonia
Lack of joy or pleasurable feelings
188
Avolition
Inability to determine and initiate goals and activities
189
Delusions
False belief that can’t be changed with reason
190
Dopamine
Primary neurotransmitter in the sympathetic nervous system that deals with pleasure and reward in the brain
191
Dystonia
Prolonged muscle contractions that may cause twisting and repetitive movements of abnormal posture
192
Hallucinations
False sensation or perception of reality
193
Photophobia
Intolerance to light
194
Psychosis
Spectrum of disorders that affect mood and behavior
195
Recidivism
When patients are hospitalized and are given meds, then they experience side effects that may be as bad as the disease, and then stop taking meds (esp bc there’s a longer time to take effect [6-10 weeks]), this causes them to repeat the behavior that caused them to be hospitalized since the psychosis returned, turns into a cycle
196
First generation antipsychotics MOA
Diminish positive symptoms of schizophrenia (symptoms added to one's behavior), but also cause many extrapyramidal effects
197
First generation antipsychotics ex
Chlorpromazine, haloperidol, fluphenazine, loxapine, perphenazine, pimozide, prochlorperazine, thioridazine, thiothixene, trifluoperazine,
198
Atypical antipsychotics MOA
Typical extrapyramidal effects are lessened, diminish positive symptoms and enhance behaviors to reduce negative symptoms (removed from typical behavior)
199
Atypical antipsychotics ex
Clozapine, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, palipericone, quetiapine, risperidone, ziprasidone,
200
Extrapyramidal effects of antipsychotics include
Parkinson-like symptoms, akathisia, and dystonia
201
Antipsychotics contraindications
Comatose patients, severe depression, bone marrow depression, blood dyscrasias, liver impairment, coronary artery disease, severe hypotension or hypertension, pregnancy (cat C)
202
Haloperidol contraindications
Parkinson’s
203
Clozapine pregnancy cat
B
204
Quetiapine contraindications
Grapefruit
205
Pimozide contraindications
Grapefruit
206
Antipsychotics precautions
Respiratory disorders, glaucoma, prostatic hypertrophy, epilepsy, decreased renal function, peptic ulcer disease
207
Antipsychotics interactions
Anticholinergic increase risk for TD and psychotic symptoms, immunologic drugs increase severity of bone marrow depression, alcohol increases risk for CNS depression
208
What to do when patients have serious manifestations of acute psychosis
Repeat parenteral administration every 1-4 hours and monitor for arrhythmia, rhythm changes and hypotension
209
Antipsychotics elderly considerations
People with dementia maybe more agitated and there is an association between increased cerebrovascular problems and mortality with the use of antipsychotics (esp atypical)
