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Psychiatry pro +1700 > Somatic Therapies II > Flashcards

Somatic Therapies II Flashcards

(61 cards)

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1
Q

What are the four major general classes of anxiolytics?

A
  • Antidepressants
  • benzos
  • Buspirone
  • Antihistamine
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2
Q

What are the antidepressants that are used to treat anxiety disorders? (3)

A

SSRIs
SNRIs
Mirtazapine

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3
Q

For treating OCD using SSRIs or clomipramine, what are the changes compared to treating depression?

A
  • SSRIs need higher doses

- Need longer response time

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4
Q

What is the drug of choice for an acute panic attack? What is the major issue with this?

A

Alprazolam (xanax)

Fast onset, but short acting, and highly addictive because of that.

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5
Q

What is the only benzo that is absorbed IM?

A

Lorazepam

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6
Q

What are the side effects of benzos?

A
  • Drowsiness
  • Reduced motor coordination
  • potential for tolerance
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7
Q

What are the withdrawal s/sx of benzos?

A

Like alcohol withdrawal

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8
Q

True or false: benzos have major adverse effects in pregnancy

A

False–generally safe PRN

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9
Q

True or false: benzos have adverse effects with breastfeeding

A

True

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10
Q

What is the MOA of buspirone? Use?

A
  • 5HT1a agonism
  • Anxiolytic w/o sedation
  • No risk of tolerance
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11
Q

True or false: buspirone is effective for treating OCD, but not panic attacks or phobias

A

False–not effective for any of them. Only GAD.

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12
Q

What is buspirone used for now?

A

Augment antidepressants for anxiety disorders

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13
Q

What is the general treatment regimen for anxiety?

A
  • SSRIs
  • SNRIs if SSRIs fail
  • Mirtazapine
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14
Q

What is the role of benzos in the treatment of anxiety disorders?

A

Short term, acute episodes PRN

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15
Q

Is buspirone used PRN or long term?

A

Long term

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16
Q

What are the four major typical antipsychotics? Which is a weak one?

A
  • Haloperidol
  • Chlorpromazine**
  • Thioridazine**
  • Fluphenazine
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17
Q

What are the atypical antipsychotics? (6)

A
  • Olanzapine
  • Clozapine
  • Quetiapine
  • Risperidone
  • Aripiprazole
  • Ziprasidone
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18
Q

What is the general MOA of antipsychotics?

A

Postsynaptic D2 receptor blockade in the mesolimbic and mesocortical pathway

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19
Q

What are the uses of FGAs?

A
  • Schizophrenia
  • Psychosis
  • Agitation
  • Tourette’s syndrome
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20
Q

What is the only antipsychotic that is not approved for use with schizophrenia? What is it used for?

A

Clozapine

Refractory schizophrenia

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21
Q

What is the use for risperidone that is unlike the other FGAs?

A

ASD

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22
Q

How fast are antipsychotics in treating agitation?

A

30-60 minutes

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23
Q

What organ metabolizes antipsychotics?

A

Liver

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24
Q

What is the duration of an adequate trial of antipsychotics?

A

4-6 weeks

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25
What percent of pts taken off of antipsychotics for schizophrenia will relapse?
75%
26
True or false: prevention of relapse with schizophrenia is more important than side effects
True
27
What is the psychotic drug that causes agranulocytosis?
Clozapine
28
What is the psychotic drug that causes hyperprolactinemia? How?
Risperidone | Dopamine antagonism
29
What is neuroleptic malignant syndrome? S/sx?
Reaction to antipsychotics - Fever - Elevated CPK - Vital sign instability - Encephalopathy - Rigidity
30
What is the treatment for NMS? (3)
- IVFs - Dantrolene - Bromocriptine or other dopamine agonist
31
Why do SGAs have a lower risk of movement disorders?
Blockade of 5HT2a receptors
32
What is acute dystonic reaction? Treatment?
- Reaction to FGAs or SGAs that causes painful muscle contractions - Treat with antihistamine or benztropine
33
What are the s/sx of pseudoparkinsonism?
- Rigidity - Coarse tremor - Hypokinesia/ bradykinesia
34
What is the treatment for pseudoparkinsonism?
Anticholinergics
35
When does akathisia usually occur with antipsychotic use?
within the 1st few weeks of treatment
36
What are the subjective symptoms of akathisia
anxiety and tension
37
How do you differentiate between akathisia and anxiety?
Akathisia will point to extremities as source of symptoms, as opposed to chest
38
What is the treatment for tardive dyskinesia?
- Beta blockers such as propranolol | - Switch drugs
39
What is the early sign of tardive dyskinesia?
See tongue fasciculations
40
Which gender is at greater risk of tardive dyskinesia?
Women
41
What happens initially with decreasing dose of antipsychotic with TD?
Gets worse, but you should not increase
42
What is the most sedating antipsychotic?
Quetiapine
43
What is the antipsychotic with the most EPS?
Risperidone
44
What are the two antipsychotics that have weight gain as a major side effect?
Clozapine | Olanzapine
45
What are the two antipsychotics that do NOT have weight gain as a major side effect?
Aripiprazole | Ziprasidone
46
What atypical has the least EPS?
Clozapine
47
What are the disadvantages of SGAs?
-Metabolic syndrome and DM
48
Which generally is more effective for the positive symptoms of schizophrenia: FGAs or SGAs?
FGAs
49
What is the major advantage of SGAs?
Lower movement disorders
50
What is the major side effect of risperidone?
CVAs
51
What is paliperidone?
Risperidone active metabolite
52
What is the role of clozapine in the treatment of schizophrenia?
Second or third line treatment
53
Drooling is caused by what SGA?
Clozapine
54
What is the major side effect of clozapine?
Agranulocytosis
55
What must be followed with clozapine?
Weekly absolute neutrophil count for 6 months, then every other week for 6 months
56
What is the major side effect with ziprasidone?
-QT prolongation
57
What is asenapine?
SGA
58
True or false: SGAs are first line for psychosis
True
59
What should be done if there are significant side effects with SGAs or FGAs?
switch or lower dose
60
What are depot formulations?
IM injections q 2-4 weeks
61
Which type of antipsychotic has a risk of metabolic symptoms?
SGAs

Psychiatry pro +1700 (28 decks)

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