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Flashcards in Week 1 Deck (31):
1

Trazodone

Want to use in depressed pts with hard time going to sleep

- mixed
block post syn 5HT2
blocks reuptake of 5HT/NE
(antagonist/agonist)

2

adequate antidepressant trial is ____ weeks

8-14 weeks

3

Why would you pick SSRI over SNRI?

higher seizure risk
withdrawal syndromes (flu-like electric shocks)

(bupripion also has higher seizure risk)

4

10 day supply of which antidepressant is lethal?

TCAs
dangerous in overdose

5

Antidepressants Good against sexual side effects

Venlafaxine (SNRI)
Bubproprion (other)

6

lesion to subthalamic nucleus

contralateral hemiballismus

7

Which is easier to tx? Mania or depression?

mania

(treating bipolar depression is very hard)

only approved tx
- quetiapine +
- Olanzapine + Fluoxetine

8

Best proven anti manic agent?

LITHIUM!
- best prove, best studies
- anti-suicical
- cheap


- narrow therapeutic window, hypothyroidism, diabetus

9

Comorbidities for ADHD

substance abuse
anxiety disorders
depression
learning disorders
oppositional behavior

10

5 models of why indiv with ADHD have comorbidities for other psychiatric disorders

1. genetic
2. developmental changes
3. psychological effects
4. living with others irritated by ADHD
5. self treating problem

11

Most effective tx of ADHD

Stimulants
- well tolerated, most effective
- cause few symptoms
- make pt less annoying and give them better self-esteem

EARLY STIMULANT TX CAN DECREASE LATER RISK OF SUBSTANCE ABUSE AND DECREASE RELAPS IN SUBSTANCE ABUSE

12

Sedative-hypnotic drugs facilitate what, leading to diminished neuronal excitability?

Fac. action of GABA at GABAA receptor-Cl channel complex →
GABA opens ion channels to increase CL- conductance →
hyperpolarization →
diminished neuronal excitability

13

1st line tx for most anxiety disorders

SSRIs

14

BDZ does not affect excitatory NTs compaired to barbs, why is this important?

BDZ are incapable of inducing and maintaining surgical anesthesia

15

IM BDZ

Lorazepam

16

Buspirone
- action
- sedative properties
- additive CNS depression?
- anticonvulsants
- myorelaxant

5HT1A partial agonist at presynaptic nerve terminal

No sedative/additive CNS depression
No Anticonvulsant, or myorelaxant properties.

Just an anxiolytic
- must be administered on routine schedule: less pt acceptance

17

Post traumatic stress disorder #1 tx

CBT
- SSRI

18

Drug toxicity
pinpoint toxicity
-tx?

Opioid

-tx with naloxone
immediate

19

Clonidine

tx for withdrawl and relapse prevention
- good against opiod withdrawl

a2 agonist

20

Methadone

Alleviate withdrawal symptoms by cross tolerance/dependence

21

buprenorphine

partial agonist at mu opioid receptors
- helps with opioid withdrawal

22

Naltrexone

blocks reinforcing action of heroin/alcohol

23

CNS stimulants strong physical or psychological dependence?

Psychological
- lack of physical symptoms in withdrawal

not that bad
(OH, BDZ bad)

24

Hallucinogens

agonist action at 5HT2 R → hallucinatory action

Also induce DA release @ DA receptors

25

High dose of this drug induces rhabdo and kidney failure

Hallucinogens

26

Disulfiram (antabuse)

tx for alcohol restraint


inhibits aldehyde dehydrogenase causing increase in acetaldehyde

- nausea, vomitting, resp collapse, convulsion

27

Alcohol withdrawal syndrome tx

BDZ
a-2 adrenergic agonists (clonidine)

28

acute alcohol intoxication tx

no specific antidote
- IV fluids (thiamine, glucose, electrolytes)
- Support respiration

29

Reducing alcohol consumption

Disulfiram:
- alcohol sensitizing

Naltrexone:
- opioid antagonist

Acamprosate:
- NMDA receptor drugs

30

tx for opioids

Methadone
- opioid agonist (taper off)

Naltrexone
- opioid antagonist

Buprenorphine
- Partial opioid agonist

31

acamprosate

resembles GABA
- ENhances GABA transmission

Interferes with glutamate transmission and reduces CNS hyperexcitability