00 Psychiatry Review Flashcards
1
Q
What is the generic name of Thorazine?
A
Chlorpromazine (typical antipsychotic)
2
Q
What is the generic name of Prolixin?
A
Fluphenazine (typical antipsychotic)
3
Q
What is the generic name of Haldol?
A
Haloperidol (typical antipsychotic)
4
Q
What is the generic name of Compazine?
A
Prochlorperazine (typical antipsychotic)
5
Q
What is the generic name of Abilify?
A
Aripiprazole (atypical antipsychotic)
6
Q
What is the generic name of Clozaril?
A
Clozapine (atypical antipsychotic)
7
Q
What is the generic name of Latuda?
A
Lurasidone (atypical antipsychotic)
8
Q
What is the generic name of Zyprexa?
A
Olanzapine (atypical antipsychotic)
9
Q
What is the generic name of Invega?
A
Paliperidone (atypical antipsychotic)
10
Q
What is the generic name of Seroquel?
A
Quetiapine (atypical antipsychotic)
11
Q
What is the generic name of Risperdal?
A
Risperidone (atypical antipsychotic)
12
Q
What is the generic name of Geodon?
A
Ziprasidone (atypical antipsychotic)
13
Q
What is the generic name of Maintena?
A
Abilify long-acting injectable (atypical antipsychotic)
14
Q
What is the generic name of Relprevv?
A
Olanzapine long-acting injectable (atypical antipsychotic)
15
Q
What is the generic name of Sustenna?
A
Paliperidone long-acting injectable (atypical antipsychotic)
16
Q
What is the generic name of Consta?
A
Risperidone long-acting injectable (atypical antipsychotic)
17
Q
Why antipsychotics have an indication as adjunctive treatment for MDD?
A
Aripiprazole, Quetiapine XR, Olanzapine-fluoxetine
18
Q
Which antipsychotic is indicated for refractory schizophrenia?
A
Clozapine
19
Q
What is the BBW with antipsychotics?
A
Increased mortality in elderly patients with dementia-related psychosis. Increased risk of suicide
20
Q
What are the multiple BBWs for Clozapine?
A
Agranulocytosis (ANC < 500 - blood testing required weekly for first 6 months). Orthostatic hypotension. Seizure
21
Q
You should inform patients and caregivers that if the patient misses taking Clozapine for more than how many days, should they not restart their medication at the same dosage, but rather contact their physician for dosing instructions?
A
48 hours
22
Q
What is an absolute contraindication to Clozapine treatment?
A
WBC < 3500 or ANC < 2000
23
Q
When should Clozapine treatment be interrupted?
A
WBC< 3000 or ANC < 1500
24
Q
When should Clozapine treatment be discontinued?
A
WBC < 2000 or ANC < 1000
25
What is the starting and target dose of Clozapine?
Starting: 12.5mg QD or BID. Target: 300-450mg QD in divided doses
26
If someone gets tardive dyskinesia, what is a good antipsychotic to switch to?
Clozapine, doesn't block D2
27
What are two treatment options for Irritability Associated with Autism?
Risperidone or Aripiprazole
28
What are the medication options for Bipolar Depression?
Quetiapine (SR or XR), Olanzapine-Fluoxetine, Lurasidone
29
What is the generic name of Symbyax?
Olanzapine-Fluoxetine Combination (fixed dosed)
30
What are the contraindications to Geodon (Ziprasidone) use?
Causes QT prolongation. Do not use with MI or other heart issues
31
What is a unique indication for Invega (Paliperidone)?
Treatment of schizoaffective disorder as monotherapy and as an adjunct to mood stabilizers and/or antidepressant therapy in adults. Given in special delivery capsule that causes GHOST SHELL in the stool
32
What two medications can cause a ghost shell in the stool?
Concerta and Invega
33
What is the generic for Saphris?
Asenapine (atypical - only sublingual antipsychotic)
34
What are the two long-acting injectable (LAI) typical antipsychotics?
Haloperidol and Fluphenazine
35
All antipsychotics that have long-acting injectables require an overlap of 2-3 weeks with the first long-acting injection except which two?
Olanzapine and Paliperidone
36
How is Relprevv dosed?
By intramuscular gluteal injection every 2-4 weeks
37
What is a rare and unique side effect of Relprevv (Zyprexa)?
Post-injection delirium sedation syndrome (PDSS). Usually happens within 3 hours after injection. You will need to stay in the clinic for at least 3 hours after injection to monitor
38
What are the common and expected ADRs of atypicals?
Dizziness. Sedation/Activation. Orthostatic hypotension. Hyperprolactinemia. Weight gain/hyperglycemia/Dyslipidemia
39
Which atypicals cause sedation?
Clozapine, Olanzapine, Quetiapine
40
Which atypicals cause activation?
Aripiprazole, Ziprasidone, Lurasidone
41
Which atpyicals cause orthostatic hypotension?
Clozapine, Quetiapine (both cause sedation as well), Risperidone
42
Which atypicals cause Hyperprolactinemia?
Risperidone, Paliperidone, Olanzapine
43
Which atypicals cause Metabolic Syndrome (weight gain/hyperglycemia/dyslipidemia)?
Clozapine, Olanzapine, Quetiapine, Risperidone
44
What is Neuroleptic Malignant Syndrome (NMS)?
Caused by antipsychotic drugs. Can cause muscle rigidity, altered mental status, acute renal failure, etc. It is NOT EPS
45
Which antipsychotics have a higher incidence of causing EPS?
High-potent D2-receptor antagonists (Haloperidol, Fluphenazine, Risperidone, Olanzapine)
46
What is Haloperidol Lactate?
Used in the cocktail for acute agitation/aggression/delirium. Given IM or IV. Higher risk of QTc prolongation
47
Which Haloperidol preparation comes in sesame oil base?
Haloperidol deconate (IM)
48
What are the common Mood Stabilizers?
Lithium, Divalproex sodium (Depakote), Valproic acid (Depakene), Carbamazepine, Lamotrigine
49
What is the PK of Lithium like?
100% F, 100% renal clearance (can use in hepatic failure)
50
What is the formula to convert from mEq to Mg?
mEq = (mg/MW) x valence
51
What are the Lithium levels for acute mania and maintenance?
Acute mania: 0.8-1.5 mEq/L
| Maintenance: 0.6-1.2 mEq/L
52
What are some general side effects with Lithium?
GI (N/V) - take with food. Lethargy. Polyuria/Polydipsia/Nocturia
53
What are some long term effects of Lithium use?
Nephrogenic DI. Hypothyroidism
54
What is seen in Lithium toxicity?
> 1.5 (tremor, persistent diarrhea, loss of coordination, slurred speech, lethargy). > 2.0 (arrhythmias, CNS depression, seizures, coma, death)
55
How is Valproic Acid usually dosed?
15-20mg/kg given BID
56
What are the BBWs with Valproic Acid?
Pancreatitis, Hepatotoxicity, Teratogenic
57
What is the main contraindication to Valproic Acid use?
Urea cycle disorder
58
What is the generic name of Prozac?
Fluoxetine (SSRI)
59
What is the generic name of Sarafem?
Fluoxetine (SSRI)
60
What is the generic name of Paxil?
Paroxetine (SSRI)
61
What is the generic name of Zoloft?
Sertraline (SSRI)
62
What is the generic name of Celexa?
Citalopram (SSRI)
63
What is the generic name of Lexapro?
Escitalopram (SSRI)
64
Which SSRI has the longest half-life?
Fluoxetine, 4-16 days (d/t its active metabolite)
65
Which is the more activating SSRI?
Fluoxetine
66
Which SSRI is cleared the fastest from the body?
Paroxetine (most likely to have withdrawal symptoms)
67
Which SSRI must be given with food to increase "F"?
Sertraline
68
Why is there an FDA warning on Citalopram to not exceed 40mg/day?
QTc prolongation
69
Which SSRIs have the fewest DDIs?
Citalopram and Escitalopram
70
What are the class side effects of SSRIs?
Sexual dysfunction (5HT2 agonism), GI upset (5HT3 agonism)
71
What is the generic name of Effexor?
Venlafaxine (SNRI)
72
What is the generic name of Pristiq?
Desvenlafaxine (SNRI)
73
What is the generic name of Cymbalta?
Duloxetine (SNRI)
74
What is the generic name of Fetzima?
Levomilnacipran (SNRI)
75
What are some common ADRs with Venlafaxine?
Increase in Blood Pressure (dose related). Nausea
76
Which SNRI causes ghost tablets?
Desvenlafaxine
77
What is the only TCA approved for OCD?
Anafranil (clomipramine)
78
What is the generic name of Elavil?
Amitriptyline (Elavil)
79
What are the ADRs caused by TCAs?
Anticholinergic (dry mouth, urinary retention, blurred vision, constipation). Sedation. Orthostatic hypotension. Weight gaine. Sexual side effects. Cardiovascular complications. Can be fatal in overdose
80
What is the generic name of Nardil?
Phenelzine (MAO-I)
81
What is the generic name of Marplan?
Isocarboxazid (MAO-I)
82
What is the generic name of Parnate?
Tranylcypromine (MAO-I)
83
What is the generic name of Emsam?
Selegiline (MAO-I PATCH)
84
What are the MAO-I drugs?
PITS: Phenelzine, Isocarboxazid, Tranylcypromine, Selegiline
85
What are the MAO-I ADRs?
Anticholinergic effects. Orthostasis. Sedation. Sexual dysfunction, weight gain, HA, insomnia. Hypertensive crisis
86
What is the only MAO-I that causes stimulation?
Tranylcypromine
87
Where can the Emsam patch be placed?
Upper arm, upper back, chest, thighs
88
What is the generic name of Wellbutrin?
Bupropion
89
What is the generic name of Zyban?
Bupropion - smoking cessation, not depression
90
What is the generic name of Remeron?
Mirtazapine
91
What is the generic name of Desyrel?
Trazodone
92
What is the generic name of Oleptro?
Trazodone ER
93
What is the generic name of Viibryd?
Vilazodone
94
What are the common ADRs with Bupropion?
Insomnia (activating), weight loss, no sexual dysfunction
95
What are the contraindications with Bupropion?
Seizure disorder
96
What are the common ADRs with Mertazapine?
Sedation! Increased appetite, weight gain, dry mouth, dizziness
97
What are the common ADRs with Trazodone?
Sedation (used commonly as a sleep aid). Orthostasis, Priapism
98
What is something that you need to make sure you mention to patients taking Viibryd (vilazodone)?
TAKE WITH FOOD
99
What are anxiety disorders primarily treated with?
SSRIs and SNRIs
100
When are Beno's used for anxiety disorders?
Short term (ex. while initiating an SSRI/SNRI). Use > 2 weeks increases risk of dependence. Abrupt discontinuation in patients treated long term should be avoided
101
When are Benzo's contraindicated?
Narrow angle glaucoma
102
What is the generic name of Buspar?
Buspirone (5HT1 partial agonist). Approved for generalized anxiety disorder. No effect when used PRN (takes a few weeks to kick in). NO ABUSE POTENTIAL. Often added to SSRI is not completely controlled
103
When is Buspirone use contraindicated?
With MAO-Is, require 10 day washout
104
What is the only Beta-Blocker approved for anxiety?
Propranolol (Inderal), a non-selective BB
105
What is the generic name of Vistaril?
Hydroxyzine (antihistamine/anticholinergic used for anxiety, mainly GAD). Works mostly be sedating
106
What is the generic name of Xyrem?
Sodium Oxybate (C III). Used for narcolepsy. It is the sodium salt of gamma-hydroxybutyric acid (GHB)
107
What is the BBW for Xyrem?
(Sodium Oxybate). CNS depressant with abuse potential; only to prescribers and patients enrolled in the Xyrem Patient Success Program; Respiratory depression
108
What is the generic name of Provigil?
Modafanil (C IV). Stimulant for sleep disorders (ex. narcolepsy)
109
What is the generic name of Nuvigil?
Armodafanil (C IV). Stimulant for sleep disorders (ex. narcolepsy)
110
What is there a risk for with Provigil and Nuvigil?
Risk of rash; requires MedGuide
111
Besides Provigil and Nuvigil, what other stimulants are used for Narcolepsy?
Methylphenidate (C II). Dextroamphetamine and Amphetamine (C II)
112
What medication classes are used for Insomnia?
Non-benzodiazepine (Z-hypnotics). Melatonin receptor agonist. TCAs (Doxepin (Silenor). Amitriptyline, Nortriptyline off label). Benzos. Antihistamines (tolerance develops)
113
What is the generic name of Ambien?
Zolpidem (Z-hypnotic)
114
What is the generic name of Sonata?
Zaleplon (Z-hypnotic)
115
What is the generic name of Lunesta?
Eszopiclone (Z-hypnotic)
116
What is the new FDA warning for Ambien?
New max dose for women, 5mg IR (instead of 10mg) and 6.25mg CR (instead of 12.5mg)
117
What is the generic name of Rozerem?
Ramelteon (melatonin receptor agonist)
118
What is the generic name of Hetlioz?
Tasimelteon (melatonin receptor agonist)
119
Which hypnotic benzos can be used for insomnia?
Temazepam (Restoril). Estazolam (Prosom). Quazepam (Doral). Flurazepam (Dalmane). Triazolam (Halcion)
120
What medication options are there for Restless Leg Syndrome?
Iron replacement if indicated. Dopamine Agonists (Ropinirole, Pramipexole, Rotigotine). Anticonvulsants (Gabapentin Enacarbil (Hirozant))
121
Which sleep aids for insomnia have no potential for abuse?
Melatonin receptor agonists (Rozerem and Hetlioz)
122
Which medication is indicated for cataplexy in narcolepsy?
Sodium Oxybate
123
What are some of the first line agents for the management of ADHD?
Methylphenidate. Dextroamphetamine & Amphetamine. Stimulants. Dexmethylphenidate. Lisdexamfetamine
124
What is the generic name of Focalin?
Dexmethylphenidate
125
What is the generic name of Ritalin?
Methylphenidate
126
What is the generic name of Methylin?
Methylphenidate
127
What is the generic name of Concerta?
Methylphenidate
128
What is the generic name of Daytrana?
Methylphenidate Transdermal Patch
129
Where should the Daytrana patch be placed?
Applied to the hip area in the morning, 2 hours prior to desired effect
130
What is the generic name of Quillivant?
Methylphenidate powder long acting suspension (stable for 4 months after reconstitution stored at room temp)
131
What is the generic name of Adderall?
Dextroamphetamine & Amphetamine
132
What is the generic name of Dexedrine or Dextrostat?
Dextroamphetamine
133
What is the generic name of Vyvanse?
Lisdexamfetamine (prodrug of dextroamphetamine) - may have less risk of abuse since cannot be injected or snorted
134
What warning did the FDA issue for Methylphenidate?
Warning on the risk of long-lasting erections (Priapism)
135
What is the generic name of Straterra?
Atomoxetine, a non-stimulant option for ADHD
136
What is the BBW for Straterra (Atomoxetine)?
Increased risk of suicidal ideation
137
What is the generic name of Intuniv?
Guanfacine XR, a non-stimulant option for ADHD
138
What is the generic name of Kapvay?
Clonidine XR, a non-stimulant option for ADHD
139
What are two good long acting stimulants?
Vyvanse and Concerta
