Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych > 2/18: Drug Syndromes > Flashcards

2/18: Drug Syndromes Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Serotonin syndrome + epidemiology

A

newborns to elderly, ppl who have overdosed on SSRIs (single SSRI dose can produce the syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Serotonin syndrome + precipitating factors

A

concurrent CYP2D6 and 3A4 inhibitors, withdrawal of concurrent drug tx; agonism of 5-HT2a receptors contribute substantially to the clinical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

serotonergic neurons in the CNS

A

midline raphe nuclei: brainstem from midbrain –> medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

serotonergic neurons in the CNS: rostral end of the raphe nuclei

A

assists in regulation of wakefulness, affective behavior, food intake thermoregulation, migraine, emesis, and sex behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

serotonergic neurons in the CNS: raphe in the lower pons and medulla

A

participate in regulation of nociception and motor tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

peripheral serotonergic neurons in the CNS

A

assist in regulation of vascular tone and GI motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

spectrum of findings in serotonin syndrome

A

from mild –> life-threatening:

akathisia, tremor, AMS, clonus (inducible–> sustained), muscular hypertonicity), hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

management of serotonin syndrome

A
  • discontinue use of all potential precipitating drugs
  • provide supportive management
  • control agitation
  • admin serotonin antagonist (cyproheptadine)
  • control autonomic instability
  • control hyperthermia
  • reassess the need to resume the use of the serotonergic agent once the sx have resolved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lithium

A

used in the tx of bipolar disorder; reported to inc serotonin metabolites in the CSF and my interact PD with SSRIs, resulting in serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

drugs assoc with serotonin syndrome: SSRIs

A

sertraline, fluozetine, fluvoamine, paroxetine, citalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

drugs assoc with serotonin syndrome: antidepressants

A

trazodone, nefazodone, busipirone, clomipramine, venlafaxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

drugs assoc with serotonin syndrome: MAOIs

A

phenelzine, isocarboxazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

drugs assoc with serotonin syndrome: AEDs

A

valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

drugs assoc with serotonin syndrome: analgesics

A

meperidinem fentanyl, tramadol, pentazocine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

drugs assoc with serotonin syndrome: antiemetics

A

ondansetron, graniestron, metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drugs assoc with serotonin syndrome: anti migraine drugs

A

sumatriptans

17
Q

drugs assoc with serotonin syndrome: dietary supplements and herbal products

A

tryptophan, st. john’s wort, ginseng

18
Q

neuroleptic malignant syndrome: MOA + sx

A

blockade of D2 receptors in hypothalamus –> HYPERTHERMIA
blockade of inhibitory actions of dopamine on the SNS –> ANS dysfx
Blockade of nigrostriatal dopamine –> inc muscle rigidity/tremor via extrapyramidal pathways (possible direct muscle toxx via an inc in Ca2+ release from the SR)

19
Q

MC RF for NMS

A

high-dose and high-potency antipsychotic agents (haloperidol»>clozapine, but both), during rapid dose escalation, and with depot forms (IM) of drug release

20
Q

other RF for NMS

A

concomitant use of predisposing drugs (anti-depressants, anticholinergics, lithium), w/drawal of anti-Parkinsonian agents, previous hx of NMS, inc ambient temp or dehydration, catatonia or agitation, history of affective disorders or physical disorders of brain that cause a dec in mental fx

21
Q

management of NMS

A

withdraw causative drug and institute supportive care

22
Q

management of NMS: avoid the following Cx

A

rhabdomyolysis, renal and respiratory failure, recurrence

23
Q

management of NMS: common drug approaches

A

1) dopamine agonists: bromocriptine&raquo_space; amantadine
2) dantrolene: sk.mm. relaxant (also used to treat malignant hyperthermia)
3) lorazepam: reduce psychosis, agitation and anxiety; act as an anticonvulsant

24
Q

management of malignant hyperthermia

A

admin dantrolene IV (to restore IC management of Ca levels), correct metabolic acidosis, monitor serum K+ (admin insulin + glucose + CaCl or gluconate + IV lidocaine for arrhythmia), cool body to <38˚C, maintain urinary output (cold fluids, furosemide and mannitol, if needed)

25
Q

malignant hyperthermia

A

uncontrolled release of Ca from the SR, leading the the sk.mm. contraction and to stimulation of intermediary metabolism –> metabolic acidosis
*assoc MC with the use of volatile anesthetics and the short-acting neuromuscular blocking drug succinylcholine

26
Q

anticholinergic “poisoning”

A

gives rise to dec PaNA activity –> conseq CV ∆ due to unimpeded SNS stim

27
Q

management of anticholinergic “poisoning”

A

hyperthermia and agitation: tx with cooling and BNZs

28
Q

when is physostigmine given for anticholinergic poisoning

A

pt with severe “self-harming” psychosis or hemodynamic dysfx 2˚ to tachydysrhythmias; can access BBB

*not given bc of toxicities: seizures, bradyasystole; contra with TCA overdose bc of seizures

Psych (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions