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Psychopharmacology > Antipsychotics and Antidepressants > Flashcards

Antipsychotics and Antidepressants Flashcards

1
Q

Antidepressants

a patient with major depressive disorder is most likely to develop antidepressant poop-out during maintenance treatment when she is taking which antidepressant?

A

sertraline

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2
Q

Antidepressants

this type of antidepressant is a selective inhibitors of norepinephrine (NE; greater reuptake of NE) & tends to have a better side effect profile (i.e., no sedative, anticholinergic, or hypotensive side effects)

A

secondary amines

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3
Q

Antidepressants

(SSRIs/TCAs) tend to have fewer side effects & are less cardiotoxic

A

SSRIs

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4
Q

Antidepressants

which antidepressant is least likely to have an adverse impact on sexual functioning?

A

bupropion (Wellbutrin)

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5
Q

First Generation Antipsychotics

this is a severe side effect of long-term use of first-gen antipsychotic?

A

tardive dyskinesia

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6
Q

Antipsychotics

this side effect primarily begins with involuntary movements of the tongue, face, and jaw

A

tardive dyskinesia

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7
Q

Antidepressants

taking both an SSRI and an MAOI together may cause this side effect, which is characterized by agitation, hyperthermia, & autonomic instability (e.g., sweating, increased body temp, rapid heart rate, high blood pressure)

A

serotonin syndrome

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8
Q

Antidepressants

this antidepressant (generic name) increases norepinephrine and dopamine levels, resulting in an energizing (stimulating) effect

A

buproprion (Wellbutrin)

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9
Q

First Generation Antipsychotics

list 4 extrapyramidal side effects (EPS) side effects caused by first-generation antipsychotics

A

1) tardive dyskinesia (e.g., involuntary, repetitive movements in the face, arms, legs)
2) parkinsonism (e.g., tremors, rigidity)
3) dystonia (e.g., involuntary muscle contractions, spasms, and abnormal postures)
4) akathisia (e.g., restlessness, inabiltiy to sit still)

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10
Q

Second Generation Antipsychotics

primary side effects of second-gen antipsychotics

A

metabolic (weight gain)

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11
Q

First Generation Antipsychotics

list the sxs of schizophrenia that are targeted by first-gen antipsychotics

A

only positive sxs
e.g., hallucinations & delusions

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12
Q

Second Generation Antipsychotics**

list the sxs of schizophrenia that are targeted by second-gen antipsychotics?

A

positive & negative sxs

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13
Q

Antipsychotics

list the main differences in treatment effects (i.e., neurological) between first-gen & second-gen antipsychotics

A

first-gen: block dopamine receptors

second-gen: block dopamine & serotonin receptors

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14
Q

First Generation Antipsychotics

list the 4 first-gen antipsychotics (generic names)

A
  • chlorpromazine (Thorazine)
  • haloperidol (Haldol)
  • thioridazine (Mellaril)
  • fluphenazine (Prolixin)
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15
Q

First Generation Antipsychotics

list 2 major side effects of first-gen antipsychotics

A
  • extrapyramidal side effects (EPS)
  • neuroleptic malignant syndrome
    (e.g., agranulocytosis
    cardiotoxic)
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16
Q

First Generation Antipsychotics

list 5 symptoms indicative of anticholinergic side effects from first-gen antipsychotics

list the 2 meds most likely to cause these side effects (low potency)

A
  • dry mouth
  • blurred vision
  • urinary retention
  • constipation
  • tachycardia

chlorpromazine & thioridazine

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17
Q

First Generation Antipsychotics

name the 2 high potency first-gen antipsychotics more likely to cause extrapyramidal side effects

A

haloperidol & fluphenazine

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18
Q

First Generation Antipsychotics

this extrapyramidal side effect is potentially life threatening, begins after long-term drug use, and is more common in women & older adults

A

tardive dyskinesia

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19
Q

First Generation Antipsychotics

list 2 symptoms of tardive dyskensia

A
  • involuntary, rhythmic movements of the tongue, face, & jaw (may also affect the limbs & trunk)
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20
Q

First Generation Antipsychotics

describe the treatment for tardive dyskinesia

A
  • irreversible
  • taper off
  • Rx benzo or second-gen antipsychotic
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21
Q

First Generation Antipsychotics

symptoms of neuroleptic malignant syndrome

A

autonomic dysfunction
- unstable blood pressure
- tachycardia
- excessive sweating

altered mental state
- confusion
- combativeness

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22
Q

First Generation Antipsychotics

describe the treatment for neuroleptic malignant syndrome

A
  • stop at first sign
  • hydrate & cool
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23
Q

Second Generation Antipsychotics

list the 5 second-gen antipsychotics (SGAs)

A
  • clozapine (Clozaril)
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • aripiprazole (Abilify)
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24
Q

Second Generation Antipsychotics

list the 2 primary disorders second-gen antipsychotics treat

A

schizophrenia
MDD

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25
# **Antipsychotics** this second-gen antipsychotic is used for **treatment-resistant schizophrenia**
clozapine (Clozaril)
26
# **Second Generation Antipsychotics** second-gen antipsychotics alleviate **positive symptoms** of schizophrenia by blocking which neurotransmitter? And, alleviate **negative & cognitive symptoms** of schizophrenia by blocking which neurotransmitter?
* **dopamine** (D3 & D4) * **serotonin**
27
# **Second Generation Antipsychotics** list the most common side effect of second-gen antipsychotics
metabolic syndrome
28
# **Second Generation Antipsychotics** list symptoms of **metabolic syndrome**
**substantial weight gain** **increased risk for diabetes & heart disease** - high blood pressure - insulin resistance - hyperglycemia
29
# **Second Generation Antipsychotics** this second-gen antipsychotic is most likely to cause **neutropenia & agranulocytosis**
clozapine (Clozril)
30
# **Second Generation Antipsychotics** this severe side effect, caused by second-gen antipsychotics, is **potentially life-threatening** and involves **dangerously low levels of white blood cells**, which are an essential part of the body’s immune system
**neutropenia** (*e.g., agranulocytosis*)
31
# **Second Generation Antipsychotics** patients taking clozapine must have regular blood tests and, when neutrophil levels are too low, treatment may include...
- **discontinuing** the drug - Rx **antibiotic** for infections - Rx meds to **improve body's ability to produce neutrophils** more quickly
32
# **Antidepressants** list 5 types of antidepressants
- selective **serotonin** reuptake inhibitors (SSRIs) - **serotonin and norepinephrine** reuptake inhibitors (SNRIs) - **norepinephrine dopamine** reuptake inhibitors (NDRIs) - **tricyclic** antidepressants (TCAs) - **monoamine oxidase** inhibitors (MAOIs)
33
# **Antidepressants** list 5 SSRIs (generic names)
1) **sertraline** (Zoloft) 2) **citalopram** (Celexa) 3) **paroxetine** (Paxil) 4) **fluoxetine** (Prozac, Sarafem) 5) **fluvoxamine** (Luvox)
34
# **Antidepressants** list the most frequently prescribed class of antidepressant, which is also generally considered first-line pharmacological treatment for MDD and PDD
SSRIs
35
# **Antidepressants** list common disorders treated with SSRIs
- MDD & PDD - PMDD - OCD - GAD - PTSD - panic disorder - **bulimia nervosa** - **premature ejaculation**
36
# **Antidepressants** SSRIs are classified as **serotonin agonists** or **indirect agonists**, explain how these meds exert their **therapeutic effects**
* **block resynaptic reuptake** of serotonin > * **increase availability** of serotonin in the synaptic cleft
37
# **Antidepressants** list 3 advantages of SSRIs
- **fewer** side effects - safer in overdose/**less cardiotoxic** - **safer** for older adults
38
# **Antidepressants** list 5 side effects of SSRIs
- mild anticholinergic effects - GI disturbances - insomnia - anxiety - sexual dysfunction
39
# **Antidepressants** abruptly stopping this class of medication can cause **discontinuation syndrome**, which is characterized by headaches, dizziness, mood lability, impaired concentration, sleep disturbances, & flu-like symptoms
SSRIs
40
# **Antidepressants** when SSRIs are combined with these meds, the likelihood of serotonin syndrome increases
* MAOIs * lithium * other **serotonergic** drugs
41
# **Antidepressants** this severe side effect of is **potentially fatal** & involves extreme **agitation, confusion, autonomic instability, hyperthermia, tremor, seizures, & delirium**
serotonin syndrome
42
# **Antidepressants** describe the treatment for serotonin syndrome
- **immediate withdrawal** of serotonergic drugs - treat symptoms w/ appropriate medical interventions
43
# **Antidepressants** this side effect is caused by taking an SSRI (or MAOI), occurs when a person with depression loses a previous antidepressant treatment response, and is caused by a person staying on the same drug & dosage
tachyphylaxis
44
# **Antidepressants & Antipsychotics** common signs of **tachyphylaxis**
- apathy - fatigue - dulled cognitive functioning - sleep disturbance - sexual dysfunction
45
# **Antidepressants** describe treatment strategies for **tachyphylaxis**
- **increasing** dosage of current drug - **switching meds** (*e.g., a different SSRI, a SNRI [Venlafaxine], a TCA [Clomipramine]*) - **augmenting** current SSRI w/ another med - **depression-focused therapy**
46
# **Antidepressants** list 4 common meds used in the treatment of tachyphylaxis to augment current SSRI
- TCAs - bupropion - lithium - atypical antipsychotic
47
# **Antidepressants** SSRIs have a delayed onset with **initial therapeutic effects** occurring at how many weeks, with **full effects** not being achieved until how long?
initial: **2 - 4 weeks** full: **6 - 8 weeks**
48
Generic names for the 3 SNRIs
1) venlafaxine (Effexor 2) duloxetine (Cymbalta) 3) desvenlafaxine (Pristiq)
49
list 3 disorders treated by SNRIs
- MDD - **social anxiety** disorder - neuropathic **pain** & other pain disorders
50
# **Antidepressants** SNRIs may be more effective than SSRIs for what disorder?
severe depression
51
# **Antidepressants** this class of meds exerts its therapeutic effects by **inhibiting the reuptake** of serotonin and norephinephrine **at synapses**
SNRIs
52
# **Antidepressants** these 2 healthissues are caused by **abruptly stopping SNRIs**, especially if combined with other serotonergic drugs
* **discontinuation** syndrome * **serotonin** syndrome
53
# **Antidepressants** SNRIs effects on norepinephrine may cause cause these 3 side effects associated to norepinephirne & are **contraindicated** for people with what pre-existing health issues
- same as SSRIs - elevated blood pressure - hypertension & heart problems
54
# **Antidepressants** list the generic name for 1 NDRI & list the disorders this med treats
- B (Wellbutrin, Zyban) - MDD - smoking cessation
55
# **Antidepressants** this class of meds exert their therapeutic effects by **inhibiting the reuptake of norepinephrine and dopamine at synapses**
NDRIs inhibiting
56
# **Antidepressants** list 6 side effects of NDRIs
- skin **rash** - decreased appetite and **weight loss** - agitation - insomnia - dizziness - seizures
57
# **Antidepressants** list 3 advantages of bupropion (Wellbutrin)
- causes **few anticholinergic effects** - does **not cause sexual dysfunction** - **not cardiotoxic**
58
# **Antidepressants** antidepressants that **increase levels of norepinephrine and dopamine** have what type of an effect? This means they’re useful for patients who have low energy and low motivation but not for those who have what disorders?
* energizing * insomnia & severe anxiety
59
# **Antidepressants** list the meds, which are categorized as tertiary or secondary amines based on their chemical structure.
TCAs
60
# **Antidepressants** list the 4 generic names for tertiary amines (TCAs)
1) amitriptyline (Elavil) 2) imipramine (Tofranil) 3) clomipramine (Anafranil) 4) doxepin (Sinequan)
61
# **Antidepressants** these meds exert their effects by inhibiting the reuptake of both serotonin and norepinephrine, with some having a stronger effect on serotonin
tertiary amines (TCAs)
62
# **Antidepressants** list the 3 generic names for secondary amines (TCAs)
1) **nortriptyline** (Pamelor) 2) **desipramine** (Norpramin)
63
# **Antidepressants** this type of TCA is more potent at **inhibiting the reuptake of norepinephrine than serotonin**
**secondary** amines
64
# **Antidepressants** list 4 disorders trerated with TCAs
- MDD - panic disorder - OCD - neuropathic **pain**
65
# **Antidepressants** list the TCA primarily used to treat **OCD**
clomipramine (Anafranil)
66
# **Antidepressants** list the TCA primarily used to treat **neuropathic pain**
nortiptyline (Pamelor) & amitriptyline (Elavil)
67
# **Antidepressants** list 5 side effects of TCAs
**CARDIOTOXIC** - **cardiovascular effects** (e.g., hypertension, tachycardia, orthostatic hypotension) **anticholinergic** effects sedation weight gain sexual dysfunction
68
# **Antidepressants** this type of TCA is **less likely** to cause sedation and anticholinergic effects.
**secondary** amines
69
# **Antidepressants** this type of antidepressant is most likely to induce a **manic or hypomanic episode when used to treat bipolar disorder**
TCAs
70
# **Antidepressants** this type of antidepressant must be **prescribed with caution** for people who have heart disease or are suicidal because they are **cardiotoxic**
TCAs
71
# **Antidepressants** list generic names for 3 MAOIs
1) phenelzine (Nardil) 2) isocarboxazid (Marplan) 3) tranylcypromine (Parnate)
72
# **Antidepressants** this type of antidepressant is most useful for **treatment-resistant depression** or **atypical depression**
MAOI
73
# **Antidepressants** list 3 symptoms of **Antidepressants**
reversed **vegetative symptoms** - hypersomnia - increased appetite - reactive dyphoria
74
# **Antidepressants** this **deactivates** norepinephrine, serotonin, and dopamine, and this med **increases** the levels of these neurotransmitters by inhibiting the activity of this enzyme
the enzyme monoamine oxidase
75
# **Antidepressants** list 4 side effects of MAOIs
- anticholinergic effets - orthostatic hypotension - sedation - sexual dysfunction
76
# **Antidepressants** combining this type of antidepressant with amphetamines, antihistamines or **foods containing tyramine** (e.g., aged cheese and meat, soy products, beer, red wine, sauerkraut, fava beans, ripe bananas can produce hypertensive crisis characterized by severe, throbbing headache, neck pain/stiffness, rapid heart rate, nausea & vomiting, sweating, sensitivity to light, and confusion & delirium
MAOIs

Psychopharmacology (2 decks)

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