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Psychiatry > Antipsychotics Pharmacology > Flashcards

Antipsychotics Pharmacology Flashcards

1
Q

Typical Antipsychotics AE?

A

AE:
1. EPS symptoms: Dystonia torticollis 4 hrs (head is tilted to one side and cannot straighten out)=> akathisia 4 days =>bradykinesia 4 weeks=>tardive dyskinesia 4 months

  1. Galactorrhea (decreased dopamine)
  2. Neuroleptic Malignant Syndrome (Think FEVER)=> No thermostat=> Too Hot=>Muscle breaks down=>Rigidity, myoglobinuria, pyrexia (Tx: D2 agonist)
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2
Q

Typical Antipsychotics

A

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine
(haloperidol + “-azines”)

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3
Q

Typical Antipsychotics MOA? Use?

A

MOA: block dopamine D2 receptors ([cAMP])
Use: Schizophrenia, acute mania, Tourette Syndrome

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4
Q

High Potency Antipsychotics?

A

High Potency: Try to Fly High
Trifluoperazine
Fluphenazine
Haloperidol

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5
Q

Low Potency Antipsychotics?

A

Low potency: (Cheating Thieves are low)

Chlorpromazine, Thioridazine

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6
Q

Chlorpromazine AE?

A

Corneal deposits

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7
Q

Thoridazine AE?

A

reTinal deposits

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8
Q

Haloperidol AE?

A

NMS, Tardive Dyskinesia

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9
Q

Atypical antipsychotics What are they?

A

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone

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10
Q

Atypical antipsychotics MOA?

A

MOA: Varied effects on 5-HT2, dopamine, and α- and H1-receptors

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11
Q

Atypicals are 1st line for?

A

Schizophrenia

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12
Q

Olanzapine/Clozapine AE?

A

Olanzapine and Clozapine make you look like an O

Clozapine Cills granulocytes (agranulocytosis)

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13
Q

Risperidone AE?

A

Increase prolactin=>gynecomastia

Menstruation and fertility issues

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14
Q

Aripiprazole Unique?

A

Partial agonist

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15
Q

CNS Stimulants (Methylphenidate, dextroamphetamine, methamphetamine) MOA? First line? AE?

A

MOA: Increased catecholamines in the synaptic cleft (NE and DA)
First line for ADHD
AE: suicide

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16
Q

Lithium MOA? First line? AE? What Drug should you not try to use it with?

A

MOA: Gq=>blocks Gs/Gi receptors
First Line: Bipolar Disorders
AE: LMNOP (Movement (tremor), Nephrogenic diabetes insipidus, HypOthyroidism,
Pregnancy problems)
Drug Interactions: Thiazides increase lithium toxicity (Tx: amilroiode)

17
Q

BUSpirone MOA, Use?

A

MOA: stimulates serotonin receptors
Use: Generalized anxiety disorder
“I always worry about whether I can get on the BUS on time”

18
Q

SSRIs?

A

Fluoxetine, paroxetine, sertraline, citalopram

Fiery, Peppery, Sizzling Condition

19
Q

SSRI MOA? 1st line?

A

MOA: 5-HT–specific reuptake inhibitors
1st line: Bulimia, Depression,
Generalized anxiety disorder, Obsessive-compulsive disorder, Panic disorder, PTSD, Social phobias

20
Q

SSRI AE: Think of the S’s

A

SSRI=>Stomach, SIADH, Sexual Stopper, Serotonin Syndrome

21
Q

Serotonin Syndrome? MOA? Tx?

A

Any drug that increases 5-HT (Serotonin)

Hyperthermia, Confusion, Flushing, Diarrhea
Tx: Cyproheptadine

22
Q

How long does it take for SSRIs to work?

A

4-8 weeks

23
Q

SNRIs?

A

Venlafaxine, Duloxetine

Very Different

24
Q

SNRIs First Line? AE? Why use it?

A

Panic disorder, PTSD, Generalized anxiety disorder
AE: Hypertension
Why? SNRIs don’t have the 3 C’s (Cardiotoxicity, Convulsions, Coma)

25
Q

TCA?

A

Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine (-ptyline, pramine)

26
Q

TCAs MOA, Use, AE?

A

MOA: Block reuptake of norepinephrine and 5-HT.
Use: OCD (clomipramine)
AE: 3 C’s Cardiotoxicity, Convulsions, Coma

27
Q

TCA AE Tx?

A

NaHCO3

28
Q

MAO inhibitors

A

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor). (MAO Takes Pride In Shanghai).

29
Q

Selective MAO-B inhibitor?

A

Selegiline

30
Q

Monoamine oxidase (MAO) inhibitors MOA?

A

MOA: Nonselective MAO inhibition=>increased levels of amine neurotransmitters (norepinephrine, 5-HT, dopamine)

31
Q

MAO AE?

A

Hypertensive Crisis
Don’t Use with SSRIs, TCAs, St. John’s wort, meperidine, dextromethorphan
STOP (SSRI, TCA, st. JOhn’s Wort, mePeridine)

32
Q

What foods should use watch out when using MAO inhibitors?

A

Tyramine, wine and cheese

33
Q

A patient w/ mao inhibitor eats cheese, wine and chocolate then drops dead. Why is he dead?

A

Hypertensive Crisis

34
Q

BuPropion (wellbutrin) Use? AE?

A

Use: smoking cessation
AE: seizures in anorexic/bulimic patients

35
Q

Mitazapine MOA? AE?

A

MOA: A2 antagonist
Use: Anorexia
AE: Increased appetite and weight gain

36
Q

Trazodone MOA? AE?

A

MOA: Blocks Serotonin and alpha 1 receptors
AE: Hypotension and trazoBONE (BONER=priaprism)

Psychiatry (10 decks)

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