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Psych > Banderas: Just the Stuff in Red > Flashcards

Banderas: Just the Stuff in Red Flashcards

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1
Q

Etiology of positive symptoms of schizophrenia

A

Excess DA in mesolimbic system

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2
Q

Etiology of negative symptoms of schizophrenia

A

Deficiency of DA in mesocortical system (2ry to excess 5HT)

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3
Q

Goals of treatment of schizophrenia?

A

Decrease DA in the mesolimbic system

Increase DA in the mesocortical system via 5HT block

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4
Q

Low potency 1st gen antipsychotic?

A

Chlorpromazine

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5
Q

High potency 1st gen antipsychotic?

A

Haloperidol

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6
Q

2nd gen antipsychotics?

A

Quick, Zippy CAR

Q = quetiapine
Z = ziprasidone
C = clozapine
A - aripiprizole
R = risperidone
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7
Q

MOA of 1st gen antipsychotics

A

Non-specific D2 antagonism

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8
Q

MOA of 2nd gen antipsychotics

A

5HT2A antagonism

Weak D2 block

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9
Q

Special considerations with clozapine

A

Decreases seizure threshold (dose-dependent)
QT prolongation risk
Agranulocytosis (requires monitoring)
Most metabolic effects (DM II, lipids, etc)

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10
Q

Tx for antipsychotic-induced dystonia?

A

Anticholinergics (often prescribed with first gen antipsychotics)

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11
Q

What to do when patient develops tardive dyskinesia?

A

D/c 1st gen antipsychotic and switch to 2nd gen antipsychotic

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12
Q

Consideration with IV haloperidol?

A

Especially likely to cause QT prolongation

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13
Q

Compare AE of low- and high-potency 1st gen anti psychotics

A

Low: more anti-HAM effects
High: more EPS effects

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14
Q

2nd gen antipsychotics causing QT prolongation?

A

Greatest risk with clozapine and ziprasidone

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15
Q

Buzzword: cataracts

A

Quetiapine

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16
Q

Antipsychotics with least potential for weight gain

A

Aripiprazole and ziprasidone

17
Q

Action of SSRIs

A

Inhibit reuptake of serotonin; effect of 5HT1A receptors mediates antidepressant effects

18
Q

Your patient runs out of his SSRI medication before leaving town and cannot refill it while away. What may occur?

A

Discontinuation effects (anxiety, rebound depression, flu-like symptoms, etc)

Fluoxetine has long half-life (“self-tapering”) and can help avoid this problem, but also can cause interactions if initiating another therapy.

19
Q

Which SSRIs hold the highest risk of QT prolongation

A

Es/citalopram

20
Q

Which SSRI has the worst sexual side effects?

A

Paroxetine

21
Q

Which SSRIs should not be used in a patient who has insomnia?

A

Fluoxetine and sertraline - these are mildly stimulating

22
Q

What is the MOA of trazadone?

A

SSRI
5HT2A antagonism
H1 antagonism

23
Q

What might be a good adjunctive therapy for a patient currently taking an SSRI but struggling with insomnia?

A

Trazadone

24
Q

Which antidepressant is most associated with orthostatic hypotension?

A

Trazadone

25
Q

MOA of SNRIs

A

Antagonizes POSTsynaptic a2 receptors
Antagonizes 5HT POSTsynaptic receptors

Inhibit reuptake of serotonin and NE

26
Q

Which antidepressant might be prescribed to a patient concerned about sexual side effects?

A

Bupropion

27
Q

Should bupropion be taken in AM or PM?

A

AM - mildly stimulating

28
Q

Special considerations with mirtazapine

A

High incidence of sedation and weight gain

29
Q

When using cyclic antidepressants to treat depression-related insomnia, what should be considered?

A

Much lower dose is used for sleep than for antidepressant effect

30
Q

What is the action of benzodiazepines?

A

Promote GABA binding to GABAa receptors –> Cl conductance

31
Q

A low dose of benzo is good for what effect?

A

Calming and decreased anxiety (higher dose = sedation)

32
Q

What is an appropriate tx for an acute, severe anxiety crisis?

A

Benzodiazepine, IV or PO

33
Q

What are appropriate tx options for chronic anxiety?

A

SSRIs/antidepressants
Buspirone
Antipsychotics

34
Q

What is the goal of ADHD pharmacotherapy?

A

Optimal dosing to improve NE signaling and better direct DA firing

35
Q

What is the association between ADHD treatment and subsequent substance abuse disorders?

A

Kids with untreated ADHD are 1.9 fold more likely to develop a substance abuse disorder later in life than those kids who are appropriately treated

Psych (6 decks)

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