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Behavioral health > BH pharmacology > Flashcards

BH pharmacology Flashcards

1
Q

BZD MOA

A

Binds postsynaptic GABA neuron (inhibitory) -> potentiates endogenous GABA

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2
Q

BZD ADRs (5)

A
  • Sedation
  • Dizziness, confusion, ataxia
  • Teratogenicity
  • Withdrawal sx
  • Abuse potential
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3
Q

BZD clinical pearl

A

Use SHORT TERM for anxiety until AD kicks in

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4
Q

Alprazolam indications (4)

A
  • GAD
  • Panic disorder +/- agoraphobia
  • Short-term relief of anxiety
  • Anxiety assoc. w/ depression
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5
Q

Clonazepam indications (2)

A
  • Panic disorder +/- agoraphobia

- Seizure disorder

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6
Q

Lorazepam indications (4)

A
  • Short-term relief of anxiety
  • Status epilepticus
  • Sedation/amnesia
  • ETOH withdrawal/”agitation”
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7
Q

Diazepam indications (2)

A
  • Seizure disorders

- “conscious sedation”

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8
Q

Midazolam indications (1)

A
  • “conscious sedation”
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9
Q

First line drug for anxiety

A

SSRI

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10
Q

First step for treating pediatric patients with anxiety

A

CBT

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11
Q

BZDs BBW

A

Taking benzodiazepines at the same time as opioids can lead to extreme sedation, slow and ineffective breathing, comas, and even death

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12
Q

SSRI MOA

A

Blocks serotonin reuptake -> increases synaptic serotonin

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13
Q

SSRI BBW

A

Suicide (monitor @ initiation, dose changes)

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14
Q

SSRI ADRs (7)

A
  • Sexual side effects (decreased libido, delayed ejaculation, anorgasmia)
  • Anorexia -> wt. loss -> wt. gain
  • Bruxism
  • SIADH
  • Long QT
  • Serotonin syndrome
  • Discontinuation/FINISH syndrome
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15
Q

Serotonin syndrome sx

A
  • Flushing
  • Hyperthermia
  • Agitation
  • Muscle rigidity
  • Seizure
  • Coma
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16
Q

Discontinuation/FINISH syndrome sx

A
  • Flu-like sx
  • INsomnia
  • Imbalance
  • Sensory disturbances (coordination)
  • Hyperarousal (agitation/anxiety)
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17
Q

SSRI categories in pregnancy (1st trimester)

A

C - all others (use fluoxetine! most data)

D - paroxetine (CV malformation)

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18
Q

SSRI adverse events in pregnancy (3rd trimester)

A
  • Neonatal ICU syndrome
  • Withdrawal rxns
  • Persistent pulmonary hypertension
19
Q

Which SSRI has the longest half life? Shortest half life?

A

Longest: fluoxetine
Shortest: paroxetine

20
Q

Fluoxetine indications (5)

A
  • MDD
  • OCD
  • Panic disorder +/- agoraphobia
  • Bulimia
  • PMDD
21
Q

Sertraline indications (6)

A
  • MDD
  • OCD
  • Panic disorder +/- agoraphobia
  • Social anxiety disorder
  • PMDD
  • PTSD
22
Q

Paroxetine indications (6)

A
  • MDD
  • OCD
  • Panic disorder +/- agoraphobia
  • Social anxiety disorder
  • GAD
  • PMDD
  • PTSD
23
Q

Citalopram indications (1)

A
  • MDD
24
Q

Escitalopram indications (2)

A
  • MDD

- GAD

25
Q

SNRI MOA

A

Inhibit serotonin & NE reuptake (pain management MOA unknown)

26
Q

SNRI ADRs (4)

A
  • Nausea
  • Constipation
  • Dizziness
  • Insomnia
  • BP and HR increase
  • Serotonin syndrome
  • Discontinuation/FINISH syndrome
27
Q

Duloxetine specific ADR

A

Hepatotoxicity

28
Q

Which SNRI has the greatest risk of discontinuation syndrome?

A

Venlafaxine

29
Q

Velafaxine indications (4)

A
  • MDD
  • GAD
  • Panic disorder +/- agoraphobia
  • Social anxiety disorder
30
Q

Desvenlafaxine indications (1)

A
  • MDD
31
Q

Duloxetine indications (3)

A
  • MDD
  • GAD
  • Pain* (diabetic neuropathy, fibromyalgia, chronic MSK pain) *not first line
32
Q

Milnacipran (type of SNRI) indication (1)

A
  • Fibromyalgia
33
Q

Levomilnacipran (type of SNRI) indication (1)

A
  • MDD
34
Q

Bupropion MOA

A

“Amphetamine-like”

35
Q

Bupropion indications

A
  • MDD
  • SAD
  • Adjunct in smoking cessation
36
Q

Bupropion ADRs (4)

A
  • Seizure threshold lowering (esp. bulimic, anorexic pt.)
  • HA
  • Anxiety
  • Insomnia
37
Q

Bupropion pearl

A

Good choice if sexual function concerns

38
Q

Trazadone indications (1)

A
  • MDD (esp. if insomnia present!!!!)
39
Q

Trazadone MOA

A
  1. Serotonin receptor antagonist
  2. Inhibits serotonin reuptake (SSRI)
  3. Antagonist of histamine and alpha receptors
40
Q

Trazadone ADRs (4)

A
  • Sedation
  • Postural hypotenion
  • QT prolongation
  • Priapism
41
Q

Mirtazapine MOA

A

Involves NE, serotonin, histamine

42
Q

Mirtazapine indications

A
  • MDD + insomnia

- MDD + anorexia

43
Q

Mirtazapine ADRs

A
  • Weight gain d/t increased appetite
  • Sedation
  • Dry mouth
44
Q

TCAs

A

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Behavioral health (2 decks)

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