Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > CNS Meds: Depression & Psychosis > Flashcards

CNS Meds: Depression & Psychosis Flashcards

(43 cards)

Start Studying
1
Q

Describe the 4 treatment modalities for depression

A
  1. pharmacotherapy
  2. Cognitive behavioral therapy
  3. Electroconvulsive therapy (ECT)
    when drugs & psychotherapy have not worked
  4. Vagus nerve stimulation
    only after treatment with at least 4 drugs has failed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 6 examples of SSRIs

A
  1. Paxil – Paroxetine
  2. Celexa – Citalopram
  3. Prozac – Fluoxetine
  4. Zoloft – Sertraline
  5. Luvox – Fluvoxamine
  6. Lexapro – Escitalopram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the indications of SSRIs?

A

Depression

Other mental disorders: OCD, PTSD, social anxiety disorder, panic disorder, eating disorder

PMS

Enuresis (involuntary urination)

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

Recognize the time that selective serotonin reuptake inhibitors (SSRIs) take to show their effects

A

Effects take 10-21 days

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

Specify 2 precautions that patients on SSRIs must take

A
  1. If they want to stop taking the medication, they should wean gradually.
  2. Take SSRIs with food at bedtime!
    - We want to minimize anticholinergic effects (dry mouth, constipation, urinary retention, dilated pupils, blurred vision, increased HR)
  • Take at bedtime unless sleep is disturbed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List 9 side effects of selective serotonin reuptake inhibitors (SSRIs)

A
  1. insomnia
  2. anxiety
  3. nervousness
  4. headache
  5. weight gain
  6. nausea
  7. GI distress
  8. dry mouth
  9. sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe serotonin syndrome and identify the clinical features of serotonin syndrome

A

It is a rare adverse effect of SSRIs due to autonomic “instability”

Can be life threatening

Sweating, agitation, confusion, hyperreflexia, fever, tremor hallucination, seizures, coma

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

Name 2 alternative antidepressant drugs to SSRIs

A
  1. SNRIs (serotonin-norepinephrine)
    Venlafaxine – Effexor
  2. NDRIs (norepinephrine-dopamine)
    Bupropion – Wellbutrin

***Bupropion is also used for smoking cessation!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the mechanism of action of tricyclic antidepressants (TCAs)

A

TCAs block the neuronal reuptake of 2 monoamine transmitters:

NE and serotonin

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

Name 5 examples of TCAs

A

Amitriptyline – Elavil
Imipramine – Tofranil
Clomipramine – Anafranil
Nortriptyline – Aventyl
Amoxapine –Asendin

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

List 2 indications of TCAs

A

Depression
***Chronic pain: fibromyalgia, migraine, severe depression

TCAs can have sedative/hypnotic effect

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

List 10 side effects of tricyclic antidepressants (TCAs)

A

Sedation & Confusion
Orthostatic hypotension

Arrhythmias, cardiac toxicity

Weight gain

Anti-cholinergic effect

**especially for the elderly
**Take at bedtime to minimize side effects

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

Name 4 examples of monoamine oxidase inhibitors (MAOIs)

A

Isocarboxazid (Marplan)

Phenelzine (Nardil)

Tranylcypromine (Parnate)

Selegiline (Emsam)

Tips to remember:
“Take Pride in Shanghai” lol

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

List 3 examples of monoamine neurotransmitters

A

Norepinephrine

Serotonin

Dopamine

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

Discuss the effect of a patient consuming tyramine-rich foods while being treated with a monoamine oxidase inhibitor (MAOI)

A

MAOIs inhibit monoamine oxidase, so the body cannot get rid itself of excess NE

–> Raised level of NE

–> Hypertensive crisis (life-threatening increase in BP)

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

List the classic examples of tyramine-rich foods

A

Tyramine is commonly found in foods that are aged

  • cheese
  • smoked fish
  • tofu
  • protein extracts
  • sauerkraut
  • miso

There are more!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List 3 drug classes that are likely to lead to serotonin syndrome

A

SSRIs

MAOIs

MDMA (phenylethylamines)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List 2 drug interactions that will also cause serotonin syndrome

Study These Flashcards
A

combine MAOIs with:

  1. opioids like meperidine
  2. tricyclic antidepressants (TCA)
19
Q

List 4 indications of monoamine oxidase inhibitors (MAOIs)

Study These Flashcards
A
  1. Depression
  2. Bulimia nervosa (eating disorder)
  3. Obsession-compulsive disorder
  4. Panic attacks

We do not see MAOIs often in practice, but MAOIs can work effectively for some patients with depression.

20
Q

Recall the disorders for which mood stabilizers are indicated

Study These Flashcards
A

They are often used in bipolar disorder, borderline personality disorder (Luka Yamano!!) , and schizophrenia.

21
Q

List two types of mood stabilizers

Study These Flashcards
A
  1. Lithium
  2. Anticonvulsants – treat epilepsy but can also act as mood stabilizers
22
Q

Describe how lithium benefits patients with bipolar disorder

Study These Flashcards
A

We use lithium to treat acute mania OR prevent future mania/depression

23
Q

Recall how long lithium might take to exert a therapeutic effect

Study These Flashcards
A

Onset of the effects to kick in: 5 - 7 days
Peak: 2-3 weeks after

24
Q

Describe characteristics of borderline personality disorder and explain the role of lithium in the treatment

Study These Flashcards
A

Borderline personality disorder: characterized by mood swings, impulsiveness, and intense fear of abandonment (getting alone)

25
The therapeutic ranges for lithium therapy
Normal: 0.6 - 1.2 mEq/L Toxic: greater than 1.5 mEq/L Can cause death: greater than 2.5 mEq/L
26
Describe mild, moderate, and severe signs of lithium toxicity
Mild: nausea, vomiting, and fatigue Moderate: confusion, agitation, delirium, Severe: coma, seizures
27
Explain how a low serum sodium level can affect lithium levels
Low serum Na can increase the risk of Li toxicity (kidney wants to hold on Na --> body cannot distinguish Na and Li --> Li is also retained)
28
Risk factors for low Na
Diet, diarrhea, and diuretics
29
Review 7 common side effects of Li early in the treatment
GI distress Since Li can mess up electrolyte balance of the body, it can cause: fatigue headache, muscle weakness, confusion, memory impairment polyuria & thirst (Li blocks the effect of ADH)
30
List the classic side effects associated with chronic lithium therapy
1. May cause degenerative changes to the kidney 2. May cause goiter OR hypothyroidism
31
Recall common indications for antipsychotic medications
Used mostly in: Schizophrenia (primary use) Bipolar disorder (in manic phase) Delusional disorders, depressive psychoses, and drug-induced psychoses *** Note: psychosis = a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.
32
Identify which age group should not be administered antipsychotics
Antipsychotics should not be used to treat dementia-related psychoses in the elderly (as they increase the risk of mortality)
33
Differentiate between 1st- and 2nd-generation antipsychotic medications
1st: "conventional antipsychotics" 2nd: "atypical antipsychotics" equally effective but differ in side effects
34
List 3 common 1st-generation antipsychotics (FGAs)
Chlorpromazine Fluphenazine Haloperidol
35
Recall how FGAs are classified
classified by potency (=the size of the daily dose needed) Low: chlorpromazine Medium: fluphenazine High: haloperidol
36
Describe why FGAs have a higher risk of causing extrapyramidal symptoms (EPS)
FGA blocks dopamine receptors in the CNS --> could develop motor issues (just like Parkinson's patients do not have enough dopamine) Note: EPS are often IRREVERSIBLE !!!
37
List 4 examples of EPS
Early reactions (first 3) 1. Dystonia (twisting movement, may respond to anticholinergic medications like benztropine) 2. Parkinsonism 3. Akathisia (motor restlessness) More common with high potent drug! Late reactions 4. Tardive dyskinesia (abnormal movement of face and limbs)
38
List common other side effects associated with chlorpromazine and haloperidol
Chlorpromazine and haloperidol can cause prolonged QT interval. They can also mess up hormonal balance --> galactorrhea, gynecomastia (men develop breast) and mensural irregularities.
39
Describe the signs and symptoms of neuroleptic malignant syndrome (NMS)
Life-threatening adverse effects of FGAs: 1. rigidity (back is arched = opisthotonos) 2. high fever 3. abnormal BP, cardiac dysrhythmias)
40
List medications used to counteract the effects of NMS
Dantrolene: relaxant for rigidity and high fever Bromocriptine: dopamine receptor agonist to relieve CNS toxicity
41
List 3 commonly used 2nd-generation antipsychotics (SGAs)
Clozapine Olanzapine Risperidone **moderately block dopamine and strongly block serotonin receptors --> low risk of EPS Review slide 18 for FGA vs SGA side effects difference!
42
Describe how SGAs may affect metabolism
SGAs can cause metabolic problems like weight gain, diabetes, and dyslipidemia --> increase cardiovascular risk
43
List a concerning side effect of clozapine that makes it a less-optimal SGA choice compared with other SGAs
Clozapine has a unique risk: agranulocytosis (low WBC count) --> could lead to sepsis

Pharmacology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions