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Psych II > Drugs > Flashcards

Drugs Flashcards

1
Q

SSRI’s

A
  • fluoxetine (prozac)
  • sertraline (zoloft)
  • paroxetine (paxil)
  • citalopragm (celexa)
  • escitalopram (lexapro)
  • luvaxamine (luvox)
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2
Q

When should you take SSRI’s?

A

In the morning

- they tend to be activating

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3
Q

Timelines for SSRI therapy?

A

Depression 2-6 weeks
Panic d/o 4-8 weeks
OCD 6-12 weeks

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4
Q

Common SSRI SE?

A 
HA
Nausea
Tinnitus
Insomnia
Nervousness
Akathisia (agitation, restless)
Bleeding
Sexual se
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5
Q

Why do SSRI’s cause bleeding?

A

They effect platelet serotonin levels -> abnormal bleeding

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6
Q

Withdrawal symptoms of SSRI’s?

A 
Dizziness
Paresthesias
Dysmorphic mood
Agitaiton
Flu-like
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7
Q

Which SSRI’s are more likely to cause withdrawal symptoms?

A

Short acting SSRI
Paroxetine (Paxil) has the shortest 1/2 life
Fluoxetine is the longest acting (4-6 days)

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8
Q

SSRI and pregnancy?

A

Nope

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9
Q

Fluoxetine (prozac) may cause?

A

Drowsiness

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10
Q

Paroxetine is aka?

A

Paxil

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11
Q

Paroxetine (paxil) may cause?

A

Drowsiness

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12
Q

Citalopram is aka?

A

Celexa

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13
Q

Citalopram (celexa) is best for what type of pt?

A

Safer w warfarin so anyone on blood thinners

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14
Q

Escitalopram is aka?

A

Lexapro

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15
Q

Luvaxamine isa aka?

A

Luvox

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16
Q

common SNRI se?

A 
Milld tachycardia
HTN
Sexual se
Mydriasis 
Urinary constriction
Abnormal bleeding
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17
Q

What are the SNRIs?

A

Venlafaxine

Duloxetine

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18
Q

Venlafaxine is aka?

A

Effexor

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19
Q

Venlafaxine (effexor) lacks?

A

Significant anticholinergic s/e

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20
Q

Venlafaxine (effexor) is not good for?

A

BP

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21
Q

Duloxetine is aka?

A

Cymbalta

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22
Q

Duloxetine (cymbalta) is not good for?

A

BP

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23
Q

TCA common SE?

A 
Anticholinergic effect
Cardiac effects 
Lower seizure threshold
Loss of libido
Sexual dysfunction

Must taper

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24
Q

Cardiac effects of TCA’s?

A

Function of anticholinergic and direct myocardial depression

  • altered rate,
  • rhythm,
  • contractility

Esp w preexisting cardiac disease
- bundle branch block

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25
Q

The TCA’s are?

A

Amitriptyline

Imipramine

26
Q

Amitryptyline is aka?

27
Q

Imipramine is aka?

28
Q

Whats bad about imipramine (tofranil)

A

Even small doses can cause lethal arrhythmias

29
Q

The atypical antidepressants are?

A

Bupropion - W
Trazadone
Mirtazapine

30
Q

Bupropion is aka?

A

Wellbutrin

31
Q

Trazadone is aka?

Its use?

A

Desyrel

Help them sleep

32
Q

Mirtazapine is aka?

Its use?

A

Remeron

Help them eat

33
Q

Never give ___ to a bipolar

A

Bupropion (wellbutrin)

34
Q

What are antipsychotics used for?

A

All forms of:

  • schizophrenias
  • psychotic ideation/delirium
  • drug induced psychosis
  • psychotic depression
  • unipolar depression
  • acute mania
  • mood cycles in bipolar
35
Q

Antipsychotics may cause (elderly)?

A

Early mortality in elderly dementia pts

36
Q

Common se of antipsychotics?

A 
Dry mouth
Blurred near vision
Urinary retention
Delayed gastric emptying
Esophageal reflux
Ileus delirium
Acute glaucoma
Orthostatic HOTN
Sexual dysfunction 
EKG changes 
Extrapyrimidal
37
Q

What extrapyrimidial symptoms do antipsychotics cause?

A

Akathias (MC)
Acute dystonia
Tardive dyskinesia
Drug induced parkinsoniasm

38
Q

Atypical have less SE but what specific SE do they have?

A 
New onset DM
Hyperlipidemia
Weight gain
Metabolic and endocrine effects
Impaired temp regulation
Water intoxication
Lactation and menstrual irregularities
Bone marrow depression
Cholestatic jaundice
39
Q

List of atypical antipsychotics?

A 
Ariprprazole (abilify)
Clozapine (clozaril)
Ziprasidone (geodon)
Quetiapine (seroquel)
Resperidone (risperdal)
Olanzapine (zyprexa)
40
Q

Ariprprazole (abilify) is good for?

A

Low risk of:

  • EPS
  • wt gain
  • hyperprolactinemia
  • delayed QT
41
Q

Aripiprazole (abilify) is also approved for?

A

Resistant depression

Maintenance of bipolar

42
Q

Clozapine (clozaril) is good for?

A

Suicidal schizophrenia pts

43
Q

Ziprasidone (geodon) is good for?

A

No:

  • weight gain
  • hyperlipidemia
  • DM II
44
Q

Ziprasidone (geodon) cardiac issues?

A

Make sure you screen for them, it causes QC interval delay

- no torsades de pointes though

45
Q

DOC for psychotics w movement d/o?

A

Quetiapine (seroquel)

46
Q

Quetiapine (seroquel) is good because?

But…

A

It’s as effective as haloperidol
W less EPS even at high doses

But it does cause QT prolongation

47
Q

Indications for resperidone (risperadal)

A

Acute stabilization

48
Q

SE for resperidone (risperadal)?

A

cause galactorrhea

49
Q

Advantages of resperidone (risperadal)?

A

Less EPS
IM form
Non sedating
Short acting

50
Q

Drug that is good for negative symptoms?

A

Olazapine (zyprexa)

51
Q

Advantages to olazapine (zyprexa)?

A

Treats neg symptoms
Injectable form
Less dystonic reactions
Less tardive dyskinesia

52
Q

Problems w olanzapine (zyprexa)?

A

Significant weight gain
Causes DM II
High risk of stroke in elderly

53
Q

What are the mood stabilizers?

A

Lithium (eskalith)
Valproic acid (divalproex)(depakote)
Carbamazepine (tegretol)

54
Q

Lithium (eskalith) requires?

A

Blood monitoring

Frank toxicity occurs >2mEq/L

55
Q

Lithium (eskalith) is used for?

A

Sig decrease freq/severity of manic and depressive attacks

Decreases nonspecific aggressive behaviors

56
Q

SE for lithium?

A

Early SE

  • mild GI
  • fine tremors
  • muscle weakness
  • somnolence
  • polyuria/polydipsia
  • weight gain
  • leukocytosis
  • hypothyroid

Long term SE

  • cogwheel rigidity
  • EPS
  • kidney function
57
Q

Lithium and preggos?

A

NO PREGNANCY

NO BREAST FEEDING

58
Q

1st line for manic episode?

A

Valproic acid (depakote)

59
Q

Other uses for valproic acid?

A

Panic d/o

Migraine HA

60
Q

SE for valproic acid (depakote)

A

GI
Weight gain
Teratogenic

61
Q

Blood monitoring for valproic acid (depakote)

A

Not like lithium but still must check

  • LFT
  • CBC
  • glucose
62
Q

What are the stimulant drugs?

A

Methylphenidate (ritalin, concerta)
Atomoxetine (strattera)
Destroamphetamine (adderall)

Psych II (10 decks)

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