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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
The TCA’s are?
Amitriptyline | Imipramine
26
Amitryptyline is aka?
Elavil
27
Imipramine is aka?
Tofranil
28
Whats bad about imipramine (tofranil)
Even small doses can cause lethal arrhythmias
29
The atypical antidepressants are?
Bupropion - W Trazadone Mirtazapine
30
Bupropion is aka?
Wellbutrin
31
Trazadone is aka? Its use?
Desyrel Help them sleep
32
Mirtazapine is aka? Its use?
Remeron Help them eat
33
Never give ___ to a bipolar
Bupropion (wellbutrin)
34
What are antipsychotics used for?
All forms of: - schizophrenias - psychotic ideation/delirium - drug induced psychosis - psychotic depression - unipolar depression - acute mania - mood cycles in bipolar
35
Antipsychotics may cause (elderly)?
Early mortality in elderly dementia pts
36
Common se of antipsychotics?
``` Dry mouth Blurred near vision Urinary retention Delayed gastric emptying Esophageal reflux Ileus delirium Acute glaucoma Orthostatic HOTN Sexual dysfunction EKG changes Extrapyrimidal ```
37
What extrapyrimidial symptoms do antipsychotics cause?
Akathias (MC) Acute dystonia Tardive dyskinesia Drug induced parkinsoniasm
38
Atypical have less SE but what specific SE do they have?
``` 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
List of atypical antipsychotics?
``` Ariprprazole (abilify) Clozapine (clozaril) Ziprasidone (geodon) Quetiapine (seroquel) Resperidone (risperdal) Olanzapine (zyprexa) ```
40
Ariprprazole (abilify) is good for?
Low risk of: - EPS - wt gain - hyperprolactinemia - delayed QT
41
Aripiprazole (abilify) is also approved for?
Resistant depression | Maintenance of bipolar
42
Clozapine (clozaril) is good for?
Suicidal schizophrenia pts
43
Ziprasidone (geodon) is good for?
No: - weight gain - hyperlipidemia - DM II
44
Ziprasidone (geodon) cardiac issues?
Make sure you screen for them, it causes QC interval delay | - no torsades de pointes though
45
DOC for psychotics w movement d/o?
Quetiapine (seroquel)
46
Quetiapine (seroquel) is good because? But...
It’s as effective as haloperidol W less EPS even at high doses But it does cause QT prolongation
47
Indications for resperidone (risperadal)
Acute stabilization
48
SE for resperidone (risperadal)?
cause galactorrhea
49
Advantages of resperidone (risperadal)?
Less EPS IM form Non sedating Short acting
50
Drug that is good for negative symptoms?
Olazapine (zyprexa)
51
Advantages to olazapine (zyprexa)?
Treats neg symptoms Injectable form Less dystonic reactions Less tardive dyskinesia
52
Problems w olanzapine (zyprexa)?
Significant weight gain Causes DM II High risk of stroke in elderly
53
What are the mood stabilizers?
Lithium (eskalith) Valproic acid (divalproex)(depakote) Carbamazepine (tegretol)
54
Lithium (eskalith) requires?
Blood monitoring Frank toxicity occurs >2mEq/L
55
Lithium (eskalith) is used for?
Sig decrease freq/severity of manic and depressive attacks Decreases nonspecific aggressive behaviors
56
SE for lithium?
Early SE - mild GI - fine tremors - muscle weakness - somnolence - polyuria/polydipsia - weight gain - leukocytosis - hypothyroid Long term SE - cogwheel rigidity - EPS - kidney function
57
Lithium and preggos?
NO PREGNANCY NO BREAST FEEDING
58
1st line for manic episode?
Valproic acid (depakote)
59
Other uses for valproic acid?
Panic d/o | Migraine HA
60
SE for valproic acid (depakote)
GI Weight gain Teratogenic
61
Blood monitoring for valproic acid (depakote)
Not like lithium but still must check - LFT - CBC - glucose
62
What are the stimulant drugs?
Methylphenidate (ritalin, concerta) Atomoxetine (strattera) Destroamphetamine (adderall)

Psych II (10 decks)

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