Jeopardy Hard ?s Schizo/Anti-depressants/antipsychotics Flashcards by Amber Alberts

This SGA may cause side effects of sialorrhea, weight gain, sedation, anticholinergic effects, myocarditis, and a lower seizure threshold

What is clozapine (clozaril)?

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This SGA is unique since it

is a partial agonist

What is aripiprazole (abilify)?

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This SGA has almost zero risk of 
EPS or agranulocytosis, is 
often sedating &amp; has a 
moderate risk of 
metabolic syndrome

What are quetiapine (seroquel)?

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This SGA does not require hepatic metabolism because it is an active metabolite of risperidone (risperdal)

What is paliperidone (invega)?

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This SGA has the highest risk
of metabolic syndrome, is very sedating, and the CATIE study showed patients are highly
likely to be compliant

What are olanzapine (zyprexa)?

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This SGA has a low risk of metabolic syndrome, needs to be taken with food, and is the most likely SGA to cause qTc prolongation

What is ziprasidone (geodone)?

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These 2 SGA’s are available in
 long acting injectable form 
but can cause dose
dependent EPS &amp;
prolactin elevation

What are risperidone (risperdal) & palliperidone (invega)?

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This SGA has a particularly long half life and a low risk of metabolic syndrome, but is the SGA most
likely to cause akathisia

What is aripiprazole (abilify)?

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These two SGA’s are least likely to have EPS side effects

What is clozapine (clozaril) and quetiapine (seroquel)?

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This is the most likely SSRI
to cause the side effect
of weight gain

What is paroxetine (paxil)

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The washout period when
switching from an MAOI
to any SSRI is this

2 weeks

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These two SSRI’s have very
short half lives & should
be tapered to be
discontinued

What is paroxetine (paxil) & fluvoxamine (luvox)

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This SNRI is the psychoactive metabolite of another SNRI

What is desvenlafaxine (pristiq)

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Whether the dose is very high,

moderate, or low, this neurotransmitter’s reuptake is blocked by venlafaxine (effexor)

What is serotonin?

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At very high doses (>375mg/d) 
of venlafaxine (effexor) this neurotransmitter’s reuptake 
may begin to be blocked

What is dopamine?

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This SNRI is preferred for painful symptoms of depression or
diabetic neuropathy pain

What is duloxetine (cymbalta)

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As with the SSRI’s, some patients take SNRI’s for depression,
have an initial response,
continue taking the medication
but then experience this

What is poop-out syndrome (relapse)?

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As with all antidepressants, a depressed patient started on an SNRI who experiences activation & agitation may be having this

What is an induced bipolar state?

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While venlafaxine (effexor) may cause the side effect of sweating, ironically it may be helpful to perimenopausal women with this

What are hot flashes/flushes?

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Venlafaxine (effexor) has
this relatively common, dose
dependent, cardiac system
related side effect

What is increased blood pressure?

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This medication is the most

well known NDRI

What is Bupropion (Wellbutrin)

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NDRI’s are useful in treating cravings from dependence

on this substance

What is nicotine (smoking cessation)?

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Not only do NDRI’s not have this common SSRI side effect, NDRI’s may be used to treat patients who have this SSRI side effect

What is sexual dysfunction?

Like most anti-depressants, at typical doses NDRI’s carry a small risk 
of this serious side effect but 
the risk increases from 
0.4% to 4% at very 
high doses

What is a seizure?

Compared to SSRI’s or SNRI’s, NDRI’s are less effective in treating this class of psychiatric illnesses

What are Anxiety Disorders

NDRI’s may be especially helpful in treating this sleep disturbance that is seen in atypical depression

What is hypersomnia? (> 10 hours/nite)

NDRI’s commonly do this | to a patient’s weight

What is decrease? (or no change)

While not a first line treatment, | NDRI’s “stimulating” effects may be helpful in treating children and adults with this disorder

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Bupropion:Onset of therapeutic action is usually not immediate, but is delayed until this time period

What is 2-4 weeks

NaSSA stands for this

What is Noradrenergic and Specific Serotonergic Agent?

NaSSA’s novel mechanism of action by which norepinephrine and serotonin system activity is increased is this

What is pre-synaptic alpha 2 adrenergic antagonist

``` The medication that is in the NaSSA class is this ```

What is mirtazepine (remeron)?

SSRIs or venlafaxine (effexor) may cause these common side effects which NaSSA’s 5HT3 antagonism may help reduce or remove

What are GI side effects? (nausea, diarrhea, stomach cramps)

``` This mirtazapine (remeron) side effect is more likely in women than men, before menopause than after, and is unlikely to be a problem if it has not occurred within the first 6 weeks of treatment ```

What is weight gain?

``` Mirtazapine (remeron) is an antagonist of: a presynaptic receptor, serotonin post synaptic receptors, and this post synaptic receptor ```

What is histamine? (H1)

Mirtazapine: Onset of therapeutic effect on insomnia and anxiety is typically in this time period

What is almost immediately?

Cytochrome P450 enzyme system that is significantly effected by mirtazepine (remeron) is

What is none?

A tertiary amine, amitriptyline (elavil), is metabolized to a secondary amine which is this TCA

What is nortriptyline (pamelor)?

A tertiary amine, imipramine (tofranil), is metabolized to a secondary amine which is this TCA

What is desipramine (norpramin)?

TCA’s may be more effective than SSRI’s in treating depression for this sex of the clinical population

What are men?

Fluoxetine (prozac), paroxetine (paxil), bupropion (wellbutrin), duloxetine (cymbalta) and other medications may increase all TCA’s concentration by inhibiting this p450 enzyme

What is cytochrome p450 2D6?

Side effects of dizziness, sedation, and hypotension likely result from TCA’s antagonist activity of this receptor

What is alpha adrenergic-1 receptor?

The dangerous side effects from a TCA overdose are cardiac arrhythmias caused by blockade of this

What are sodium channels?

This typical antipsychotic has the greatest risk of any antipsychotic for dose dependent QTc prolongation, torsades de pointes, and cardiotoxicity

What is thioridazine (Mellaril)?

This SGA is a partial dopamine agonist & commonly has the side effect akathisia

What is aripiprazole (Abilify)?

This atypical is FDA approved for adjunct treatment of major depression

What is aripiprazole (Abilify)?

Lurasidone (latuda), asenapine (saphris) & these two SGA’s are the most metabolically “neutral”

What are ziprasidone (geodone) & aripiprazole (abilify)?

There is a blackbox warning for the use of antipsychotics in elderly dementia patients due to increased risk of this

What is sudden death (cardiovascular cause?)?

While NMS is uncommon to rare (incident rate 0.02-3%), its | cause is this

What is dopamine antagonism?

Hypoactivity of this dopamine tract is believed to be associated with the development of negative symptoms

What is the mesocortical pathway?

Prochlorperazine (Compazine) Metoclopramide (Reglan) Droperidol (Inapsine) Promethazine (Phenergan) This antiemetic medication(s) is/are a D2 blocker(s) and may cause EPS or TD

What is all 4 of them?

About 75% of pts with schizophrenia do this unhealthy activity which also induces an  metabolic rate of antipsychotic medications

What is cigarette smoking?

Antipsychotics approved for the treatment of bipolar depression are olanzapine/fluoxetine (symbyax), lurasidone (latuda), and this

What is quetiapine (Seroquel)?

This atypical has a significant risk of causing hyperprolactinemia, is the active metabolite of risperidone (Risperdal), and needs to be taken with food

What is paliperidone (Invega)?

While muscular rigidity, hyperthermia, & autonomic instability are all common symptoms of NMS, most often this symptom presents first

What is mental status changes?