Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm 585 > MCP CNS Meds Part 2 > Flashcards

MCP CNS Meds Part 2 Flashcards

1
Q

What is psychosis?

A
  • Psychosis is a symptom not a disease
  • ​​A disturbance in perception of reality
    • halluctionation: think something is there that isn’t
    • delusions: False sense of belief
    • thought disorganization
  • Seen in a variety of disorders:
    • schizophrenia
    • bipolar disorder
    • subtance-induced psychotic disorders
    • and many others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Schizophrenia: Epidemiology

A
  • Typically manifests in late teens and early twenties
  • Roughly affects equal numbers of men and women
    • occurs earlier in men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Schizophrenia: Symptoms

A
  • Positive symptoms: something is there that shouldn’t be
    • hallucinations, delusions, though disorganization, bizarre behavior
    • Dopamine receptor lackade helps resolve these symptoms
  • Negative symptoms: something isn’t there but should be
    • Social withdrawl, lack of emotional response, loss of motivation
    • Serotonin receptor blockade helps resolve these symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Typical/First Generation Antipsychotics: MOA, Uses, Onset, Admin

A
  • MOA: Dopamine antagonist
  • Uses: Schizophrenia, bipolar disorder
  • Onset: 6-8 wks
  • Admin: with or w/o food
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Typical/First Generation Antipsychotics: SE

A
  • ​Sedation
  • Hypotension
  • Anticholinergic effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Typical/First Generation Antipsychotics: Important Pearls

A
  • ​**Highest **incidence of movement disorders
  • Poor adherance (50%)
  • Injectable forms available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Typical/First Generation Antipsychotics: Drugs

A
  • Chlorpromazine (Thorazine)
  • Perphenazine (Trilafon)
  • Trifluoperazine (Stelazine)
  • Thiothixene (Navane)
  • Haloperidol (Haldol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Generic: Chlorpromazine

A

Thorazine

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

Generic: Perphenazine

A

Trilafon

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

Generic: Trifluoperazine

A

Stelazine

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

Generic: Thiothixene

A

Navane

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

Generic: Haloperidol

A

Haldol

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

Brand: Thorazine

A

Chlopromazine

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

Brand: Trilafon

A

Perphenazine

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

Brand: Navane

A

Thiothixene

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

Brand: Haldol

A

Haloperidol

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

Haloperidol: MOA, Dosage forms, Important Pearls

A
  • MOA: Blocks dopamine receptor
  • Dosage Form: Tab, IM Injection, syrup
  • Important Pearls:
    • Most potent typical antipsychotic
    • Highest incidence of EPS of all antipsychotics
      • table>>injection
    • Also called “vitamin H” when used for acute agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

EPS

A
  • Extrapyramidal Symptoms
    • Akathisia: inability to remain motionless
    • **Dystonia: **involuntary muscle contractions
    • Onset: within weeks of starting antipsychotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TD

A
  • Tardive dyskinesia
    • Syndrome consisting of involuntary movements
      • Lip smacking, tounge and jaw movements
    • Onset= YEARS of antipsychotic use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Atypical/Second Generation Antipsychotics: MOA, Uses, Onset, Admin

A
  • MOA: antagonize dopamine and serotonin receptors
  • Uses: Schizophrenia, bipolar disorder, and others
  • Onset: 3-6 wks
  • With or w/o food
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Atypical/Second generation Antipsychotics: SE

A
  • Sedation, hypotension, anticholinergic effects, metabolic effects
    • More orthostatic hypotension, QT prolongation, and weight gain/diabetes risk
    • Less movement disorders than typical antipsychotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Quetiapine: SE, Alternative use

A
  • Seroquel
  • SE:
    • somnolence, HA, sedation​
  • Alternative Use:
    • acute agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risperidone: S/E

A
  • ​Risperdol
  • SE:
    • QT prolongation, EPS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Olanzapine: SE, Alternative Use

A
  • Zyprexa
  • ​SE:
    • somnolence, HA, weight gain
  • Alternative Use:
    • Acute agitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Ziprasidone: SE, Alternative Use
* **Geodon** * SE: * OT prolongation, somnolence * Alternative Use: * Acute agitation
26
Aripiprazole: SE, Alternative Use
* **Abilify** * SE: * Agitation, insomnia, HA * More "stimulating" than other antipsychotics * Well tolerated * Alternative Use: * depression
27
Clozapine: SE
* **Clozaril** * SE * Agranulocytosis risk, REMS program, black box with elderly w/ dementia, increased risk seizure * Usually not a first line, main use is in refactory schizophrenia
28
Brand: Seroquel
Quetiapine
29
Brand: Risperdol
Risperidone
30
Brand: Zyprexa
Olanzapine
31
Brand: Geodon
Ziprasidone
32
Brand: Abilify
Aripiprazole
33
Brand: Clozaril
Clozapine
34
3 most common side effects of all anti-psychotics
anticholinergic, hypotension, sedation
35
Side effects more commonly seen in atypical antipsychotics
orthostatic hypotension, QT prolongation, metabolic effects
36
Which antipsychotic class has the faster onset?
Atypical antipsychotics
37
What is a seizure?
Abnormal, excessive electrical discharges of the brain
38
What is epilepsy?
Chronic, recurrent seizures
39
When do we treat epilepsy?
* When a seizure won't stop, status epilepticus * Maintenance therapy usually started after the second seizure episode
40
How do antiepileptics works?
* Stabilizing neuronal membranes, decreasing the release of excitatory neurotransmitters (NT) and increasing inhibitory NT release through several mechansims of action * **Sodium Channels** * Phenytonin, Carbamezepine, Oxcarbazepine, Zonisamide, Lacosamide, Lamotrigine​ * **Calcium Channels:** * Ethosuximide * **Inihibitory Transmission:** * Benzodiazepine, Phenobarbital * **Multiple Mechanisms:** * Gabapentin, Levetiracetam, Topiramate, Valproate, Zonisamide
41
Antiepileptics (AED): Onset, Admin, SE
* Onset: Work within hourse but need to up-titrate to acheive therapeutic doses * Admin: Take w/ good if GI upset occurs * SE: drowsiness, fatique, solmnolence
42
AED: Important Pearls
* Take regularly, as non-adherance can result in seizures * Many DDI * Phenotyoin, Carbmazepine are enzyme inducers * Valoproic Acid can inhibit some drugs' metabolism * Often have narrow therapeutic index (NTI)
43
Phenytoin: Brand Name, MOA, Dosage Form, Important Pearls
* **Dilantin** * MOA: Inhibts excitatory NT and stabalizes neuronal membrane * Dosage Form: tablet, capsule, chewable tablet, suspension, ER, injection * Important Pearls * Good oral hygiene is essential due to the risk of gingiival hyperplasia * Hair growth can occur (Hirsutism) * Drug Interaction
44
Topiramate: Brand Name, MOA, Dosage Froms, Important Pearls
* **Topamax** * MOA: Drecreases release of excitatory NT and potentiates inhibitory NT * Dosage Forms: Tablet, Capsul * Important Pearls: * Also used for migraines and for weightloss * Decreased work finding abilityabnormal thinking occurs in 31% of patients
45
Lamotrigine: Brand name, MOA, Dosage Forms, Important Pearls
* **Lamictal** * MOA: Decreases relase of excitatory NT * Dosage Forms: Tabs, chewable tabs, ODT, ER * Important Pearls * Start at a low dose then titrate due to risk of SJS (Stevens-Johnson Syndrome) and toxic epidermal necrolysis (TEN) * Patients should be monitored for rash when starting therapy
46
Lamictal: SE, Alternative Use
* Lamotrigine * SE: well tolerated, rash, requires slow uptitration * AU: Biolar disorder
47
Depakote: SE, AU
* Valproic Acid * SE: tremor, weight gain, GI issues, pregnancy category X * AU: Migraine prophylaxis
48
Tegretol: SE, AU
* Carbamezapine * SE: hyponatremia, rash * AU: Bipolar
49
Topamax: SE, AU
* Topiramate * SE: word finding, weight loss * AU: migraine prophylaxis
50
Keppra: SE
* ​Levetiracetam * SE: well tolerated, caution in patients with psychiatric history
51
Dilantin: SE
* Phenytoin * SE: gingival hyperplasia, hirsutism, bone density loss, rash
52
Vimpat: SE, Othe info
* Lacosamide * SE: PR prolongation * Expensive, Controlled Substance (V)
53
Neurontin/Lyrica: SE, AU
* Gabapentin/Pregabalin * SE: somnolence * AU: neuropathic pain
54
Skeletal Muscle Relaxant: MOA, Onset, Admin, SE, Important Pearls
* MOA: Cause CNS depression which leads to skeletal muscle relazaxation * Onset: 30-60 min * Admin: with or w/o food * S/E: Drowsiness, dizziness, anticholinergic effects * Important Pearls: * Alcohol intensifies effects * Duration of therapy should not exceed 2-3 weeks * No benefit for longer, pain may be from something else
55
Cyclobenzaprine: Dosage Forms, Important Pearl
* **Flexeril** * Dosage Form: Tablet, ER capsule * Important Pearl * Structurally similar to TCAs. Avoid concurrent use
56
Carisoprodol: Dosage Form, Important Pearl
* **Soma** * Metabolized to meprobamate which has anxiolytic and sedative effects * Dosage Form: Tablets * Important Pearl * Schedule IV, because of UW pharmacy!
57
ADHD: Clinical Presentation, Treatment Options
* Attention Deficit Hyperactivity Disorder * Clinical Presentation: * Inattention--\>forgetful, easily distracted * Hyperactivity--\>excessive fidgeting, talking * Impulsivity--\>difficulty waiting turns, interrupts often, risky behavior * Treament Options: * Non-pharmacologic options * Pharmacologic options: Stimulants 1st line
58
Stimulants: MOA, Use, Onset, Admin
* MOA: Mediate CNS stimulation thoguh blocking the reuptake of norepinephrine (NE) and dopamine or stimulating NE and dopamine release * Use: Treat ADHD, narcolepsy and excessive daytime sleepiness * Onset: 1-2 hours * Admin: With or without food
59
Stimulants: SE, Important Pearls
* ​SE: Insomnia, Loss of appetit, weight loss, growth supression, cardiac effects * Imporant Pearls * Amphetamines and methylphenidate contraindicated in those with cardiovascular disease such as HTN and arteriosclerosis * Avoid alcohol and caffeine * Abuse potential
60
Vyvanse
Lisdexamfetamine Less abuse potential?
61
Methylphenidate: MOA, Important Pearls
* Concerta, Ritalin, Daytrana, Metadate * MOA: Blocks reuptake of NE and dopamin * Important Pearls * Immediate release form has the highest potential for abuse * C-II * Take IR tabs 30-45 min before meals (food affects absorbtion)
62
Amphetamine/Dextroamphetamine: MOA, Important Pearls
* ​Adderal, Adderall XL * MOA: Stimulating NE and dopamine release * Important Pearls: * Do not crush/chew extended release formulations * C-II
63
Atomoxetine: MOA, Onset, Important Pearls
* Strattera * MOA: Inhibts reuptake of NE * Onset: 2-4 wks * Important Pearls: * Only stimulant that is non-controlled * Typically reserved for those who fail convential stimulants/high abuse potential

Pharm 585 (13 decks)

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