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Adv. Pharm > Mental Health > Flashcards

Mental Health Flashcards

Exam 3

1
Q

What drugs are antidepressants?

A

Escitalopram
Sertraline
Venlafaxine
Duloxetine
Amitriptyline
Bupropion
Selegiline
Mirtazapine

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2
Q

What drugs are SSRIs?

A

Escitalopram
Sertraline

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3
Q

What drugs are SNRIs?

A

Venlafaxine
Duloxetine

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4
Q

What drugs are tricyclic antidepressants?

A

Amitriptyline

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5
Q

What drugs are sopamine and norepinephrine reuptake inhibitors?

A

Bupropion

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6
Q

What drugs are monoamine oxidase inhibitors?

A

Selegiline

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7
Q

What drugs are “other”?

A

Mirtazapine

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8
Q

What drugs are anxiolytics?

A

Buspirone
Hydroxyzine
Benzodiazepines- alprazolam

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9
Q

What drugs are antipsychotics?

A

Haloperidol (1st gen)
Aripiprazole (2nd gen)
Clozapine (2nd gen)
Lurasidone (2nd gen)
Quetiapine (2nd gen)
Lithium (mood stabilizer)

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10
Q

What drugs are for ADHD?

A

Methylphenidate (stimulant)
Amphetamine/dextroamphetamine (stimulant)
Lisdexamfetamine (stimulant)

Atomoxetine (non-stimulant)
Guanfacine (non-stimulant)
Clonidine (non-stimulant)

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11
Q

What drugs are used for pain management?

A

Acetaminophen (non-opioid)
NASAID: (non-opioid)
Ibuprofen
Ketorolac
Meloxicam
Diclofenac

Opioid:
Morphine
Oxycodone
Hydromorphone
Fentanyl
Tramadol

Naloxone

Neuropathic agents:
Gabapentin
Pregabalin

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12
Q

What drugs are for migraine management?

A

Triptan- sumatriptan
CGRP antagonist- Rimegepant
Topiramate

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13
Q

Neurotransmitters involved in MDD?

A

Serotonin (most important)
Norepinephrine
Epinephrine
Dopamine
Glutamate
Acetylcholine

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14
Q

Diagnostic criteria for MDD?

A

At least 5 criteria for two consecutive weeks
Including depressed mood and/or diminished interest/pleasure

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15
Q

What is the trial period for a MDD medication?

A

6-8weeks, then reassess

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16
Q

SSRIs- MOA?

A

Inhibits reuptake of serotonin -> increases serotonin concentration

Inhibits reuptake of norepinephrine and dopamine

(Escitalopram & Sertraline)

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17
Q

SSRIs- side effects?

A

Discontinuation syndrome- avoid abrupt d/c
Decreased libido, ED

Contraindicated:
MAO inhibitors (linezolid)- 14day washout

Increased bleed risk w/ anticoagulants, antiplatelets, NSAIDs

QT prolongation
SIADH/hyponatremia, fall risk

(Escitalopram & Sertraline)

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18
Q

SNRIs- MOA?

A

Inhibit reuptake of serotonin and norepinephrine -> increased concentration of serotonin and NE

(Venlafaxine & Duloxetine)

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19
Q

SNRIs- side effects?

A

Increased NE -> increased HR, dilated pupils, dry mouth, sweating, increased BP

Contraindicated: MAO- linezolid: 14 day washout

SIADH/hyponatremia
Bleeding
Serotonin syndrome

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20
Q

Tricyclic antidepressant- MOA?

A

Inhibits NE and serotonin reuptake
Blocks ACh and histamine receptors

(Amitriptyline-broader)

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21
Q

Tricyclic antidepressants- side effects?

A

Cardiotoxicity- QT prolongation, arrhythmia risk
Anticholinergic- dry mouth, blurred vision, urinary retention, constipation, sedation
Weight gain, muscle twitching(toxicity)

Contraindicated:
MAO inhibitor- linezolid: 14day washout
Recent myocardial infarction

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22
Q

Bupropion- MOA?

A

Inhibits reuptake of dopamine and NE
(no effect on serotonin)

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23
Q

Bupropion- side effects?

A

Contraindicated:
Seizure disorder, anorexia, bulimia (seizure/weight loss risk)
MAO inhibitors -> serotonin syndrome, hypertensive crisis

Nueropsych. effects

CNS stimulation- lowers seizure threshold, insomnia, weight loss

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24
Q

Selegiline- MOA?

A

Inhibits monoamine oxidase (breaks down catecholamines) -> increased concentrations of catecholamines (serotonin, NE, epinephrine, dopamine)

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25
Q

Selegiline- side effects?

A

Contraindications:
Cardiovascular disease
Sympathomimetics
Drugs that increase serotonin
Tyrosine rich foods (can increase NE)

Hypertensive crisis, serotonin syndrome

Anticholinergic effects, orthostasis, sedation, sexual dysfunction, weight gain, insomnia, headache

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26
Q

Mirtazapine- MOA?

A

Increased release of NE and serotonin

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27
Q

Mirtazapine- side effects?

A

Sedation
Increased appetite
Weight gain

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28
Q

What drugs are used as anxiolytics?

A

Buspirone
Hydroxyzine
Benzodiazepine- Alprazolam

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29
Q

What drugs are first line for GAD?

A

SSRIs:
Sertraline
Escitalopram

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30
Q

What drugs are second line for GAD?

A

SSRI: (different than 1st line)
Sertraline
Escitalopram

SNRI:
Venlafaxine
Duloxetine

31
Q

Anxiety management drugs?

A

Buspirone - after SSRI or SNRI failure

Hydroxyzine- used as bridge

32
Q

Buspirone- MOA?

A

Serotonin receptors

33
Q

Buspirone- indications?

A

GAD
Used after failure w/ SSRI / SNRI

34
Q

Buspirone- side effects?

A

Serotonin syndrome- w/ other serotonergic drugs
Dizziness
Drowsiness
Headache
Lightheadedness

2-4weeks to work, no abuse risk

Contraindications:
MAO
Linezolid

35
Q

Hydroxyzine- indication?

A

GAD, short-term for symptoms not cause

36
Q

Hydroxyzine- MOA?

A

Histamine receptor antagonist
Anticholinergic properties

37
Q

What drug is a benzodiazepine?

A

Alprazolam (Xanax)

38
Q

Alprazolam- indication?

A

GAD, anxiety relief
Short-term, treats symptoms not cause

Selective use d/t risk of dependence/tolerance (<1-2weeks)

39
Q

Alprazolam- MOA?

A

Enhances GABA (inhibitory NT -> CNS depression -> sedative/muscle relaxant properties)

40
Q

Alprazolam- side effects?

A

Elderly: confusion, dizziness, falls

Risk of dependence/tolerance

BBW: profound sedation, RR depression, coma, death

CNS depression

No abrupt d/c

Additive effects w/ CNS depressants: alcohol, antipsychotics, etc.

41
Q

What drugs are used for ADHD?

A

Stimulants:
Methylphenidate
Amphetamine/dextroamphetamine
Lisdexamfetamine

Non-stimulants:
Atomoxetine
Guanfacine
Clonidine

42
Q

What drugs are first-line for ADHD?

A

Stimulants:
Methylphenidate
Amphetamine/dextroamphetamine
Lisdexamfetamine

43
Q

What schedule are ADHD stimulants?

A

Schedule 2 meds

44
Q

Methylphenidate- MOA?

A

Blocks reuptake of NE and DA
Increases normal release of NE and DA

45
Q

Methylphenidate- indications?

46
Q

Amphetamine/dextroamphetamine- indications?

47
Q

Amphetamine/dextroamphetamine- MOA?

A

Promotes release of NE and DA
Blocks reuptake of NE and DA

48
Q

Stimulants- side effects?

A

Cardiovascular events (MI, increased BP/HR)
Growth suppression
Decreased appetite
Insomnia
Irritability

BBW: Abuse/dependence
BBW Amphetamine: Sudden cardiac death/ serious cardiac effects

Contraindicated: MAO-i within 14days

(Methylphenidate
Amphetamine/dextroamphetamine
Lisdexamfetamine)

49
Q

Atomoxetine- MOA?

A

Selective inhibition of NE reuptake

50
Q

Atomoxetine- indications?

A

ADHD- non stimulant

51
Q

Atomoxetine- side effects?

A

BBW: suicidal ideation

Aggression
Cardiovascular events
Growth suppression, hepatotoxicity
Decreased appetite, nausea, insomnia

Contraindications: MAO-i within 14days, glaucoma, Dx/Hx: pheochromocytoma, cardiovascular disease

52
Q

Guanfacine- indications?

A

ADHD- pediatric

53
Q

Guanfacine- MOA?

A

Non-stimulant

Alpha 2 agonist -> decreased sympathetic outflow -> working memory/behavioral inhibition

54
Q

Guanfacine- side effect?

A

Sedation
Hypotension
Dizziness
Abdominal pain
Headache
CNS depression warning

55
Q

Schizophrenia- first line rteatment?

A

2nd gen antipsychotics:
Aripiprazole
Clozapine
Lurasidone
Quetiapine

To treat positive Sx

56
Q

Extrapyramidal Symptoms (EPS)

A

Dystonia- prolonged contractions of muscles/muscle spasm

Akathisia- restlessness w/ anxiety

Parkinsonism- tremors, abnormal gait

Tardive Dyskinesia- abnormal facial movement, tongue/mouth

57
Q

Haloperidol- indications?

A

1st gen antipsychotic

Schizophrenia

58
Q

Haloperidol- MOA?

A

Blocks dopamine receptors

59
Q

Haloperidol- side effects?

A

QT prolongation
Sedation
EPS
Hyperprolactinemia
Neuroleptic malignant syndrome

60
Q

2nd gen antipsychotics- MOA?

A

Blocks dopamine and serotonin receptors

Can prolong QT interval

(Aripiprazole
Clozapine
Lurasidone
Quetiapine)

61
Q

Aripiprazole- indications?

A

Antipsychotic
Schizophrenia

62
Q

Aripiprazole- side effects?

A

Lower risk of weight gain

63
Q

Clozapine- indications?

A

Antipsychotic
Schizophrenia

64
Q

Clozapine- side effects?

A

BBW: Agranulocytosis
Monitor ANC

Seizures, constipation, bradycardia

65
Q

Lurasidone- indications?

A

Antipsychotic
Schizophrenia

66
Q

Lurasidone- side effects?

A

Somnolence
EPS
Nausea
Risk of metabolic syndrome

Contraindications: CYP inducers/inhibitors

67
Q

Quetiapine- indications?

A

Antipsychotic
Schizophrenia

68
Q

Quetiapine- side effects?

A

Lower EPS risk

Somnolence
Metabolic syndrome
Ocular effects

69
Q

What drugs are used for acute bipolar disorder?

A

Lithium

Or lithium w/ antipsychotic

70
Q

Lithium- indications?

A

Mood stabilizer

Bipolar disorder

71
Q

Lithium- MOA?

A

Decreased reuptake of serotonin and NE
Modulate glutamate

Therapeutic range: 0.6-1.2mEq/L

72
Q

Lithium- side effects?

A

BBW: serum lithium levels monitored to prevent toxicity

Renal impairment
Hyponatremia
Dehydration
Serotonin syndrome

GI upset
Cognitive effects
Weight gain

Therapeutic range: 0.6-1.2mEq/L

> 1.5mEq/L: ataxia, coarse hand tremor, vomiting, diarrhea, confusion

> 2.5mEq/L: CNS depression, arrhythmia, seizure, comaL

73
Q

Lithium- DDI?

A

NSAIDS

Increased risk serotonin syndrome w/ SSRI, SNRI, Linezolid

Increased risk neurotoxicity w/ diltiazem

Adv. Pharm (9 decks)

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