Mental Health Medications

Question 1

Anxiolytic drugs

Answer 1

benzodiazepines
nonbenzodiazepines
atypical antipsychotics (second gen)
pindolol
buspirone

Question 2

Adverse effects of benzodiazepines

Answer 2

habit forming
sedation –> increased accidents
tolerance
amnestic effects
impaired psychomotor speed
not for long-term use

Question 3

Common benzodiazepines

Answer 3

Chlordiazepoxide (Librium)
Diazepam (Valium)
Lorazepam (Ativan)
Flurazepam (Dalmane)
Oxazepam (Serax)
Clonazepam (Rivotril)

Question 4

Common non-benzodiazepines

Answer 4

Buspirone
Zolpidem

treat anxiety w/o CNS depression. low risk for abuse/withdrawal

Question 5

Buspirone

Answer 5

controls anxiety symptoms
no effect on panic disorders/OCD
DOES NOT CAUSE SEDATION

Question 6

Zolpidem

Answer 6

sleep medication

Question 7

SSRI

Answer 7

paroxetine
citalopram
fluoxetine
sertraline
escitalopram
fluvoxamine

Question 8

SNRI

Answer 8

venlafaxine
duloxetine
desvenlafaxine

Question 9

Benzodiazepine MOA

Answer 9

increases GABA ion channel opening
increases amount of GABA –> reduce post-synaptic neuron firing

Question 10

Buspirone MOA

Answer 10

block 5HT receptors @ the pre/postsynaptic neurons
does not affect GABA –> no sedative, muscle relaxant or anticonvulsant properties

Question 11

Z-drugs

Answer 11

used to treat insomnia
zopiclone
eszopiclone
zaleplon
zolpidem

Question 12

Typical antipsychotics

Answer 12

haloperidol
chlorpromazine
thioridazine
**greater risk of EPS side effects

Question 13

Atypical antipsychotics

Answer 13

clozapine
risperidone
olanzapine
quetiapine
ziprasidone
aripiprazole
paliperidone
lurasidone
iloperidone
asenapine

Question 14

Types of typical antipsychotics

Answer 14

phenothiazines
dibenzoxazepines
dihydroindolones

Question 15

Phenothiazines typical antipsychotics

Answer 15

chlorpromazine
thioridazine
mesoridazine
fluphenazine
perphenazine
trifluoperazine

Question 16

Thioxanthenes typical antipsychotic

Answer 16

thiothixene

Question 17

Dibenzoxazepines typical antipsychotic

Answer 17

loxapine

Question 18

Dihydroindolones typical antispychotic

Answer 18

molindone

Question 19

Anticholinergic side effects

Answer 19

dry mouth
constipation
urinary hesitancy/retention
vaginal dryness
blurred vision
dry eyes
nasal congestion
confusion/decreased memory

Question 20

Anticholinergics

Answer 20

benzotropine (used for EPS)
trihexyphenidyl
biperiden

Question 21

Antihistamines

Answer 21

diphenhydramine (H1 receptor antagonist)

Question 22

Mood stabilizers

Answer 22

Lithium
Carbamazepine
Lamotrigine
Oxcarbazepine
Valproic acid
Divalproex sodium
Quetiapine
Gabapentin
Topiramate

Question 23

Lithium dose

Answer 23

300 mg BID/TID

Question 24

Lithium ranges

Answer 24

Fraser health: 0.6-0.8 mmol/L
>1 = toxic
0.8-1.4 mEq/L for mania
0.4-1. mEq/L for maintenance

Question 25

Lithium excretion

Answer 25

100% excreted in the kidneys lithium is a SALT. reabsorption increases in states of dehydration

Question 26

Lithium toxicity S/S

Answer 26

flu-like symptoms arrhythmia coarse tremor seizures coma myocarditis severe diarrhea vomiting drowsiness muscular weakness lack of coordination

Question 27

Typical antipsychotics & schizophrenia

Answer 27

used to treat positive symptoms

Question 28

Atypical antipsychotics & schizophrenia

Answer 28

used to treat positive AND negative symptoms

Question 29

Serotonin antagonists

Answer 29

trazadone nefazodone

Question 30

Atypical antipsychotic protoypte

Answer 30

Clozapine

Question 31

SSRI prototype

Answer 31

Fluoxetine

Question 32

SNRI protoype

Answer 32

Venlafaxine

Question 33

Typical antipsychotic side effects

Answer 33

weight gain EPS

Question 34

Typical antipsychotic MOA

Answer 34

block dopamine receptors in the limbic system (strong D2 affinity) effective against positive symptoms of schizophrenia

Question 35

Atypical antipsychotic MOA

Answer 35

block dopamine/serotonin receptors in the limbic, cortex, niagra strital pathways effective against positive/negative sx of schizophrenia

Question 36

Atypical antipsychotic side effects

Answer 36

weight gain elevated glucose elevated lipids

Question 37

Which atypical antipsychotic requires regular blood work

Answer 37

clozapine can cause agranulocytosis

Question 38

Monitoring guidelines for antipsychotics

Answer 38

vital signs (postural BP, HR) behaviors weight glucose cholesterol EKG CBC (WBC, neutrophils) EPS symptoms anticholinergic effects

Question 39

Antipsychotic serious adverse effects

Answer 39

EPS tardive dyskinesia QTc prolongation prolactin elevation sexual dysfunction agranulocytosis neuroleptic malignant syndrome orthostatic hypotension (d/t a1 antagonism) anticholinergic side fx agranulocytosis/leukopenia/neutropenia metabolic syndrome (weight gain, diabetes, dyslipidemia, DKA, CVD)

Question 40

Dystonia

Answer 40

severe muscle spasm tongue, neck, eyes, torso, legs may impair breathing

Question 41

EPS Treatment

Answer 41

benztropine diphenhydramine lorazepam (dystonia, akathisia)

Question 42

Serotonin syndrome

Answer 42

caused by multiple serotonergic agents delirium, agitation, fever, sweating, tremor, diarrhea, uncoordinated myoclonus, hyperreflexia, hypertension, tachycardia, death

Question 43

Serotonergic agents

Answer 43

antidepressants (MAOI, TCA, venalfaxine, St. John's wort) migraine medication - sumatriptan other - linezolid, dextromethorphan, meperidine, tramadol, ondansetron

Question 44

Miscellaneous antidepressants

Answer 44

trazodone mirtazapine bupropion

Question 45

Benzodiazepine remedy

Answer 45

Flumazenil

Question 46

H1 receptor antagonist side effect

Answer 46

sedation

Question 47

Serious antipsychotic side effects

Answer 47

neuroleptic malignant syndrome seizures agranulocytosis death hypersensitivity tardive dyskinesia