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COC N126 Psych 🧠 > Midterm 1 Psych Meds; Antidepressants, Antipsychotics, Antiepileptics, Antianxiety > Flashcards

Midterm 1 Psych Meds; Antidepressants, Antipsychotics, Antiepileptics, Antianxiety Flashcards

1
Q

What are the antipsychotic medications? (Conventional)

A

chlorpromazine
fluphenazine
haloperidol

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2
Q

What is the antidote for first generation antipsychotics?

A

benztropine

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3
Q

What could occur as a result of taking too much of an anticholinergic drug? Such as benztropine

A

Anti-cholinergic crisis consisting of the following s/s

Blurred vision
Dry mouth
Constipation
Urinary retention

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4
Q

What is the action of typical/conventional/first generation antipsychotics?

A

These drugs bind to D2 receptors resulting in a decrease in dopaminergic neuron transmission (Or simply decrease dopamine levels to simplify it)

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5
Q

What do first generation antipsychotics treat (symptoms of the disease) Give examples

A

Positive symptoms of schizophrenia such as;

Hallucinations
Delusions
Bizarre behavior
Formal thought disorder
Catatonia

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6
Q

What side effects could occur as a result of FGAs? Elaborate

A

EPS such as…
Acute Dystonia
Parkinsonism
Akathisia
NMS
Tardive Dyskinesia

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7
Q

Define Acute Dystonia

A

Occurring 1-5 days after taking a conventional antipsychotic

Includes uncontrolled muscle spasms mainly on tongue, neck, and face

Torticollis; twisted neck (stiff turned neck)
Ocular garlic crisis; Eyes gazed upward and outward
Oropharyngeal dysphasia; difficulty swallowing

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8
Q

Define Parkinsonism…

A

Occurring 1-4 weeks after taking a first generation antipsychotic

Consists of Parkinsonian features such as…
Generalized muscle rigidity
Bradykinesia/akinesia
Mask-like face
Tremors

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9
Q

Define Akathisia

A

Occurring 5-60 days after taking a typical antipsychotic

When the body is restless and the patient has an inability to stay still

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10
Q

Define NMS….

A

Occurring weeks to months after taking a typical antipsychotic

(Life Threatening Emergency)

Consists of the following symptoms; Increased AMS, lead pipe rigidity, hyperthermia, autonomic instability (increased HR, RR, increasing and decreasing BP)

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11
Q

Define tardive dyskinesia…

A

Occurring after months to years of taking conventional antipsychotics,

Involuntary painless movements of face and upper extremities (chorea), and formal thought disorder

Is potentially irreversible and is due to chronic antipsychotic use

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12
Q

Depot medications are…
The reason they are used is to…

A

Long acting injectable medications that can last up to months aimed to prevent a patient from relapsing from non adherence to a medication regime

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13
Q

What pathway keeps ACh and DA balanced

A

Nigrostriatal pathway

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14
Q

Why is Benztropine given with 1st gen antipsychotics

A

To balance out the ACh and DA levels. DA is decreased so you’d want to decrease ACh too

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15
Q

Pros & cons of 1st gen antipsychotics

A

Pros:
Fewer withdrawal symptoms

Cons:
Increase risk for tardive dyskinesia
More likely to cause EPS

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16
Q

How do atypical antipsychotics work

A

Blocks DA & 5-HT receptors. Decrease DA & increases 5-HT

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17
Q

What do atypicals tx, list a few examples

A

Negative & positive symptoms
Negative:
-apathy
-social withdrawal
-blunted/flat affect
-anhedonia (lack of joy)
-poverty and speech

18
Q

Atypical drugs (6) & things to look out for

A

Clozapine: metabolic syndrome, decrease bone marrow (neutropenia)

Olanzapine: (M.S. taken @ HS)

Risperidone: OHTN & sedation= Fall risk

Quetiapine: helps w/ sleep

Ziprasidone: prolonged QTC interval….ECG needed

Aripriprazole: tx schiz, bipolar, and Major Depression

19
Q

Pros and cons of atypical

A

Pros: less likely to cause EPS
Low tardive dyskinesia

Cons:
Higher risk of NMS
All cause M.S. (weight gain, increased Blood glucose, triglycerides, hyperlipidemia)

20
Q

How do SSRIs work

A

Inhibit 5-HT protein transporter to prevent the reuptake of 5-HT

21
Q

SSRI drugs

A

Fluoxetine
Escitalopram
Paroxetine
Sertraline

22
Q

Side effects from SSRIs

A

Decreased libido
Agitation
Insomnia
Nausea
Serious:
Birth defects
Dizzy/blurred vision

23
Q

Key points to note while taking SSRIs

A

Do not take while pregnant
Do not discontinue abruptly
Do not take 2 serotonergic drugs at the same time
Can cause neonatal withdrawals if mother takes while pregnant
Not recommended ages 18-24

24
Q

Who shouldn’t take SSRIs and why

A

Mothers (birth defects)
People ages 18-24 (increase risk of suicide)
Bipolar 1 (increases mania)

25
Q

How do TCAs work

A

Block NE and 5-HT protein transporters to prevent reuptake of NE & 5-HT and increase sensitivity of receptors

26
Q

What do TCAs tx (3)

A

OCD/anxiety (?)
depression
Neuropathic pain

27
Q

TCA side effects

A

*Anti-Cholinergic effects (block muscurinic receptors)
-dry mouth
-urinary retention
-blurred vision
-constipation
*increase dizziness & decrease BP= fall risk
*increase weight
*increase sedation
* Risk of TCA OD and leads to cardiotoxicity (caution w/ elderly pts, slower metab. So increase risk)

28
Q

TCA drugs

A

Amitriptyline
Noritriptyline
Clomipramine
Imipramine

29
Q

How do MOAIs work

A

Blocks monamine oxidase leading to increase in DA, NE, & 5-HT

30
Q

Side effects of MAOIs

A

Weight gain
Fatigue
Sexual dysfunction
Hypotension
Muscle cramp
Urinary retention
Constipation

31
Q

Serious side effect from MAOIs doses (9-12mg) & Tyramine diet

A

Hypertensive crisis

Sweating
N/V
Palpitations
Tachycardia
Confusion

32
Q

What foods should you avoid while taking MAOIs list a few examples

A

Alcohol
Fermented fruit/veggies
Chocolate
Cheese
Dried/cured meats
Caffeine
Dry pickled & cured fish
Dried fruit/veggies

33
Q

What are the MAOI drugs

A

Phenelzine
Tranylcypromine

34
Q

things to know about MAOIs (2)

A

Don’t take with ANY other antidepressants

Wait 2 weeks after stopping MAOIs to move onto another antidepressant

35
Q

What are the two mood stabilizer classes

A

Anti-Mania
Anti-epileptic

36
Q

How do Anti-Mania meds work

A

Alters Na ion channels, also increases GABA and decrease DA & glutamate

37
Q

What do anti-manias tx

A

Bipolar 1&2
Schiz
MDD (not very helpful)
Impulsivity disorder

38
Q

Therapeutic vs non therapeutic range of lithium

A

0.6-1.2mEq/L
Non: 1.5<

39
Q

Long term side effects of lithium

A

Hypothyroidism
Renal failure

40
Q

What labs to check when on lithium

A

CBC
Cr
GFR
BUN
TSH

41
Q

Atypical drug medications

A

clozapine
olanzapine
risperidone
quetiapine
ziprasidone
aripiprazole

COC N126 Psych 🧠 (9 decks)

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