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Behavioral Health > Nt > Flashcards

Nt Flashcards

1
Q

Where is the majority of serotonin

A

G.I. tract

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2
Q

Where is serotonin released from in the brain

A

Ralphe nuclei of synaptic vesicles

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3
Q

Serotonin plays a role in

A

Sleep mood sexual desire sexual function appetite memory and learning temperature regulation social behavior

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4
Q

Serotonin is responsible for on its own

A

Obsessions compulsions memory

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5
Q

Serotonin and dopamine are responsible for

A

Appetite sex aggression

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6
Q

Doug mean on its own is responsible for

A

pleasure reward motivation

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7
Q

Serotonin norepinephrine are responsible for

A

Anxiety impulse irritability

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8
Q

Norepinephrine on its own is responsible for

A

Alertness concentration energy

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9
Q

Norepinephrine and dopamine are responsible for

A

Attention

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10
Q

Norepinephrine serotonin and dopamine are all responsible for

A

Mood and cognition

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11
Q

Dopamine and norepinephrine are derived from

A

Tyrosine

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12
Q

Tire seen concentrates in

A

The midbrain (substantia nigra) the hypothalamus

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13
Q

Dopamine is stored here

A

Synaptic vesicles

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14
Q

Three Marano systems that dopamine is primarily in

A

Nigrostriatal
Mesolimbic
Mesocortical

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15
Q

This degrades norepinephrine

A

MAO

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16
Q

Norepinephrine is really used in the brain by

A

locus ceruleus

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17
Q

Noradrenergic neurons are found in these three places in the brain

A

Pons Maduell and thalamus

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18
Q

How serotonin is made

A

Tryptophan plus tryptophan hydroxylase equals serotonin

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19
Q

Most commonly prescribed drug class for psychiatric illnesses and other uses

A

SSRI

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20
Q

Mechanism of action for SSRI

A

Increase serotonin activity by decreasing the action of the presynaptic serotonin reuptake pump

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21
Q

Name the six SSRIs and their brand name

A 
Citalopram-celexa 
Escitalopram-lexapro 
Fluoxetine-Prozac
Fluvoxamine -Luvox
Sertraline-Zoloft
Paroxetine-Paxil
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22
Q

Indications for SSRIs

A

Anxiety disorders
anorexia
premenstrual dysphoric disorder
major depressive disorder

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23
Q

Class of drugs that uses CYP 450

A

SSRIs except Celexa and Lexapro

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24
Q

What to drugs should you avoid while taking SSRIs to prevent serotonin syndrome

A

Triptans and tramadol

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25
Q

What happens if you give a bipolar patient SSRIs

A

Mania or rapid cycling

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26
Q

Which SSRI is specifically associated with headaches

A

Prozac

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27
Q

Which drug class is associated with hematologic effects even though there is no reduction platelet number

A

SSRIs

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28
Q

Which drug class has a suicide risk as a FDA blackbox warning

A

SSRIs in ages 18 to 24

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29
Q

Symptoms of serotonin syndrome

A 
Diarrhea 
restlessness 
agitation 
myoclonus 
delirium/death
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30
Q

Treatments for serotonin syndrome

A

Benzodiazepines and cyproheptadine a serotonin antagonist

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31
Q

Mechanism of action for SNRIs

A

Block presynaptic serotonin and norepinephrine

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32
Q

3 SNRis

A

Venlaxafine-Effexor
Desvenlafaxine-pristine
Duloxetine-cymbalta

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33
Q

Indications for Effexor

A

MDD generalized anxiety disorder social anxiety disorder panic disorder

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34
Q

Indications for pristiq

A

MDD

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35
Q

Indications for Cymbalta

A

MDD

Neuropathic pain

36
Q

What drug can’t you use SNRIs in conjunction with

A

Maoi –> serotonin syndrome

37
Q

When are atypical antidepressants

A

When SSRIs aren’t effective

38
Q

To a typical antidepressants

A

Bupropion-wellbutrin

Mirtazapine-remeron

39
Q

What has a similar structure to amphetamines

A

Bupropion

40
Q

Bupropion MOA

A

Inhibits presynaptic reuptake of dopamine and norepinephrine greatest effect on dopamine inhibits CYP 450

41
Q

What two types of patients can you not use bupropion in

A

Bulimia and anorexia causes seizures

42
Q

When is the worst time to take bupropion

A

Nighttime.

43
Q

What is structurally similar to TCAs and tetracyclic antidepressants

A

Mirtazapine

44
Q

mirtazapine MOA

A

Antagonizes presynaptic alpha-2 adrenergic receptors and postsynaptic serotonin receptors (increases norepinephrine and serotonin release)

45
Q

What receptors does Remeron have a high affinity for

A

Histamine

46
Q

The Remeron make you sleepy or awake

A

Sleepy, this is great for people with insomnia

47
Q

To side effects of Remeron

A

Drowsiness and weight gain

48
Q

Main side effect of Wellbutrin

A

Insomnia

49
Q

MOA of TCAs

A

Inhibit reuptake of serotonin norepinephrine and acetylcholine

50
Q

For TCAs

A

Amitryptiline-elavil
Nortriptyline-panel or
Desipramine-norpramin
Doxepin-silenor

51
Q

Indications for TCAs

A

MDD OCD bedwetting

52
Q

Metabolism of TCAs

A

Liver

53
Q

Why TCAs are falling from favor

A 
Central and peripheral anti-cholinergic side effects 
fatal overdose 
drowsiness 
orthostatic hypotension 
weight gain 
sexual dysfunction
54
Q

Most common cause of death with TCAs

A

Prolonged QT leading to arrhythmia lipophilic property means it is in effectively removed by dialysis

55
Q

MOA for MAOis

A

Monoamine oxidase inhibitor

56
Q

For MAOIs

A

Isocarboxazid-marplan
Phnelzine-nardil
Seligiline-eldepryl
Trancypromine- parnate

57
Q

First antidepressant ever approved

A

Isoniazid

58
Q

What must you avoid with MAOIs

A

Tyramine containing foods

59
Q

What drugs must you avoid with MAOIs

A

Cold medication
asthma medication
pain medication
antihistamines

60
Q

What is the worst side effect of MAOIs

A

Lethal hypertension

61
Q

What are typical and hide psychotics primarily used for

A

Depression with psychotic symptoms but also schizophrenia and delusional disorders

62
Q

Mechanism of action for typical antipsychotics

A

Dopamine receptor antagonist

63
Q

For typical antipsychotics

A

Chlorpromazine- thorazine
Fluphenazine- prolixin
Haloperidol- half ok
Pimozide- orap

64
Q

MOA of atypical antipsychotics

A

Serotonin dopamine antagonists

65
Q

What are atypical antipsychotics more selective for

A

Mesolimbic dopamine pathway

66
Q

Three indications of atypical antipsychotics

A

Major depression
acute mania
bipolar disorder

67
Q

Seven atypical antipsychotics

A 
Risperidone- risperdal
Olanzapine- zypreza
Quetiapine- Seroquel 
Ziprasidone- geodon 
Clozapine- clozaril 
Paliperidone- invega 
Carbamazepine- tegretol
68
Q

Indication of mood stabilizers

A

Bipolar disorder

69
Q

First-line treatment for bipolar

A

Lithium

70
Q

Mechanism of action for lithium

A

Unknown

71
Q

To indications for lithium

A

Bipolar maintenance and acute mania

72
Q

Six labs needed for lithium

A 
CBC 
BMP
EKG 
TSH 
pregnancy test
Lithium levels
73
Q

Lithium toxicity

A 
NVD 
tremor 
ataxia 
slurred speech 
confusion 
arrhythmia
74
Q

Long-term side effects of lithium

A

Kidney
hypothyroid
cardiac arrhythmia

75
Q

Valproate (depakene/ depakote) classification

A

Mood stabilizer/anticonvulsant

76
Q

Also I first-line treatment for bipolar acute mania and maintenance

A

Depakote

77
Q

Depakote mechanism of action

A

Unknown

78
Q

To blackbox warnings for depakote

A

Hepatotoxicity within the first six months and pancreatitis within the first six months

79
Q

Can Depakote be combined with lithium

A

Yes

80
Q

Can Depakote be combined with Lamictal

A

No it causes SJS

81
Q

Labs to be run with Depakote

A 
Serum levels 
LFT 
CBC 
platelet 
pregnancy
82
Q

Two indications for lamictal

A

Epilepsy and bipolar disorder

83
Q

Mechanism of action for lamictal

A

Block sodium channels in the brain related to neurons firing. Diminishes the build up of glutamate in the CSF

84
Q

Does lamictal have anti-mania properties

A

No

85
Q

When you increase the dose of lamictal too fast

A

Sjs

86
Q

Side effects of back/joint pain

A

Lamictal

Behavioral Health (4 decks)

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