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Psychiatry > Pharm > Flashcards

Pharm Flashcards

1
Q

Escitalopram and citalopram are part of what family of medications?

A

SSRIs

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2
Q

This medication stimulated 5-HT1A receptors. It does not cause sedation, addiction, tolerance, and does not interfere with alcohol. It is indicated for Generalized Anxiety disorder. What drug is at hand?

A

Buspirone

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3
Q

Pimozide, trifluoperazine, fluphenazine, thioridazine, and chlorpromazine are part of what family of medications?

A

Typical antipsychotics that include Haloperidol.

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4
Q

What is the MOA, and why are typical antipsychotics more toxic?

A

Work on D2 receptors, and they are more toxic due to being more lipid soluble. Can cause EPS.

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5
Q

What is EPS, and its clinical manifestations?

A

Extrapyramidal side effects, that include: Muscle stiffness, acute dystonia (muscle spasms), Akathisia (restlessness), and Parkinsonism (tardive dyskinesia - orofacial chorea).

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6
Q

What family of medications do these drugs belong to: Aripripazole, asenapine, clozapine, iloperidone, paliperidone, lurasidone, and ziprasidone.

A

Atypical antipsychotics - Have less side effects than typical antipsychotics.

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7
Q

These side effects are specific to which class of drugs? Prolonged QT interval, metabolic Sd (weight gain, hyperlipidemia, diabetes), and ______ can cause agranulocytosis. _______ can cause hyperprolactinemia (amenorrhea, galactorrhea, gynecomastia).

A

Atypical Antipsychotics.
Clonidine - agranulocytosis
Risperidone - Hyperprolactinemia

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8
Q

This drug causes tremor, hypothyroidism, polyuria (causes Nephrogenic DI), and teratogenesis. Therapeutic window is very slim and should be monitored in serum levels. What psych drug is at hand?

A

Lithium

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9
Q

What is the MOA of CNS stimulants?

A

Increase catecholamines in the synaptic cleft, especially NE and Dopamine.

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10
Q

Intoxication with this drug causes violence, impulsivity, psychomotor agitation, nystagmus, tachycardia, hypertension, analgesia, psychosis, delirium, and seizures. Trauma is MC complication. What drug is at hand?

A

Phencyclidine (PCP)

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11
Q

Intoxication with this drug causes perceptual distortion (visual, auditory), depersonalization, anxiety, paranoia, psychosis, possible flashbacks. What drug is at hand?

A

Lysergic Acid Diethylamide

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12
Q

Intoxication with this drug causes euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations. Withdrawal causes irritability, anxiety, depression, insomnia, restlessness, and decreased appetite.

A

Marijuana (cannabinoid)

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13
Q

Intoxication with this drug is a hallucinogenic stimulant causing: Euphoria, disinhibition, hyperactivity, distorted sensory and time perception, and teeth clenching. LIFE THREATENING effects include hypertension, tachycardia, hyperthermia, hyponatremia, and serotonin syndrome. Withdrawal causes depression, fatigue, change in appetite, difficulty concentrating, and anxiety.

A

MDMA (ecstasy)

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14
Q

Triad of: Confusion, ophthalmoplegia, and ataxia. May progress to irreversible memory loss, confabulation, and personality change. What pathology is at hand? What is the cause?

A

Wernicke Encephalopathy. When progressed, it is Korsakoff syndrome. Due to B1 def. Associated periventricular hemorrhage/necrosis of mammillary bodies.

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15
Q

Withdrawal from this drug causes: Sweating, dilated pupils, piloerection, fever, rhinorrhea, lacrimation, yawning, nausea, stomach cramps, diarrhea (flu-like symptoms). MCC of drug overdose death.

A

Opioids - intoxication causes, euphoria, respiratory CNS depression, pupillary constriction (pinpoint pupils), seizures.

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16
Q

Intoxication with this drug causes impaired judgement, pupillary dilation, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death. Chronic use may lead to vasoconstriction and resulting ischemic necrosis.

A

Cocaine

17
Q

Intoxication with this drug causes euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, hypertension’s, tachycardia, anorexia, paranoia, and fever. Skin excoriations with ___ use. Severe cases can cause cardiac arrest and seizures.

A

Amphetamines —> Methamphetamine causes the skin excoriations.

18
Q

What drug is used as a long-acting oral opiate, used for heroin detoxification or long-term maintenance therapy?

A

Methadone

19
Q

What drug is used sublingually (partial agonist) in maintenance therapy with an antagonist (not available orally) is added to lower IV abuse potential? What two drugs are used as a combo?

A

Buprenorphine + naloxone

20
Q

What drug is used as a long-acting opioid given IM or as a nasal spray to treat acute overdose in unconscious individuals? Also used for relapse prevention once detoxified.

A

Naltrexone

21
Q

Inhibits NE and Dopamine reuptake. Favorable sexual side effects, but may cause tachycardia, insomnia, seizures in anorexic/bulimic patients. Also used for smoking cessation.

A

Bupropion - atypical antidepressant

22
Q

Alpha-2 antagonist (increases the release of NE and 5-HT), potent 5-HT2 and 5-HT3 receptor antagonist and H1 antagonist. Toxicity: sedation, increased appetite, weight gain, and dry mouth.

A

Mirtazepine - atypical antidepressant

23
Q

Primarily blocks 5-HT2, alpha-adrenergic, and H1 receptors; also inhibits 5-HT reuptake. Used primarily for insomnia, as high doses are needed for antidepressant effects. Toxicity: Sedation, nausea, priapism, postural hypotension.

A

Trazodone - atypical antidepressant

24
Q

Nicotine Ach reuptake; 5-HT1A receptor partial agonist and 5-HT receptor antagonist. Used for MDD. Toxicity: Headache, diarrhea, nausea. Increased weight gain, anticholinergic effects. May cause serotonin syndrome if taken with other serotonergic agents.

A

Vilazodone - atypical antidepressant

25
Q

Inhibits 5-HT reuptake. 5-HT1A receptor agonist, and 5-HT3 receptor antagonist. Used for MDD. Toxicity: nausea and sexual dysfunction, sleep disturbances (abnormal dreams) anticholinergic effects. May cause serotonin syndrome if taken with other serotonergic agents.

A

Vortioxetine - atypical antidepressant

26
Q

What is the worst side effect of Clozapine?

A

Agranulocytosis

27
Q

What are the 3 most common side effects of TCAs…

A

Convulsions, Coma, cardio toxicity

Also: hyperpyrexia and respiratory depression

28
Q

What medication inhibits alcohol dehydrogenase?

A

Fomepizole

29
Q

What medication inhibits acetaldehyde dehydrogenase?

A

Disulfiram

30
Q

What are the high potency antipsychotics?

A

Trifluoperazine
Fluphenazine
Haloperidol

Produce more EPS

31
Q

What are the low potency antipsychotics?

A

Chlorpromazine

Thioridazine

32
Q

What is the treatment for Neuroleptic Malignant Syndrome?

Myoglobinuria
Fever
Encephalopathy 
Vitals unstable 
Increased enzymes- incr CK
Rigidity of muscles —> like lead pipe
A

Stop offending agent, IV fluids, balance the electrolytes, treat the rhabdomyolysis, and use cooling blankets

Dantroline (used to tx anesthetic caused hyperthermia)
Bromocriptine

33
Q

What are the 3 ma n SEs of TCAs?

A

3 Cs:
Convulsions
Coma
Cardiotoxicity

Others: Respiratory depression, hyperpyrexia, confusion and hallucinations (due to anticholinergic blocking properties in elderly - aka delirium

34
Q

What medication SEs are associated with dry mouth, blurred vision, and mania? And why?

A

Amitriptyline - due to medication with increased anticholinergic SEs

35
Q

What are the two enzymes used in the catabolism of norepinephrine?

A

COMT (catechol-o-methyltransferase)

And

MAO (monoamine oxidase)

Psychiatry (7 decks)

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