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Pharmacology Flashcards

1
Q

3 first gen antipsychotics

A

ZUCLOPENTHIXOL (clopixol)
FLUPENTHIXOL (fluanxol)
HALOPERIDOL (haldol)

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2
Q

4 second gen antipsychotics

A

OLANZAPINE (zyprexal)
RISPERIDONE (risperdal)
QUETIAPINE (seroquel)
CLOZAPINE (clozaril)

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3
Q

2 drugs used to treat acute psychosis

A 
LORAZEPAM
ZUCLOPENTHIXOL ACETATE (ACUPHASE)
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4
Q

1 Tricyclic drug

A

AMITRIPTYLINE (elvail)

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5
Q

1 MAOI drug

A

PHENELZINE (nardil)

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6
Q

6 SSRIs

A 
FLUOXETINE (prozac)
FLUVOXAMINE (luvox)
PAROXETINE (paxil)
CITALOPRAM (celexa)
ESCITALOPRAM (cipralex)
SERTALINE (zoloft)
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7
Q

3 mood stabilizers

A

LITHIUM (carbolith, durallith)
CARBAMAZEPINE (tegretol)
VALPROIC ACID (clepukene, epival)

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8
Q

2 Benzos for sleep and anxiety

A

CLONAZEPAM (rivotril)

LORAZEPAM (ativan)

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9
Q

Non benzo tx for sleep and anxiety

A

ZOPICLONE (imovane)

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10
Q

Anti-anxiety med

A

BUSPIRONE (buspar)

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11
Q

8 types of neurological symptoms

A 
1 neuroleptic malignant syndrome
2 tardive dyskinesia
3 actue dystonic reactions
4 Parkinsonism
5 akinesia
6 akathisia
7 rabbit syndrome
8 pisa syndrome
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12
Q

What causes neurological symptoms?

A

dopamine blockade

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13
Q

What meds most commonly cause neurological SE?

A

first generation antipsychotics

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14
Q

What are the s&s of neuroleptic malignant syndrome? (7)

A

muscle cramps, fever, agitation, unstable BP, deliruim, coma and cognition changes

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15
Q

What are the s&s of tardive dyskinesia?

A

repetitive involuntary movements of the face and sometimes trunk and extremities

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16
Q

What are the s&s of acute dystonic reactions?

A

anticholingeric drug action causes muscle spasms and abnormal posture

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17
Q

What are the s&s of parkinsonism? (6)

A

shuffling gait, slow movement, mask like expression, stiffness, resting tremors, postural instability

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18
Q

What are the s&s of akinesia?

A

loss of VOLUNTARY movement

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19
Q

What are the s&s of akathisia?

A

feeling of inner restlessness

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20
Q

What are the s&s of rabbit syndrome?

A

perioroal tremors with tongue involvment

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21
Q

What are the s&s of pisa syndrome?

A

tonic trunk flexion to one side

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22
Q

What med most commonly causes metabolic syndrome?

A

second generation antipsychotics

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23
Q

What are the s&s of metabolic syndrome? (5)

A

increased BP, increased body fat especially around waist, abnormal cholesterol and triglyceride levels and increased blood sugar

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24
Q

What medications most commonly cause serotonin syndrome?

A

SSRI and SNRI

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25
What are the s&s of serotonin syndrome? (10)
agitation, restlessness, hallucinations, vomiting, diarrhea, increased temperature, nausea, BP changes, fast heart rate, overactive reflexes
26
Increased dopamine =
schizophrenia and mania
27
Decreased dopamine =
parkinson and depression
28
Increased Norepinephrine =
mania, anxiety and schizophrenia
29
Decreased norepinephrine =
depression
30
Increased serotonin =
anxiety
31
Decreased serotonin =
depression
32
Decreased histamine =
sedation and weight gain
33
Increased GABA =
reduction of anxiety
34
Decreased GABA =
anxiety, schizophrenia, mania, Huntington's
35
What are the 2 types of glutamate?
NMDA and AMPA
36
Increased NMDA =
neurotoxic and alzheimers
37
Decreased NMDA =
psychosis
38
Increased acetylcholine =
depression
39
Decreased acetylcholine =
alzheimers. hungingtons and parkinsons
40
What s&s do first generation antipsychotics treat?
only positive symptoms
41
What s&s do second generation antipsychotics treat?
both positive and negative symptoms
42
What are the side effects of first generation antipsychotics? (10)
extrapyramidal symptoms, drowsiness, dizziness, constipation, dry mouth, urinary retention, blurred vision, photosensitivity, weight gain, prolactin elevation
43
What meds are used to treat akathisia?
CLONAZEPAM (rivotril) | PROPRANOLOL (inderal)
44
What side effects can be treated with BENZOTROPINE (cogentin)
dystonia and parkinsonism
45
Why use second generation antipsychotics?
less or no EPS, improve cognition, continued improvement over time and treats both positive and negative symptoms
46
What are the side effects of olanzapine? (6)
weight gain, insulin resistance, diabetes and sedation | rare: agranulocytosis
47
What are the side effects of risperidone? (3)
hyperprolactinemia | rare: parkinsonism and akathsia
48
What are the side effects of quetiapine? (1)
sedation
49
What are the side effects of clozapine? (6)
insulin resistance, diabetes, sialorrhea (drooling), sedation rare: seizures, agranulocytosis
50
What second generation antipsychotic needs bloodwork and monitoring?
Clozapine
51
How do antidepressants work?
increase the activity of 1 or more of the following: serotonin, norepinephrine and dopamine
52
How long does it take for a patient to respond to an antidepressant?
4-6 weeks
53
What is the most important thing about amitriptyline (elvail)?
lethal in overdose because of cardiotoxic effects
54
What things does pheneizine (nardil) interact with and what do these interactions cause?
cheese, wine and other drugs | the interactions cause dangerous elevation of BP
55
Why are SSRIs the drug of choice for depression?
decreased side effects and fairly safe in overdose
56
Main side effects of SSRIs?
headache, anxiety, loss of libido, weight gain
57
What are the s&s of serotonin syndrome? (11)
agitiation, restlessness, diarrhea, fast heart beat, hallucinations, increased temperature, loss of cordination, nausea, overactive reflexes, rapid BP changes and vomiting
58
What is the main s&s of discontinuing SSRIs?
electric like shock sensations
59
What is the response rate of lithium in bipolar disorder?
40%
60
Why should lithium levels be monitored?
Narrow therapeutic window and toxicity is a medical emergency requiring rapid tx
61
What are the side effects of lithium? (8)
stomach discomfort, excessive thirst and urination, weight gain, weakness, dizziness, confusion, bad long term effects on thyroid (hypothyroidism)
62
What are the early signs of lithium toxicity? (9)
increased thirst, polyuria, vomiting and diarrhea, ataxia, slurred speech, blurred vision, tinnitus, increased muscle weakness
63
What are the late signs of lithium toxicity? (8)
confusion, disorientation, nystagmus (uncontrollable eyes), seizures, decreased urine output, coma, death, muscle twitching, hyper-relexia
64
How do anticonvulsants work?
enhancing the effects of GABA
65
What are the side effects of carbamazepine? (5)
blood dyscrasis (monitor CBC, report any fever, sore throat, petechia or bruising), drowsiness, dizziness, ataxia, double vision
66
What is the 3 line of tx for bipolar disorder?
carbamazepine
67
When is valproic acid effective and how long does it take to respond?
in both maniac and depressed phases | it takes 1-2 weeks
68
What are the side effects of valproic acid? (19)
neuromuscular disturbances, dizziness, stupor, agitation, disorientation, nystagmus, urinary retention, N/V, increased HR, BP changes, shock, coma and respiratory depression GI complaints, weight gain, menstrual changes, pancreatitis and hair loss
69
Which mood stabilizers are lethal in OD?
all 3
70
What are the concerns about the ongoing use of benzos?
dependence, tolerance, euphoria, withdrawal and abuse
71
What are the 2 choices of needle gauge and length in IM deltoid injections?
23 gauge and 1 inch | 22 gauge and 1 1/2 inch
72
What are the 2 choices of needle gauge and length in IM ventrogluteal injections?
22 gauge and 1 1/2 inch | 21 gauge and 2 inch
73
What 2 meds can't be mixed IV or IM?
olanzapine and lorazepam

Mental Health (8 decks)

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