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Mental Health > Pharmacology > Flashcards

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
Q

What are the s&s of serotonin syndrome? (10)

A

agitation, restlessness, hallucinations, vomiting, diarrhea, increased temperature, nausea, BP changes, fast heart rate, overactive reflexes

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26
Q

Increased dopamine =

A

schizophrenia and mania

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27
Q

Decreased dopamine =

A

parkinson and depression

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28
Q

Increased Norepinephrine =

A

mania, anxiety and schizophrenia

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29
Q

Decreased norepinephrine =

A

depression

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30
Q

Increased serotonin =

A

anxiety

31
Q

Decreased serotonin =

A

depression

32
Q

Decreased histamine =

A

sedation and weight gain

33
Q

Increased GABA =

A

reduction of anxiety

34
Q

Decreased GABA =

A

anxiety, schizophrenia, mania, Huntington’s

35
Q

What are the 2 types of glutamate?

A

NMDA and AMPA

36
Q

Increased NMDA =

A

neurotoxic and alzheimers

37
Q

Decreased NMDA =

A

psychosis

38
Q

Increased acetylcholine =

A

depression

39
Q

Decreased acetylcholine =

A

alzheimers. hungingtons and parkinsons

40
Q

What s&s do first generation antipsychotics treat?

A

only positive symptoms

41
Q

What s&s do second generation antipsychotics treat?

A

both positive and negative symptoms

42
Q

What are the side effects of first generation antipsychotics? (10)

A

extrapyramidal symptoms, drowsiness, dizziness, constipation, dry mouth, urinary retention, blurred vision, photosensitivity, weight gain, prolactin elevation

43
Q

What meds are used to treat akathisia?

A

CLONAZEPAM (rivotril)

PROPRANOLOL (inderal)

44
Q

What side effects can be treated with BENZOTROPINE (cogentin)

A

dystonia and parkinsonism

45
Q

Why use second generation antipsychotics?

A

less or no EPS, improve cognition, continued improvement over time and treats both positive and negative symptoms

46
Q

What are the side effects of olanzapine? (6)

A

weight gain, insulin resistance, diabetes and sedation

rare: agranulocytosis

47
Q

What are the side effects of risperidone? (3)

A

hyperprolactinemia

rare: parkinsonism and akathsia

48
Q

What are the side effects of quetiapine? (1)

A

sedation

49
Q

What are the side effects of clozapine? (6)

A

insulin resistance, diabetes, sialorrhea (drooling), sedation
rare: seizures, agranulocytosis

50
Q

What second generation antipsychotic needs bloodwork and monitoring?

A

Clozapine

51
Q

How do antidepressants work?

A

increase the activity of 1 or more of the following: serotonin, norepinephrine and dopamine

52
Q

How long does it take for a patient to respond to an antidepressant?

A

4-6 weeks

53
Q

What is the most important thing about amitriptyline (elvail)?

A

lethal in overdose because of cardiotoxic effects

54
Q

What things does pheneizine (nardil) interact with and what do these interactions cause?

A

cheese, wine and other drugs

the interactions cause dangerous elevation of BP

55
Q

Why are SSRIs the drug of choice for depression?

A

decreased side effects and fairly safe in overdose

56
Q

Main side effects of SSRIs?

A

headache, anxiety, loss of libido, weight gain

57
Q

What are the s&s of serotonin syndrome? (11)

A

agitiation, restlessness, diarrhea, fast heart beat, hallucinations, increased temperature, loss of cordination, nausea, overactive reflexes, rapid BP changes and vomiting

58
Q

What is the main s&s of discontinuing SSRIs?

A

electric like shock sensations

59
Q

What is the response rate of lithium in bipolar disorder?

A

40%

60
Q

Why should lithium levels be monitored?

A

Narrow therapeutic window and toxicity is a medical emergency requiring rapid tx

61
Q

What are the side effects of lithium? (8)

A

stomach discomfort, excessive thirst and urination, weight gain, weakness, dizziness, confusion, bad long term effects on thyroid (hypothyroidism)

62
Q

What are the early signs of lithium toxicity? (9)

A

increased thirst, polyuria, vomiting and diarrhea, ataxia, slurred speech, blurred vision, tinnitus, increased muscle weakness

63
Q

What are the late signs of lithium toxicity? (8)

A

confusion, disorientation, nystagmus (uncontrollable eyes), seizures, decreased urine output, coma, death, muscle twitching, hyper-relexia

64
Q

How do anticonvulsants work?

A

enhancing the effects of GABA

65
Q

What are the side effects of carbamazepine? (5)

A

blood dyscrasis (monitor CBC, report any fever, sore throat, petechia or bruising), drowsiness, dizziness, ataxia, double vision

66
Q

What is the 3 line of tx for bipolar disorder?

A

carbamazepine

67
Q

When is valproic acid effective and how long does it take to respond?

A

in both maniac and depressed phases

it takes 1-2 weeks

68
Q

What are the side effects of valproic acid? (19)

A

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
Q

Which mood stabilizers are lethal in OD?

A

all 3

70
Q

What are the concerns about the ongoing use of benzos?

A

dependence, tolerance, euphoria, withdrawal and abuse

71
Q

What are the 2 choices of needle gauge and length in IM deltoid injections?

A

23 gauge and 1 inch

22 gauge and 1 1/2 inch

72
Q

What are the 2 choices of needle gauge and length in IM ventrogluteal injections?

A

22 gauge and 1 1/2 inch

21 gauge and 2 inch

73
Q

What 2 meds can’t be mixed IV or IM?

A

olanzapine and lorazepam

Mental Health (8 decks)

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