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Pschyopharmacology Flashcards

1
Q

which drug is ass with no tardive dyskinesia

A

clozapine

pimozide and loxapine less

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2
Q

extrapyramidal reactions sequence of antisychotics

A 
DARTAR
dystonic(jerky mov,trouble speaking)
akinesia
tremor
rigidity
akithisia
pisa and rabbit syn
(1,2,3wks,1.5,2.5,4.5mth)
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3
Q

tardive dyskinesia occurs after

A

3-6 months

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4
Q

cause of tardive dyskinesia

A

supersenitivity to postsynaptic DA recep

i.e why may persisit even after drug termination

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5
Q

EP and tardive dyskinesia tt

A

1.acuteEP:antimuscurinic drugs (benztropine,diphenhydramine,trihexyphenidyl)
2.chronic EP(TD only)
should prevent by giving drug holiday on onset of symptoms i.e.discontinuation
switch to atypical

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6
Q

receptors on which antipsychotics act

A

block

  1. dopamine (EP,Tardive dyskinesia,prolactin inc)
  2. alpha-adrenergic(hypotension)
  3. H1(wt gain,sedation,impaired memory)
  4. muscuranic(dry mouth,blurry vision, constipation)
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7
Q

are the followinf se of antipsychotics

  1. particular taste(dental caries)
  2. altered bodily response to temp
A

yes

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8
Q

among typicals max EPS(D acting)

A

haloperidol
fluphenazine
(chlorpromazine, thio- more on M,H1,alpha)

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9
Q

peculiar side effects of thioridazine

A

retrograde ejaculation
retinitis pigmentosa
cardiotoxicity(torsades-quinidine like)

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10
Q

antispychotics given vua inj

A

fluphenazine

ziprasidone

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11
Q

which antipsychotic will be most likely caustive of malignant neuroleptic syn and TD

A

haloperidol

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12
Q

main side effect of clozapine

A

agranulocytosis
seizure(high dose)
increased salivation

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13
Q

name 5 typical Antipsychotics

A 
haloperidol
fluphenazinr
thioridazine
chlorpromazine
loxapinr
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14
Q

wet pillow syn caused by

A

clozapine

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15
Q 
if acute symptoms(agressiveness etc)
which class to be used
A

typicals-more likely to act

for maintaince can shift to atypicals if they work

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16
Q

which class treats both + and - schizophrenic symptoms

A

atypical

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17
Q

if fear of EP symptoms ..which atypical not to use

A

haloperidol like

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18
Q

highest incidence of dibetrs,chol,wt gain

A

olanzapine

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19
Q

name atypicals

A 
cloza
resperidone
olanza
quetiapinr
aripiprazole
ziprasidone
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20
Q

uses of antipsychotics

A 
schizophrenia
psyhotic symptoms-hallu,delusions
movement disorder-toureytr,huntingtons
n/v
intractable hiccups
pruritis
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21
Q

uses of antidepressants

A 
depression
anxiety
chronic pain with/without depression
OCD
panic
enuresis
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22
Q

window of suicide risk

A
  • for all antidepressants

- motor activity incresese before depression is affected so increased risk of suicide

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23
Q

moa of TCA

A

blockage of 5HT and NE reuptake

also block alpa adrrnergic and muscrinic rep

24
Q

adr of TCA

A
  1. anticholinergic
  2. alpha blokade: CVS -orthostatic hyptsn, tachcardia
  3. CNS:drowsiness, insomnia, agitation, headache , fine tremor
  4. sexual:men(erectile dysfxn) and women
  5. metabolic:changrs in blood sugar
25
exclusion of bipolar necessary for giving antidepressant
these can ppt maniac phase
26
fewest side effects of which class of antidepresant
SSRI
27
side effects of SSRI
sexual :anorgasmia ,delayed orgasm serotonin syndrome git
28
symptoms of Serotonin syn
``` (due to inc serotonin) general restlessness sweating, hyperthermia insomnia nause diarrhoea cramps, rigidity,myoclonus delerium ```
29
cause of serotonin syn
high dose SSRI SSRI+MAOI MAOI+ synthetic narcotics
30
tt of serotonin syn
stop drug | give cyproheptadine if req
31
moa enzyme action
metabolizes epi,NE, serotonin
32
major adr of MOAI
``` hypertensive crisis(MAOI + tyramine) occipetal headache stiff neck n/v chest pain dilated pupils nosebleed elevated blood pressure ```
33
tt of hypertensive crisis due to MAOI
stop drug | phrntolamine/chlorpromazine
34
tyramine containing foods
``` cheese chocolates dried fish avocado sausage sauerkraut (sage foods:cottage cheese and only some wines) ```
35
use of ECT
Mainly depression | scizoaffective disorder, bipolar
36
c/i for ECT
Increased ICP(tumor)
37
t/f | ECT used to treat episodrs not prophylaxis
yes
38
side effects of ECT
memory losd and headache | returns to normal in several weeks
39
ECT is especially considered for
highly suicidal patients | depressed pregnent women
40
how do we get to know about the recovry after ECT
increasr in slow wave (delta)activity
41
antidepressant used for smoking cessation
bupropion
42
main se of trazodone
priapism
43
mitrazepine se
increased sleep,increased appetite,wt gain | anorexia nervosa with concomitant depression
44
mitrazepine se
increased sleep,increased appetite,wt gain (anorexia nervosa with concomitant depression) bupropion opposite in se(appetite suppresant, agitation, insomnia)
45
depression + pain
duloxetine
46
use of lithium
bipolar(control, prophylaxis) migraine cluster headaches chronic aggression combined with TCA for resistant depression
47
Li has very narrow safety margin .How?
requires reaching plasma levels very close to toxic levels for effect
48
therapeutic level for Li
0.8- 1.5 mEq/L toxic-1.4 mEq/L may be toxic frank toxixity: 2 hemodialysis: above 2.5
49
se of lithium
therapeutic- tremor, thirst, anorexia, git seisures coma DI:polyuria and polydypsia( dec ADH effect) acne benign leukocytosis hypothyroidism(dec TSH effect) nephrotoxic
50
teratogenic effect of lithium
ebstein anomaly of tricuspid valve
51
other drugs used for bipolar
valproic(rapid action) | carbamezipine
52
OCP and BZD should not be used together
yes | OCP inc BZD level
53
buspirone
``` antianxiety drus moa- effects serotonin not gaba no anticonvulsant , m relaxing properties no abuse potential not potentiated by alcohol(others are) ```
54
moa of mirtazipine | bupropion
stimulates 5HT and NE release | weak inhibitor of dopamine, modest effect on NE,no effect on 5 Ht reuptake
55
use of SSRI
``` Major depression OCD bulimia anxiety ds- chronic( for acute- BDZ) premenstrual dysphoric syn ```
56
irreversible inhibitor of both mao enz
tranylcypromine | phenelzine
57
drugs used in ADHD
methylphenidate -amphetamine like | atomoxetine- selective NE reuptake inhibitor

Pharmacology (16 decks)

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