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Pharmacology > Pschyopharmacology > Flashcards

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
Q

exclusion of bipolar necessary for giving antidepressant

A

these can ppt maniac phase

26
Q

fewest side effects of which class of antidepresant

A

SSRI

27
Q

side effects of SSRI

A

sexual :anorgasmia ,delayed orgasm
serotonin syndrome
git

28
Q

symptoms of Serotonin syn

A 
(due to inc serotonin)
general restlessness
sweating, hyperthermia
insomnia
nause
diarrhoea
cramps, rigidity,myoclonus
delerium
29
Q

cause of serotonin syn

A

high dose SSRI
SSRI+MAOI
MAOI+ synthetic narcotics

30
Q

tt of serotonin syn

A

stop drug

give cyproheptadine if req

31
Q

moa enzyme action

A

metabolizes epi,NE, serotonin

32
Q

major adr of MOAI

A 
hypertensive crisis(MAOI + tyramine)
occipetal headache
stiff neck
n/v
chest pain
dilated pupils
nosebleed
elevated blood pressure
33
Q

tt of hypertensive crisis due to MAOI

A

stop drug

phrntolamine/chlorpromazine

34
Q

tyramine containing foods

A 
cheese
chocolates
dried fish
avocado
sausage
sauerkraut
(sage foods:cottage cheese and only some wines)
35
Q

use of ECT

A

Mainly depression

scizoaffective disorder, bipolar

36
Q

c/i for ECT

A

Increased ICP(tumor)

37
Q

t/f

ECT used to treat episodrs not prophylaxis

A

yes

38
Q

side effects of ECT

A

memory losd and headache

returns to normal in several weeks

39
Q

ECT is especially considered for

A

highly suicidal patients

depressed pregnent women

40
Q

how do we get to know about the recovry after ECT

A

increasr in slow wave (delta)activity

41
Q

antidepressant used for smoking cessation

A

bupropion

42
Q

main se of trazodone

A

priapism

43
Q

mitrazepine se

A

increased sleep,increased appetite,wt gain

anorexia nervosa with concomitant depression

44
Q

mitrazepine se

A

increased sleep,increased appetite,wt gain
(anorexia nervosa with concomitant depression)
bupropion opposite in se(appetite suppresant, agitation, insomnia)

45
Q

depression + pain

A

duloxetine

46
Q

use of lithium

A

bipolar(control, prophylaxis)
migraine cluster headaches
chronic aggression
combined with TCA for resistant depression

47
Q

Li has very narrow safety margin .How?

A

requires reaching plasma levels very close to toxic levels for effect

48
Q

therapeutic level for Li

A

0.8- 1.5 mEq/L
toxic-1.4 mEq/L may be toxic
frank toxixity: 2
hemodialysis: above 2.5

49
Q

se of lithium

A

therapeutic- tremor, thirst, anorexia, git
seisures coma
DI:polyuria and polydypsia( dec ADH effect)
acne
benign leukocytosis
hypothyroidism(dec TSH effect)
nephrotoxic

50
Q

teratogenic effect of lithium

A

ebstein anomaly of tricuspid valve

51
Q

other drugs used for bipolar

A

valproic(rapid action)

carbamezipine

52
Q

OCP and BZD should not be used together

A

yes

OCP inc BZD level

53
Q

buspirone

A 
antianxiety drus
moa- effects serotonin not gaba
no anticonvulsant , m relaxing properties
no abuse potential
not potentiated by alcohol(others are)
54
Q

moa of mirtazipine

bupropion

A

stimulates 5HT and NE release

weak inhibitor of dopamine, modest effect on NE,no effect on 5 Ht reuptake

55
Q

use of SSRI

A 
Major depression
OCD
bulimia
anxiety ds- chronic( for acute- BDZ)
premenstrual dysphoric syn
56
Q

irreversible inhibitor of both mao enz

A

tranylcypromine

phenelzine

57
Q

drugs used in ADHD

A

methylphenidate -amphetamine like

atomoxetine- selective NE reuptake inhibitor

Pharmacology (16 decks)

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