Psych Flashcards
positive symptoms of schizophrenia
suspiciousness, delusions, hallucinations, conceptual disorganization
negative symptoms of schizophrenia
flat affect, alogia, anhedonia, avolition
cognitive symptoms of schizophrenia
impaired attention, impaired working memory, impaired executive function
monitoring for atypical antipsychotics
BG/hgbA1c LFTs neurologic function serum cholesterol weight QTC
teaching for atypical antipsychotics
may take several weeks before full effects
may need to taper off
avoid alcohol
atypical antipsychotics examples
aripiprazole (Abilify) lurasidone (Latuda) olanzapine (Zyprexa) Quetapine (Seroquel) Risperidone (Risperdal); Paliperidone (Invega) Ziprasiidone (Geodon)
atypical antipsychotics least likely to cause weight gain
abilify (aripiprazole)
lurasidone (latuda)
zipradisone (geodon)
atypical antipsychotics oral disintegrating tab vs no disintegrating formulations
peak serum concentration occurs slower in oral disintegrating tabs
atypical antipsychotics that need to be taken with food
lurasidone (latuda)
ziprasidone (geodon)
paliperidone is a metabolite of which atypical antipsychotic?
respiridone
common AEs of atypical antipsychotics
sedation, weight gain, extrapyramidal effects, dizziness, poor thermoregulation, glucose dysregulation, black box warning for increased risk w dementia, QT prolongation
akathisia
restlessness
can increase risk for suicide
patho of depression
changes in monoamine neurotransmitters including NE, 5-HT, and DA
symptoms of serotonin syndrome
euphoria, DROWSINESS, HYPERACTIVE REFLEXES, rapid muscle contractions, dizziness, SWEATING, hyperthermia, shivering,, hyperactive bowel sounds, death
AEs of SSRIs
serotonin syndrome, nausea, drowsiness/dizzines, HA/tremor, black box warning
SSRI interactions
other drugs containing serotonin
alcohol
CYP2D6
optimal dosing of escitalopram (Lexapro)
20 mg daily
> 20mg does not have effect
which SSRI has significant GI side effects?
paroxetine
SSRIs to avoid d/t CYP2D6 pathway
paroxetine (paxil)
fluoxetine (prozac)
citalopram or sertraline least likely to have interactions
SSRI with longest half life
fluoxetine
good for pts who are poorly adherent or have had trouble w discontinuation previously
SSRI least likely to cause weight gain
paroxetine
SNRI examples
duloxetine (cymbalta)
venlafaxine (effexor XR)
desvenlafaxine (prestiq)
AEs of TCAs
dr mouth, dry eyes, blurred vision, sun sensitivity, sedation, glucose dysregulation
TCA examples
amitriptyline
nortriptyline
doxepin (sinequan)
mirtazapine (remeron)
trazodone moa
increases serotonin and norepinephrine to cause antidepressive effects
used off label for sleep
trazodone AEs
sedation, orthostasis, dry mouth, nausea
less likely to cause sexual dysfunction, agitation, and weight changes than other antidepressants
vilazodone (viibryd) MOA
SSRI and 5HT-1A partial agonist
lithium AEs
sodium dysregulation, dizziness/drowsiness, nausea
benzodiazepines MOA
produce CNS depression by enhancing GABA-benzidiazepine receptor compless
act at the level of the limbic, thalamic, hypothalamic regions of CNS
what pregnancy category are benzos?
D - may cause congenital malformations in first trimester
benefits of buspirone (buspar) for anxiety
no impaired psychomotor, sedation, dependence, or decreased concentration
MOA of eszopiclone (lunesta) & zolpidem (ambien)
non-benzodiazepine hypnotics
selectively bind to GABA receptors to induce sleepiness
tamazepam (restoril) use
benzodiazepine indicated for sleep
AEs of stimulants
upset stomach, insomnia, HA, rebound symptoms, stimulant-induced sleep disturbances
atomexetine (strattera) MOA & use
SNRI approved for ADHD maintenance
