psych 521 - 524 Flashcards
describe the evolution of EPS side effects
- 4hr: dystonia (muslce spasm, stiffness, oculogyric crisis)
- 4 day: akathisia (restlessness)
- 4 wk: bradykinesia (parkinsonism)
- 4 mo: tardive dyskinesia
name the 3 high potency antipyschotic drugs
Try to Fly High
Trifluoperazine
Fluphenazine
Haloperidol
what is alpha 2 antagonist that release norepinephrine and 5HT?
Mirtazapine
mirtazapine is also what types of potent receptor blockers?
5 HT2 and 5 HT3
3 clinical app for mirtazapine
depressed pts with insomnia with low appetite
what are the 2 targets for trazadone?
blocks 5HT2 and alpha 1 receptor
trazadone is mainly used for what?
insomnia
what is a 5HT2 receptor antagonist that is used for serotonin syndrome?
cyproheptadine
3 toxicities of SSRI
- GI distress
- SIADH
- sexual dysfunction
7 clinical applications for SSRI?
depression generalized anxiety disorder panic disorder OCD bulimia social phobias PTSD
3 types of drug that can cause serotonin syndrome with SSRI
MAO inhibitors
SNRI
TCA
symptoms of serotonin syndrome
HARMED
Hyperthermia Autonomic instability Rash (flushing) Myoclonus Encephalopathy Diarrhea
what is venlafaxine and what is it used for?
SNRI, generalized anxiety, panic disorder, PTSD
what is duloxetine and its unique clinical application?
SNRI, diabetic peripheral neuropathy
name 4 SSRIs
Fluoxetine, paroxetine, sertraline, citalopram
name 7 tricyclic antidepressants
amitriptyline nortriptyline imipramine desipramine clomipramine doxepin amoxapine
5 clinical applications for tricyclic antidepressants?
major depression OCD (clomipramine) peripheral neuropathy chronic pain migraine prophylaxis
name 6 atypical antipsychotics
olanzapine clozapine quetiapine risperidone aripiprazole ziprasidone
clinical uses for atypical antipsychotics?
MOST BAD condition
Mania
OCD
Shcizophrenia (both + and -)
Tourette
Bipolar
Anxiety disorder
Derpession
what 2 atypical antipsychotics can cause weight gain?
olanzapine, clozapine
which atypical antipsychotic can cause inc prolactin and gynecomastia?
risperidone
symptoms of NMS caused by typical antipsychotics
FEVER
Fever Encephalopathy Vitals unstable Enzymes inc Rigidity of muscles
treatment for NMS?
dantrolene (Ca2+ blocker) D2 agonist (bromocriptine)
what is targeted by buspirone?
stimulates 5-HT1a receptors
unlike babiturates and benzo, buspirone does not interact with what?
alcohol
MOA of lithium?
blocks phosphoinositol cascade –> dec cAMP
side effects of lithium?
tremor
hypothyroidism
polyuria (nephrogenic DI)
Ebstein anomaly in newborn
what is unique about lithium excretion by the kidney? and what other drug toxicity is it associated with?
lithium is mostly reabsorbed at PCT with Na+
Thiazide use is implicated in lithium toxicity in bipolar pats
