Psych Flashcards
TCAs
Give an example of a tertiary amine and a secondary amine.
What is the difference in side effect profile between tertiary versus secondary amines?
Tertiary amines: amitriptyline, clomipramine, imipramine, doxepin
Secondary amines: nortriptyline, desipramine, protriptyline
(ex. amitriptyline -> nortriptyline)
Tertiary amines have MORE antihistaminic and anticholinergic activity than secondary amines
List major side effects of TCAs
- Cardiac toxicity (QT prolongation, ventricular arrhythmias)
- anticholinergic
- antiadrenergic (orthostatic hypotension)
- antiserotonergic (sedation, weight gain)
Which SSRI is the most anticholinergic?
Paroxetine
Which SSRI has the longest half life?
Fluoxetine
Which antidepressant medication has been shown to inhibit warfarin metabolism?
Sertraline
Which SSRI is most selective?
Citalopram
Which SSRI also blocks DA transporter?
Sertraline
Describe symptoms of lithium toxicity
What medications are known to increase lithium toxicity?
Delirium, tremor, ataxia, renal failure, seizure, QT prolongation, diarrhea
NSAIDs and phenytoin
Which atypical antipsychotic is least likely to cause extrapyramidal symptoms?
Clozapine
(can use for PD related psychosis)
(Quetiapine is second least likely to cause EPS and is also useful in PD, no risk of agranulocytosis)
Which atypical antipsychotic has the greatest likelihood to cause extrapyramidal symptoms?
Ziprasidone
Which medications can worsen catatonia?
DA antagonists (atypical antipsychotics) Baclofen
Which three neurotransmitters are likely involved in the pathogenesis of schizophrenia?
Dopamine
Serotonin
Glutamate
Which three neurotransmitters are primarily involved in the pathogenesis of anxiety
Norepinephrine
Serotonin
GABA
List two pharmacologic treatment options for OCD
SSRIs
Clomipramine
List the Cluster A personality disorders
“odd, suspicious”
Paranoid
Suspects deception in others, doubts loyalty, believes other intend malice
Schizoid
No desire for close interpersonal relationships, few nonfamilial friends, emotionally cold, little pleasure, difficult to engage
Schizotypal
Ideas of reference, magical thinking, inappropriate affects, unusual behavior, odd thinking or speech
List the Cluster B personality disorders
“dramatic, impulsive”
Histrionic
Strives to be center of attention, uses physical appearance to drawl attention, overvalues relationships, theatrical
Narcissistic
Inflated self-importance, fantasizes about unlimited success, power or ideal love, can only be friends with other special people, requires admiration
Antisocial
Hx of conduct disorder as a child, repeated unlawful acts, deceitfulness, impulsive, violent
Borderline
Frantic avoidance of perceived abandonment, unstable and intense relationships, unstable self imagine, recurrent suicidal behavior or self-mutilation
List the Cluster C personality disorders
“anxious”
Avoidant
Avoids activities involving interpersonal contact, fears shame/ridicule/rejection/criticism
Dependent
Requires reassurance/advice to make decisions, needs other to be responsive for their life, unable to express disagreement, must be involved in a relationship
Obsessive compulsive
Preoccupation with rules, details, order. Perfectionism interferes with progress, excessively devoted to work, inflexible about morality, ethics or values, unable to delegate
Describe the clinical and radiologic features of Marchiafava-Bignami disease
Bilateral frontal lobe dysfunction, sexual disinhibition
Demyelination of the middle of the corpus callosum
