Psych Flashcards
ADHD
Stimulants (methylphenidate, amphetamines)
Alcohol withdrawal
Benzodiazepines (eg, chlordiazepoxide,
lorazepam, diazepam)
Bipolar disorder
Lithium, valproic acid, atypical antipsychotics
Bulimia nervosa
SSRIs
Depression
SSRIs
Generalized anxiety disorder
SSRIs, SNRIs
Obsessive-compulsive disorder
SSRIs, venlafaxine, clomipramine
Panic disorder
SSRIs, venlafaxine, benzodiazepines
PTSD
SSRIs, venlafaxine
Schizophrenia
Atypical antipsychotics
Social anxiety disorder
SSRIs, venlafaxine
Performance only: β-blockers, benzodiazepines
Tourette syndrome
Antipsychotics (eg, fluphenazine, pimozide),
tetrabenazine
CNS stimulants MOA
increase catecholamines in the synaptic cleft, especially norepinephrine and dopamine.
Neuroleptic malignant syndrome (NMS)
—
rigidity, myoglobinuria, autonomic instability,
hyperpyrexia.
MOA:
block dopamine D2
receptors (increase [cAMP]).
Antipsychotics
Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine (haloperidol + “-azines”).
antipsychotics
High potency: Trifluoperazine, Fluphenazine,
Haloperidol (Try to Fly High)—cause:
neurologic
side effects (eg, extrapyramidal symptoms
[EPS]).
Aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine,
risperidone, ziprasidone.
atypical antipsychotics
Side effect of clozapine
agranulocytosis (monitor WBC
weekly).
SE of -pines
metabolic syndrome (weight gain, diabetes, hyperlipidemia).
SE of risperidone
hyperprolactinemia (amenorrhea,
galactorrhea, gynecomastia).
Se of olanzapine
obesity: monitor the lipid panel and fasting glucose
buspirone MOA:
Stimulates 5-HT1A receptors..
Takes 1–2
weeks to take effect. Does not interact with
alcohol (vs barbiturates, benzodiazepines).
SSRI MOA:
5-HT–specific reuptake inhibitors.
Fluoxetine, paroxetine, sertraline, citalopram
SSRI
MC SE of SSRI
sexual dysfunction
Venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran
SNRI
SNRI MOA
Inhibit 5-HT and norepinephrine reuptake
MC SE of SNRI
increase blood pressure
Serotonin Syndrome
Can occur with any drug that increases 5-HT (eg, MAO inhibitors, SNRIs, TCAs).
Characterized by
3 A’s: neuromuscular Activity (clonus, hyperreflexia, hypertonia, tremor, seizure), Autonomic
stimulation (hyperthermia, diaphoresis, diarrhea), and Agitation.
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
TCAs
TCAs MOA:
Block reuptake of norepinephrine and 5-HT.
What can happen with TCAs?
Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmia due to Na+ channel inhibition);
also respiratory depression, hyperpyrexia.
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline
MAO inhibitors
MAO inhibitor MOA
Nonselective MAO inhibition increase levels of amine neurotransmitters (norepinephrine, 5-HT,
dopamine).
Atypical depression= mood reactivity, leaden paralysis (heavy arms/legs), rejection sensitivity (get butt hurt), increased sleep and appetite
MAO inhibitor used
Contraindicated with SSRIs, TCAs, St. John’s wort,
meperidine, dextromethorphan to prevent?
serotonin syndrome
bupropion MOA
increase norepinephrine and dopamine
Mirtazapine MOA:
α2-antagonist ( release of NE and 5-HT), potent 5-HT2 and 5-HT3 receptor antagonist and H1
antagonist.
Trazodone MOA
Primarily blocks 5-HT2, α1-adrenergic, and H1 receptors
Varenicline MOA
Nicotinic ACh receptor partial agonist.
MC toxicity with bupropion?
seizures in anorexic/bulimic patients
MC toxicity with mirtazapine?
increase appetite and weight gain. Give to old ladies that are depressed and won’t eat or give to those that are depressed but not sleeping well ( due to sedation effects)
MC SE of trazadone?
priapism
MC SE of varenicline?
sleep disturbances
1st line treatment for major depressive disorder that does not cause sexual dysfunction
bupropion
MAO type B inhibitor that is given to prevent MPTP associated parkinsoniam type symptoms
Selegiline
used to treat delirium
Haloperidol or other low dose antipsychotic
All antidepressants carry the risk of inducing what? in susceptible patients.
mania
What drug is used in treatment resistant schizophrenia?
clozapine
TCA’s inhibit _______channel conduction, slowing down myocardial depolarization and leading to cardiac arrhythmias.
Sodium
What is the MCC of death in patients with TCA overdose?
cardiac arrhythmias
Nonbenzodiazepine anxiolytic used to treat generalized anxiety disorder that has a slow onset of action, lacks muscle relaxant, or anticonvulsant properties, and carries no risk of dependence
buspirone
patient has depression, fatigue, hypersomnia, vivid dreams. What is this patient withdrawing from?
cocaine
Left side frontal lobe lesions are associated with?
apathy and depression
right sided frontal lobe lesions are associated with?
disinhibited behavior
Methadone is great for treating opioid abuse because it has?
has a long half life
Full mu-opioid receptor agonist to control chronic pain and in opioid withdrawal and maintenance treatment of addiction?
methadone
