Psych

Question 1

Acute Dystonia

Answer 1

Sx: Involuntary muscle contraction or spasm (torticollis, oculogyric crisis)
Tx: anticholingergics (benztropine, diphenhydramine)

Question 2

Tardive dyskinesia

Answer 2

Sx: oral-facial movements, often IRREVERSIBLE
Tx: discontinue drug used and replace. anticholinergics may worsen initially.

Question 3

Akathisia

Answer 3

Sx: restlessness
Tx: decr dose or use B-blockers or benzos/anticholinergics

Question 4

Dyskinesia

Answer 4

Sx: pseudoparkinsonism (shuffling gait, cogwheel rigidity)
Tx: anticholinergics (benztropine) or DA agonist (amantadine)

Question 5

First Generation Typical Antipsychotics

Answer 5

High potency: Haloperidol, Fluphenazine

Low potency: Thioridazine, Chlorpromazine

Question 6

Second Generation ATypical Antipsychotics

Answer 6

Aripiprazole, Risperidone, Olanzapine, Quetiapine, Ziprasidone, Clozapine

Question 7

Mood Stabilizers

Answer 7

Lithium, Valproic Acid, Carbamazepine, Anticonvulsants (Lamotrigine, Gabapentin, Topiramate)

Question 8

AntiDepressants

Answer 8

Selective Serotonin Reuptake Inhibitors (SSRIs): Sertraline, Fluoxetine, Paroxetine, Fluvoxamine, Citalopram, Escitalopram

Tricyclics (TCAs): Nortriptyline, Desipramine, Imipramine, Amitriptyline, Clomipramine, Doxepin

Monoamine Oxidase Inhibitors (MAOIs): Phenelzine, Tranylcypromine, Selegiline

Atypical: Mirtazapine, Bupropion, Venlafaxine, Trazodone

Question 9

Anxiolytics

Answer 9

Benzodiazepines, Buspirone, Zolpidem, Antihistamines

Question 10

Benzodiazepines

Answer 10

Use: ANXIETY, ALCOHOL W/D, insomnia, anesthesia, seizures, and muscle spasms; rapid onset
Contraindications: abuse, tolerance, dependence, withdrawal, augment sedation and respiratory depression, delirium and fall in elderly

Question 11

Buspirone

Answer 11

MoA: 5-HT partial agonist
Use: GAD and CHRONIC ANXIETY, augment therapy for depression or OCD, substance abuse; no anticonvulsant or muscle relaxant properties
Contraindications: slow onset, lower efficacy than benzos, No MAOIs

Question 12

Zolpidem

Answer 12

Use: INSOMNIA; rapid onset

Question 13

Antihistamine

Answer 13

Use: short term management of insomnia, preop sedation

Question 14

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 14

Use: 1st line for DEPRESSION, ANXIETY disorders
Interactions: can incr warfarin due to P450 intrxn
SE: SEXUAL DYSFUNCTION, nausea, diarrhea, anorexia, headache, anxiety, tremor, sleep disturbance

Question 15

Mirtazapine

Answer 15

MoA: a2-antagonist incr NE and 5HT
SE: SEDATION, WT GAIN, no sex dysfx

Question 16

Bupropion

Answer 16

MoA: dopamine reuptake inh, incr dopamine
Use: 1st for DEPRESSION AND SMOKING CESSATION, no sex dysf, no wt gain
SE: LOWERS SEIZURE THREHOLD, anxiety, agitation, insomnia

Question 17

Venlafaxine

Answer 17

MoA: 5HT and NE reuptake inh, incr 5HT and NE
Use: MAJOR DEPRESSION and GAD, rapid onset
SE: DIASTOLIC HTN, SEXUAL DYSFX, insomnia, nervousness, sedation, anticholinergic effects, nausea

Question 18

Trazodone

Answer 18

MoA: inhibit 5HT reuptake, incr 5HT
Use: INSOMNIA
SE: PRIAPISM, sedation

Question 19

Tricyclics (TCAs)

Answer 19

MoA: block reuptake of NE and 5HT, incr NE and 5HT