Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adv Pharm Faculty Page (Smoller/Bose) > Psych > Flashcards

Psych Flashcards

1
Q

Monoamine oxidase inhibitors (MAOIs) examples/concerns

A

Phenelzine (Nardil, tranylcypromine (Parnate), selegiline (Emsam), isocarboxazid (Marplan)

Very rarely used

Many potentially lethal drug interactions

Must avoid foods with tyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SSRI MOA

A

prevent the reuptake of serotonin into presynaptic nerve terminals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

SNRI MOA

A

prevent the reuptake of serotonin and norepinephrine into presynaptic nerve terminals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

dopamine deficiency results in

A

Anhedonia, lack of ability to love/feel attachment to others, lack of remorse about actions, distractability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common SSRIs

A

Citalopram; Escitalopram; Sertraline; Fluoxetine; Paroxetine; Fluvoxamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which ssri side effects are most common at initiation and often improve

A

šNausea

šLightheadedness

šHeadache

šSedation/sleep disruptions

šIncreased sweating

šAgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SSRI GI effects are

A

Impaired attention, problems concentrating, deficiencies in working memory, slowness of information processing, depressed mood, psychomotor retardation, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Serotonin deficiency results in

A

Depressed mood, anxiety, panic, phobia, obsessions and compulsions, food cravings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

sexual side effects are common with which classes of antidepressants

A

SSRIs, SNRIs, TCAs (NNSRIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long for SSRI to start working?

A

4 to 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SSRI benefits

A

cheap and low toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common SNRIs

A

venlafaxine, duloxetine, desvenlafaxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SNRI and SSRI not all

A

not all are created equally. Depending on the brand it may have a greater affinity for one neurotransmitter over another. As an example sertraline as a greater effect for dopamine then others. It can also be impacted by dose. An example of this would be effexor that has a greater impact on serotonin at lower doses and will not have an impact on norepi until you reach higher dosese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SNRI uses

A

anxiety, depression, panic, neuropathic pain, phobias, PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SNRI side effects

A

HTN, headache, GI, insomnia, sexual side effects,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

NDRI example

A

bupropion (wellbutrin, Zyban)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

NDRI MOA

A

šblocks reuptake of dopamine and norepinephrine at the presynaptic cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bupropion side effects

A

sleep disturbance, appetite suppression, lowers seizure , jitteriness, irritability, headache, dry mouth

minimal sexual side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

indications for NDRIs

A

Depression, SAD, smoking cessation

Can exacerbate anxiety

Off label: ADHD, chronic fatigue, medication induced sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mirtazpaine MOA, pro/cons

A

šEffects both serotonin and norepinepherine along with alpha 2 blockade

šCause significant weight gain and sedation – good for patients with depression and poor appetite and/or sleep disturbance

šLess nausea or sexual side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Trazadone MOA, risks/benefits

A

šSerotonin modulator (SSRI subclass), also blocks H1 and alpha adrenergic receptors

šDoses required for antidepressant effect (>300mg daily) are too sedating, much more often used for sleep (50-150mg qhs)

šHeadache, dizziness, hypotension common side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bupropion cautions/contraindications

A

use with caution in people who use ETOH as it lowers seizure threshold

avoid in anyone who has ever had a seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

symptoms of serotonin syndrome

A

šnausea, diarrhea, chills, sweating, htn, tremor, agitation, disorientation, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

drugs that can cause depression

A

šBeta blockers

šCorticosteroids (mania and euphoria common with short term use)

šFluoroquinolones

šInterferon

šAnticonvulsants (CNS depression)

šOpioids

šHormonal BC

šPPI (inhibits absorption of B-12)

šAnti-depressants (increased suicidal ideation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
NNSRI (TCA) indications
* Depression, Obsessive compulsive disorder, Chronic pain, Enuresis (imipramine) * Off label: Panic disorder, Bulimia, Phantom leg pain, Premenstrual symptoms, Migraine prophylaxis
26
Tricyclic MOA
* Blocks reuptake of serotonin and/or NE at presynaptic terminals * tertiary amines- inhibits serotonin and NE reuptake * secondary amines- inhibit NE reuptake
27
What are side effects of tricyclics?
* Anticholinergics * dry mouth, tachycardia, urinary retention, ileus, slow gastric emptying * cardiovascular * orthostatic hypotension, modest increase in heart rate, depresses conduction through the atria & ventricles * Central nervous system * lower sz threshold, weakness, fatigue * \*\*these effects can be fatal with overdose
28
Common TCAs
Amitriptyline Imipramine Desipramine Nortriptyline
29
How long for TCAs to take effect?
2-4 weeks
30
Stimulant MOA
block reuptake of NE and DA
31
Stimulants Indications
ADD/ADHD Narcolepsy Fatigue, depression (palliative care setting)
32
Stimulant Adverse effects
Anorexia, weight loss, appetite suppression Sleep disturbance Jitteriness Emotional lability Increased pulse and BP
33
Stimulant contraindications
diabetes, hyperthyroidism, hypertension, issues with aggression, bipolar disorder, psychosis
34
Non-stimulant alternative for ADHD
atomoxetine (Strattera) Selective norepinepherine reuptake inhibitor Not a controlled substance
35
Commonly used stimulants
Methylphenidate (Ritalin, Concerta) Dexmethylphenidate (Focalin) Amphetamines Dextroamphetamine (Dexedrine) Dextroamphetamine-amphetamine (Adderall) Lisdexamfetamine (Vyvanse)
36
lithium excretion
not metabolized by the liver, excreted into the urine unchanged - therefore kidney function is critical when prescribing.
37
Lab monitoring - lithium
baseline renal function, TSH, electrolytes - especially sodium, CBC, ECG at baseline and yearly, lithium levels every 3-6 months once stable
38
signs/symptoms lithium toxicity
tremor, N/V/D, polydipsia/polyuria, confusion, muscle weakness, ataxia
39
Lithium indications
bipolar disorder (mania)
40
Things that effect lithium level
dehydration, excessive sweating, illness, AKI. Anything that effects fluid and electrolyte imbalance.
41
Lithium adverse effects
fine tremor, dry mouth, nausea, headache, drowsiness
42
Benzodiazepines MOA
enhancing the effect of GABA
43
Benzodiazapines ADR
withdrawal, dizziness, fall risk in elderly, cognitive effects long term
44
Common Benzodiazepine Uses
Insomnia Induce relaxation and loss of memory of medical procedures or surgery Reduce anxiety (anxiolytic) Panic disorders Treat or prevent seizures Alcohol withdrawal treatment Muscle relaxant
45
Benzo black box warning
2016 - avoid use with opioids
46
Non-benzodiazepine hypnotic examples
(zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta) controlled substances - can cause withdrawal if stopped abruptly
47
ramelteon (Rozerem) MOA
melatonin receptor agonist not a controlled substance
48
Benzo with highest addiction potential and why?
Alprazolam - shortest half life (6-12 hours)
49
Non-benzodiazepine hypnotic side effects
headache, dizziness, somnolence, nausea, mild transient anterograde amnesia abnormal behaviors such as sleep driving, worsening depression
50
Zolpidem dosing for women/older adults vs men
Women/older adults max 5mg, men 10mg
51
Nonbenzodiazepine hypnotics patient education
take immediately before bed time Get at least 6 hours of sleep Use caution/avoid driving, heavy machinery Do not combine with other sleep aides, alcohol
52
4 dopamine pathways
Mesocortical Mesolimbic Tuberoinfundibular Nigrostriatal
53
Mesocortical SE
underactive D1 stimulation = responsible for negative symptoms
54
Mesolimbic SE
overactive D2 stimulation = responsible for positive symptoms
55
Tuberoinfundibular SE
increase polactin galactorrhea amenorrhea
56
nigrostriatal SE
controls motor function and movement Too much dopamine = tics, dyskinesias Not enough dopamine = dystonia, Parkinsonian symptoms
57
Typical Antipsychotics Examples
Chlorpromazine Acetaphenazine Fluphenazine Haloperidol Trifluoperazine Triflupromazine
58
Typical antipsychotics MOA
Blockade of Dopamine (D2) receptors causing: Reduced positive symptoms (mesolimbic pathway) Less effective treating negative symptoms (mesocortical pathway)
59
Atypical antipsychotics examples
Aripiprazole (Abilify) Clozapine (Clozaril) Risperidone (RIsperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (Geodon)
60
Atypical antipsychotics MOA
Effect on multiple dopamine pathways as well as serotonin pathways reducing negative and positive symptoms
61
Black box warning antipsychotics
Increased Mortality in Elderly Patients With Dementia-Related Psychosis Suicidal behavior when combined with antidepressants
62
Atypical Antipsychotics risk/benefit
Decreased risk for EPS and tardive dyskinesia than typicals Higher incidence of metabolic syndrome (weight gain, hypertriglyceridemia, altered glucose metabolism, hypercholesteremia)
63
Drugs for Alzheimer’s Disease
Cholinesterase inhibitors Other drugs used – Namenda – decreases glutamate levels – Adjunctive and symptom management also done with: SSRI, Atypical Antipsychotics, Anxiolytics
64
Cholinesterase inhibitors
indirect-acting parasympathomimetic Alzheimers patients usually have a defeciency in aCh so these are used
65
Other drugs used for Alzheimers
Namenda – decreases glutamate levels – Adjunctive and symptom management also done with: SSRI, Atypical Antipsychotics, Anxiolytics
66
Positive symptoms of psychosis
, delusions, disorganized thinking, agitation
67
Negative symptoms of psychosis
anhedonia, social withdrawal, apathy, depression
68
Typical antipsychotics adverse effects
Too much D2 blockade leads to EPS (nigrostriatal pathway) motor abnormalities (parkinsonism), tardive dyskinesia or hyperkinetic movement disorder, sedation, anticholinergic effects Hyperprolactinemia (Tuberoinfundibular pathway)

Adv Pharm Faculty Page (Smoller/Bose) (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions