Psych

Question 1

5 classes of psychotropics

Answer 1

Antidepressants • Stimulants • Mood Stabilizers • Anxiolytics and Hypnotics • Antipsychotics (Neuroleptics)

Question 2

Classes of Antidepressants

Answer 2

Tricyclic antidepressants Monoamline oxidase inhibitors SSRI SNRI Atypical Antidepressants

Question 3

Tricyclic antidepressants (TCAs) MOA

Answer 3

prevent the reuptake of both norepinephrine and serotonin (5-HT) into presynaptic nerve terminals

Question 4

Monoamine oxidase inhibitors (MAOIs) MOA

Answer 4

block the action of monoamine oxidase, an enzyme that breaks down neurotransmitters inside the presynaptic nerve terminals. In other words, MAOIs slow the destruction of norepinephrine, dopamine, and serotonin, increasing the levels of these neurotransmitters in the brain.

Question 5

SSRI MOA

Answer 5

prevent the reuptake of serotonin into presynaptic nerve terminals.

Question 6

SNRI MOA

Answer 6

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

Question 7

TCA Disadvantages

Answer 7

– Action on histamine and Ach – Orthostatic hypotension – Cardiac effects – Potential death via overdose

Question 8

5-HT

Answer 8

5-hydroxtryptamaine

Question 9

TCA used in

Answer 9

Migraine prevention, sleep, depression, and chronic pain

Question 10

TCA consideration

Answer 10

taper off if they have been on long term to prevent symptoms of withdrawal or relapse of depression

Question 11

TCA side effects

Answer 11

anticholinergic side effects due to histamine and Ach action.

Question 12

TCA is a bad option

Answer 12

for people with active SI due to risk for overdose.

Question 13

MAOI disadvantages

Answer 13

Hypertensive crisis/Tyramine – Drug interactions – Orthostatic hypotension – Serotonin syndrome

Question 14

MAOI are not used

Answer 14

1st, 2nd or 3rd line. Used for treatment resistant or refractory depression

Question 15

MAOI interact with

Answer 15

virtually everything

Question 16

foods that contain tyramine

Answer 16

aged foods, like processed meats, beef or chicken liver,, yogurt, peperoni, bologna, sour cream, bananas, raisons, soy sauce, beer, whine, yeast, chocolate. CAN LEAD TO A HYPERTENSIVE CRISIS

Question 17

If tyramine in foods isn’t enough then MAOI

Answer 17

cause cause orthostatic hypotension and possibly serotonin syndrome

Question 18

Serotonin helps regulate

Answer 18

perceive pain, sleep (cycling between non REM and REM), emotional states, mood, anxiety

Question 19

SSRI disadvantages

Answer 19

GI side effects – Sexual dysfunction – Take time to work

Question 20

SSRI GI effects are

Answer 20

transient and go away in a week or two

Question 21

SSRI receptors are mostly found in our

Answer 21

Gut. 90 to 95%

Question 22

SSRI sexual dsyfunction

Answer 22

sexual dysfunction tends to not go away

Question 23

SSRI time it takes to work

Answer 23

4 to 6 weeks

Question 24

SSRI benefits

Answer 24

cheap and low toxicity

Question 25

SNRI may have more

Answer 25

benefit for lethargic, fatigue-based symptoms

Question 26

SNRI and SSRI not all are created equally. True or False?

Answer 26

TRUE - Not all are created equally. Depending on the brand it may have a greater affinity for one neurotransmitter over another. As an example - Sertraline has a greater effect on dopamine than others. It can also be impacted by dose. Venlafaxine [Effexor] that has a greater impact on serotonin at lower doses and will not have an impact on norepinephrine until you reach higher doses

Question 27

SNRI used

Answer 27

anxiety, depression, panic, chronic pain

Question 28

SNRI side effects

Answer 28

headache, GI, insomnia, sexual side effects, dose dependent increased BP`

Question 29

Atypical Antidepressants include

Answer 29

NDRI and others

Question 30

NDRI example

Answer 30

bupropion (wellbutrin, Zyban)

Question 31

NDRI lowers

Answer 31

seizure threshold/ alcohol

Question 32

Bupropion does not cause

Answer 32

weight gain or sexual dysfunction, which makes it an appealing option for some clients

Question 33

off-lable use of NDRI

Answer 33

ADHD, chronic fatigue, medication induced sexual dysfunction

Question 34

Mirtazapine, trazodone benefits

Answer 34

Faster onset than SSRIs – Lower incidence of sexual SE

Question 35

mirtazapine, trazadone SE

Answer 35

Sedation, weight gain

Question 36

Bupropion [Zyban] is used for

Answer 36

smoking cessation

Question 37

Be mindful of what with bupropion

Answer 37

people who use ETOH or have a seizure disorder, because it can lower the threshold and make it easier to have a seizure

Question 38

histamine contributes to

Answer 38

sedation and weight gain

Question 39

Serotonin syndrome

Answer 39

Too much serotonin in the synaptic cleft

Question 40

signs of serotonin syndrome

Answer 40

Tremor, myoclonus, altered mental status • Agitation, diarrhea, fever, diaphoresis • Hyperreflexia, delirium, coma, death

Question 41

serotonin syndrome can develop within

Answer 41

several hours

Question 42

treatment of serotonin syndrome

Answer 42

stop taking and and use supportive measures