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Cognitive-Behavioral > Psych And Psych Meds > Flashcards

Psych And Psych Meds Flashcards

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1
Q

Which SSRIs have the FEWEST drug-drug interactions?

A

Citalopram and escitalopram

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2
Q

Major side effects of atypical antipsychotics (as a group)

A
  • Weight gain
  • DM2
  • dyslipidemia
  • antimuscarinic, anticholinergic, antiadrenergic
  • negative inotropic effect (thioridazine, haldol, ziprasidone, quetiapine)
  • sedation (H1, esp quetiapine)
  • hyperprolactinemia, amenorrhea (tuberoinfundibular pathway antagonism)
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3
Q

List the Cluster A personality disorders

A

Paranoid

Schizoid (loner, blunted affect)

Schizotypal (odd, eccentric, magical thinking, paranoid)

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4
Q

How do tertiary TCAs (amitriptyline, clomipramine, imipramine) affect warfarin levels?

A

Tertiary tricyclics compete with warfarin for CYP enzymes and may increase warfarin levels

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5
Q

amitriptyline, doxepin, and imipramine are [DRUG CLASS] that work by [DRUG MECHANISM]

A

Amitriptyline, doxepin, and imipramine are TCAs that work by inhibiting BOTH serotonin and nroepi reuptake

clomipramine is a TCA that primariliy inhibits 5HT reuptake

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6
Q

List the atypical antipsychotics and primary mechanism of action

A

ATYPICAL ANTIPSYCHOTICS

  • clozapine
  • olanzapine
  • quetiapine
  • risperidone
  • ziprasidone
  • aripiprazole

Mainly work by blocking serotinergic 5HT2A receptors; D2 antagonism is secondary (so fewer EPS but not 0)

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7
Q

Mechanism of action of donepezil

A

noncompetitive, REVERSIBLE AchE inhibition (organophosphates are IRreversible)

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8
Q

Principal site of serotonergic neuronal cell bodies is the __________ in the _________

A

Principal site of serotonergic neuronal cell bodies is the RAPHE NUCLEI of the brainstem

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9
Q

List the TCAs

A

TCAS

  • Amitriptyline
  • Clomipramine
  • Imipramine
  • Nortriptyline
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10
Q

serotonin is SYNTHESIZED from ______ via _____ and _______

serotonin is METABOLIZED by ______

A

serotonin is SYNTHESIZED from tryptophan via tryptophan hydroxylase and aromatic L-amino acid decarboxylase

serotonin is METABOLIZED by MAO-A

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11
Q

Antidepressant class leading to convulsions, coma, and cardiac arrhythmias in overdose (3C’s)

A

TCAs

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12
Q

mechanism of action of galantamine

A

inhibition of AchE and modulation of nicotinic AchR

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13
Q

Which OTC narcotic can inhibit serotonin reuptake and cause serotonin syndrome?

A

Tramadol

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14
Q

List the SSRIs

A

SSRIs

Fluoxetine

Fluvoxamine

Sertraline

Paroxetine

Citalopram

Escitalopram

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15
Q

Amitriptyline, nortriptyline, doxepin, clomipramine, and imipramine are [DRUG CLASS]. Their side effects are related to their [OFF TARGET EFFECTS] and therefore include [SIDE EFFECTS]

A

Amitriptyline, nortriptyline, doxepin, clomipramine, and imipramine are TCAs. Their side effects are related to their off target binding to muscarinic, alpha-adrenergic, and histamine H1 receptors, and therefore include:

Antimuscarinic: dry mouth, constipation, urinary retention, tachycardia, blurry vision (with inc risk of glaucoma)

Antihistamine: sedation, xerostomia, weight gain

Adrenergic: conduction abnormalities (rare), postural hypotension

ALSO: fine rapid tremors, delirium, weight gain

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16
Q

contrast histrionic vs borderline personality disorders

A

Histrionic: attention-seeking, constant need to be center of attention, inappropriately seductive or provocative, use their physica appearance, emotional lability

Borderline: pervasive instability in self image, affect, relationships; splitting; fear of abandonment; suicidal gestures or threats, comorbid bulemia

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17
Q

in depression, ______ is hypOmetabolic and _________ is hypERmetabolic

Study These Flashcards
A

in depression, dorsolateral prefrontal cortex is hypOmetabolic and orbitofrontalcortex is hypERmetabolic

18
Q

What is the mechanism of MAO inhibitors?

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A

MAO-A noradrenergic

MAO-B serotinergic

MAO is an enzyme on mitochondrial envelope

MAOI eventually increase synaptic catecholaimine (serotonin, dopa, norepi) lelvels

19
Q

mechanism of action of rivastigmine

Study These Flashcards
A

inhibition of AchE and butyrylcholinesterase

20
Q

Name 3 psych drugs that can cause seizure

Study These Flashcards
A
  1. Buproprion (acts via da, norepi)
  2. Clozapine (atypical antipsychotic, high dose)

amitriptyline (TCA in overdose)

21
Q

Which 3 schiz are pyschotic disorders and which 2 are personality disorders?

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A

Psychotic disorders

  • schizophrenia (+sx > 1 mo; total sx >6 mos)
  • schizophreniform (1 mo < sx < 6 mo)
  • schizoaffective (schizophrenia + mood disorder sometimes, but also psychotic w/o mood changes, vs eg depression with psychotic sx)

Personality disorders

  • schoizoid = loner, doesn’t want close friends
  • schizotypal = odd, magical thinking, can be paranoid, can have social anxiety and be uncomfortable with relationships
22
Q

Which psych med(s) cause hypERnatremia

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A

Lithium causes DI, which causes hypERnatremia

(recall that SSRIs cause SIADH -> hypOnatremia)

23
Q

Which class of antidepressant is most likely to induce a manic switch if used to treat depression in a bipolar patient?

24
Q

mechanism of action of memantine

Study These Flashcards
A

NMDAR ANTAGonist

25
List four typical antipsychotics? 1. Low potency at D2 - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 2. High potency at D2 - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
List four typical antipsychotics? 1. Low potency at D2 * chlorpomazine * thioridazine * antihistamine, antimuscarinic, antiadrenergic effects predominate 2. High potency at D2 * haloperidol * fluphenazine * EPS predominate
26
List the SNRIs
SNRIs * Venlafaxine * Duloxetine * Desvenlafaxine * Milnacipran
27
Which SSRI has the MOST drug-drug interactions?
Fluvoxamine.
28
Side effects of lithium
* Tremor * thyroid dysfunction * acne * nephrogenic DI (with HYPERna) * contraindicated in sick sinus b/c of neg chronotropy
29
Dangerous side effect of clozapine?
agranulocytosis
30
Which antipsychotic causes agranulocytosis?
Clozapine
31
List the cluster C personality disorders (3)
1. Avoidant personality disorder (hypersentitivity to criticism, avoid occupation or activity b/c fear of rejection, criticism) 2. Dependent personality disorder (clingy, submissive, passive, can't make own decisions) 3. OCPD (perfectionist, different from OCD b/c OCPD lacks insight, obsessions, and compulsions)
32
Which psych med(s) cause hypOnatremia
SSRIs cause SIADH -\> hypOnatremia Most likely with fluoxetine and paroxetine risk factors: old, female, on diuretics already. Usually occurs within first month of tx (but sometimes not for a few mos.) (Recall that Li causes DI --\> hypER natremia)
33
What are the symptoms of SSRI withdrawal?
Symptoms of SSRI withdrawal * dizziness * paresthesias * dysphoria * sometimes encephalopathy
34
Most common side effect of TCAs?
Orthostatic hypotension
35
Which dopaminergic pathways are implicated in schizophrenia?
- mesolimbic - mesocortical (think of limbic and cortical dysregulation)
36
LIst the MAOIs
MAOI * Phenelzine * selegeline * Tranylcypromine * Isocarboxazid * moclobemide
37
This OCT cough medicine can can inhibit serotonin reuptake and cause serotonin syndrome
Dextromethorphan
38
# orthostatic hypotension and antidepressant Which antidepressant class typically causes orthostatic hypotension
Orthostatic hypotension is the most common side effect of **TCAs**
39
Which SSRI is least sedating
sertraline
40
Which SNRI can cause angle closure glaucoma _and_ hypertension?
Venlafaxine
41
Which SNRI can cause angle closure glaucoma and should be avoided in patients with renal or hepatic problems?
Duloxetine

Cognitive-Behavioral (5 decks)

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