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Psych Drugs Flashcards

1
Q

CNS Stimulants (4)

A
  1. methylphenidate 2. dextroamphetamine 3. methamphetamine 4. phentermine
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2
Q

Mechanism of CNS Stimulants

A

-increase catecholamines at the synaptic cleft, esp. NE and DA.

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3
Q

Clincial use of CNS stimulants

A

ADHD Narcolepsy Appetite control

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4
Q

Antipsychotics (neuroleptics) (5)

A
  1. Haloperidol 2. Trifluoperazine 3. Fluphenazine 4. Thioridazine 5. Chlorpromazine
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5
Q

Mechanism of Antipsychotics

A

All typical antipsychotics block dopamine D2 receptors (increase cAMP).

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6
Q

Clinical use of antipsychotics

A

-schizophrenia (mainly + symptoms) -psychosis -acute mania -Tourette’s

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7
Q

Antipsychotics are very slow to be removed from the body because…

A

they are highly lipid soluble and are stored in body fat.

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8
Q

Toxicity of antipsychotics

A

-extrapyramidal system effects (dyskinesias) -endocrine side effects (galactorrhea) -dry mouth, constipation (from blocking muscarinic receptors) -hypotension (from blocking alpha-1 receptors -sedation (from blocking histamine receptors)

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9
Q

Neuroleptic malignant syndrome

A

toxicity of antipsychotics causing rigidity, myoglobinuria, autonomic instability and hyperpyrexia

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10
Q

Treatment forNeuroleptic malignant syndrome

A

-dantrolene -D2 agnoists (bromocriptine)

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11
Q

Tardive dyskinesia

A

toxicity of antipsychotics casuing oral-facial movements

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12
Q

High potency antipsychotics

A

-Trifluoperazine, Fluphenazine, Haloperidol *these cause neurologic side effects (EPS system)

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13
Q

Low potency antipsychotics

A

-Chlorpromazine, Thioridazine *these cause non-neurologic side effects

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14
Q

Chlorpromazine can also cause…

A

cornela deposits.

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15
Q

Thioridazine can cause…

A

retinal deposits.

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16
Q

Haloperidol can also cause…

A

NMS or tardive dyskinesia.

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17
Q

Evolution of EPS side effects

A

-4 hr acute dystonia -4 day akathisia -4 wk bradykinesia -4 month tardive dyskinesia

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18
Q

Atypical Antipsychotics (6)

A
  1. Olanzpaine 2. Clozapine 3. Quetiapine 4. Risperidone 5. Aripiprazole 6. Ziprasidone
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19
Q

Clinical use of atypical antipsychotics

A

-schizophrenia (+ and - symptoms) -Bipolar -OCD -anxiety disorder -depression -mania -tourette’s

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20
Q

Olanzapine/Clozapine may cause…

A

significant weight gain.

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21
Q

Clozapine may cause…

A

agranulocytosis (requires weekly WBC monitoring) and seizure.

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22
Q

Risperidone may increase…

A

prolactin (lactation/gynecomastia) leading to decreased GnRH, LH and FSH (irregular menstruation/fertility).

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23
Q

Ziprasidone may…

A

prolong the QT interval.

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24
Q

Clinical use of Lithium

A

-mood stabilizer for bipolar disorder -blocks relapse and acute manic episodes -SIADH

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25
Toxicity of Lithium
-tremor -sedation -edema -heart block -polyuria -teratogenesis
26
Lithium causes polyuria because...
it is an ADH antagonist causing nephrogenic DI.
27
Fetal cardiac defects from lithium include...
Ebstein anomaly and malformation of the great vessels.
28
Buspirone mechanism
stimulates 5-HT(1A) receptors
29
Use of Buspirone
-generalized anxiety disorder (1-2 wks to take effect) (does not interact with alcohol)
30
SSRIs (4)
1. Fluoxetine 2. Paroxetine 3. Sertraline 4. Citalopram
31
Mechanism of SSRIs
5-HT specific reuptake inhibitors
32
Use of SSRIs
-depression -GAD -Panic disorder -OCD -bulimia -social phobias -PTSD
33
Toxicity of SSRIs
-GI distress -sexual dysfunction -serotonin syndrome w/ any drug that increases 5HT (MAO inhibitors, SNRIs, TCAs)
34
Serotonin Syndrome
-hyperthermia -confusion -myoclonus -CV collapse -flushing -diarrhea -seizures
35
Serotonin Syndrome is treated with...
Cyproheptadine (5-HT2 receptor antagonist)
36
For SSRIs to start taking effect, it takes...
4-8 wks.
37
SNRIs (2)
Venlafaxine Duloxetine
38
Mechanism of SNRIs
inhibit 5-HT and NE reuptake
39
Use of SNRIs
depression -Venlafaxine also for GAD and panic disorder -Duloxetine also for diabetic peripheral neuropathy
40
Toxicity of SNRIs
increased BP stimulant effects sedation nausea
41
Tricyclic Antidepressants (7)
1. amitriptyline 2. nortriptyline 3. imipramine 4. desipramine 5. clomipramine 6. doxepin 7. amoxapine
42
TCAs mechanism
block reuptake of NE and 5-HT
43
Uses of TCAs
-depression -OCD (clomipramine) -fibromyalgia
44
Toxicity of TCAs
-sedation -alpha-1 blocking effects (postural hypotension) -atropine-like effects (anticholinergic - tachycardia, urinary retention, dry mouth) -convulsions -coma -cardiotoxicity -respiratory depression -hyperpyrexia
45
Tertiary TCAs (amitriptyline) have more...
anticholinergic effects than secondary TCAs (nortriptyline) have.
46
Desipramine is less...
sedating but has higher seizure incidence.
47
In the elderly, TCAs can cause...
confusion and hallucinations due to anticholinergic side effects (use nortriptyline).
48
Treatment for cardiotoxicity from TCAs
NaHCO3.
49
Monoamine oxidase inhibitors (4)
1. Tranylcypromine 2. Phenelzine 3. Isocarboxazid 4. Selegine (slective MAO-B inhibitor)
50
Mechanism of MAO inhibitors
inhibition of MAO leading to increased levels of amine neurotransmitters (NE, 5-HT, DA)
51
use of MAO inhibitors
-atypical depression -anxiety -hypochondria
52
Toxicity of MAOIs
-hypertensive crisis (typically w/ ingestion of tyramine) -CNS stimulation
53
MAOIs are contraindicated with...
SSRIs TCAs St. John's wort Meperidine Dextromethorphan
54
Atypical Antidepressants
1. Buproprion 2. Mirtazapine 3. Trazodone
55
Buproprion increases...
NE and DA
56
Besides depression, buproprion is also used for...
smoking cessation.
57
Toxicity of Buproprion
-stimulant effects -HA -seizure in bulimic pts
58
Mirtazapine MOA
-alpha2-antagonist (increased release of NE and 5-HT) -potent 5-HT2 and 5-HT3 antagonist
59
Toxicity of Mirtazapine
-sedation -increased appetite -weight gain -dry mouth
60
Trazodone mechanism
-blocks 5-HT2 and alpha1-adrenergic receptors
61
Trazodone is primarily used for...
insomnia.
62
Toxicity of Trazodone
sedation nausea priapism postural hypotension

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