Psych Drugs Flashcards
Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine
Antipsychotics - Neuroleptics
Block D2 receptors - ↑cAMP
What are the antipsychotics used for?
Schizophrenia - + symptoms
Psychosis
Acute mania
Tourette
What are the high potency antipsychotics
Trifluoperazine, fluphenazine, haloperidol
EPS symptoms
What are the low potency antipsychotics
Chlorpromazine, thioridazine
Antichol, antihistamine, α1-blockade
What is the evolution of EPS symptoms
4 hr: Acute dystonia (spasm)
4 day: Akathesia (restlessness)
4 week: Bradykinesia (Parkinonism)
4 month: Tardive dyskinesia (oral/facial movements)
How do you treat the EPS symptoms from antipsychotics?
Benztropine
Diphenhydramine
What is a unique side effect of chlorpromazine?
Corneal deposit
What is a unique side effect of Thioridazine?
Retinal deposits
Neuroleptic Malignant Syndrome
Fever Encephalopathy Vitals unstable - autonomic instability Enzymes ↑ Rigidity
→Dantrolene, D2 agonist (Bromocriptine)
What are the atypical antipsychotics?
Olanzapine, clozapine, quetiapine, risperidone, aripirazole, ziprasidone
What is the mechanism of the atypical antipsychotics
Varied effects on 5-HT, dopamine, α, H1 receptors
When are atypical antipsychotics indicated?
Schizophrenia: Neg and Pos symptoms Bipolar OCD Anxiety Depression Mania Tourette
What are the side effects of Clozapine?
Agranulocytosis - weekly WBC monitoring
Seizure
Which two atypical antipsychotics cause weight gain?
Olanzapine
Clozaine
What are the side effects of Risperidone
↑Prolactin -
gynecomastia, ↓GnRH, fertility/menstruation problems
What are the side effects of Ziprasidone
Prolong the QT
When is Lithium indicated?
Bipolar
Blocks relapse of manic events
SIADH
What are the side effects of Lithium?
Nephrogenic diabetes insipidus Tremor, sedation Heart block Hypothyroidism Fetal: Ebstein anomaly, malformation of the great vessels **Inc. by Loop/thiazide diuretics**
Buspirone
Stimulates 5-HT 1A receptors
Generalized anxiety
Takes 1-2 weeks to work
No interaction with Alcohol
SSRI
Fluoxetine, paroxetine, sertraline, citalopram
“flashbacks paralyze senior citizens”
What are SSRIs indicated for?
Depression, GAD, panic disorder, OCD
Bulimia, social phobias, PTSD
What are the side effects of SSRIs
GI distress, sexual dysfunction
Serotonin Syndrome w/ any drug that ↑5-HT
MAOI, SNRI, TCA
Serotonin Syndrome
Too much serotonin - SSRI/SNRI/MAOI/TCA
Hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures
Cyproheptadine - 5HT2 R antagonist
How long does it take for antidepressants to have an effect?
4-8 weeks
SNRIs
Venlafaxine, duloxetine, milnacipran
Inhibit 5-HT and NE reuptake
Duloxetine is also indicated for ___________.
Diabetic Peripheral Neuropathy
What are the side effects of SNRIs
↑BP, stimulant effects, sedation, nausea
Amitriptyline, nortriptyine, imipramine, desipramine, clomipramine, doxepin, amoxapine
TCAs: Block reuptake of NE and 5-HT
Major depression, OCD, fibromyalgia, peripheral neuropathy
What are the side effects of TCAs
Convulsions Coma Cardiotoxicity (arrhythmias-block fast NA channels α-1 blocking Atropine like
MAOIs
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (MAO-B)
↑amine NT: NE, 5-HT, dopamine
When are MAOIs indicated?
Atypical depression, anxiety, hypochondriasis
What are the side effects of MAOIs
Hypertensive crisis - ingestion of tyramine
Treat with Phentolamine (α-blocker)
MAOIs are contraindicated with which things?
SNRIs, TCAs, St. Johns wort, meperidine, dextromethorphan - prevent Serotonin Syndrome
Bupropion
Blocks presynaptic reuptake of dopamine and NE
- Seizure in bulimic patients*
- No sexual side effects*
Mirtazapine
α2-antagonist - ↑release of NE and 5-HT
5-HT2 and 3 antagonist
SE: sedation, ↑appetite/weight gain, dry mouth
Trazodone
Blocks 5-HT2 and α1-adrenergic receptors
Treats Insomnia
SE: Priapism, sedation, nausea
