Psych drugs (GOOD REV!) Flashcards
List the 6 typical anti-psychotics
+common suffix
Haloperidol Pimozide Trifluoperazine Fluphenazine Thioridazine Chlorpromazine (azine/azide)
(Haloed pimps & trifling thieves flew by cheating)
increase cAMp
block D2 receptor
typical anti-psychotics
High potency typical antipsychotics
Haloperidol
Trifluoperazine
Fluphenazine
(trifling Halos flew High)
Low potency typical antipsychotics
Chlorpromazine, Thioridazine
cheating theives are low
List 1 atypical antipsychotic and the other’s 2 common suffix
Aripiprazole
(+apine)(+Peridone/ idone)
asenapine, clozapine, quetipine,
iloperidone, paliperidone, risperidone, lurasidone, ziprasidone
serotonin (2A) and dopamine (D2) antagonist
Atypical antipsychotics
which atypical anti-psychotic is a partial D2 agonist
Aripiprazole
Ari is a pipsqueak and an atypical pop-star
causes agranulocytosis and seizures
Clozapine; atypical
watch clozapine closely
causes hyperprolactenemia (galactorrhea, amenorrhea, man boobs/ gynecomastia)
Risperidone; atypical
makes me think of the ice-cream a raspado. ice-cream is milky
causes metabolic syndrome
weight gain, dyslipidemia, diabetes
Clozapine
Olanzapine
Risperidone
Quetiapine
(put a CORQ in it)
Antipsychotics (2)
causes a prolonged QT interval
Ziprasidone (less EPS)
Risperidone (more EPS)
For treatment resistant schizophrenia &
schizophrenia associated with Suicidality
Clozapine
Clozapine can cause:
Metabolic syndrome
agranulocytosis
and what else (2)
Seizures
Myocarditis (angina/dyspnea)
Antipsychotics (2)
Causes sedation, orthostatic hypotension, &
anticholinergic side effects (dry mouth, dilated pupils, tachycardia, constipation)
Chlorpromazine, Thioridazine
1st gen low potency
Can cause sudden onset sustained muscle contractions, Dystonia. (3)
Haloperidol
Trifluoperazine
Fluphenazine
(typical antipsychotics high potency)
Can cause Tremor, Rigidity, Blunted affect, and Bradykinesia
Haloperidol
Trifluoperazine
Fluphenazine
(typical antipsychotics high potency)
Can cause subjective restlessness with inability to sit still (Akathisia)
Haloperidol
Trifluoperazine
Fluphenazine
(typical antipsychotics high potency)
Can cause involuntary tics or choreoathetoid movements after chronic use
Haloperidol
Trifluoperazine
Fluphenazine
(typical antipsychotics high potency)
Fever, Rigidity with Hyporeflexia, mental status change, diaphoresis, Autonomic Instability
Recent use of Dopamine Antagonist
Neuroleptic malignant syndrome
Schizophrenia: excess dopamine in this pathway
Mesolimbic
Fever, Clonus with Hyper-reflexia, mental status change, Hypertension, tachycardia, diaphoresis
use of SSRI, MOA-I, Dextromethorphan (cough syrup)
Serotonin Syndrome
Drug-induced parkinsonism is caused by dopamine (D2) receptor blockade in the ____ pathway.
naigrostriatal
Drug-induced parkinsonism can be caused by (4)
1st gen Antipsychotics
Antiemetics/gastric motility agents
(metoclopromide, Odansetron/ prochlorepezine)
Mood stabilizers
(Valproate, Lithium)
MPTP dmg to Substantia Nigra
Mood stabilizer for Bipolar
Manic & Depressive features
Lithium
Mood stabilizer for Bipolar
Manic features only
Valproate, Carbamazepine
Mood stabilizer for Bipolar Depressive features (only)
Lamotrigene
Mood stabilizer with following AE: Nephrogenic Diabetes Insipidus Tremor Hypothyroidism Teratogen (Ebstein's Anomaly)
Lithium
Mood stabilizer with following AE:
Hepatotoxicity
Teratogen (neural tube defects)
Valproate
Mood stabilizer with following AE:
Aplastic Anemia
SIADH
Teratogen (neural tube defects)
Carbamezapine
Mood stabilizer with following AE:
Benign Rash
Steven Johnson Syndrome
Lamotrigene
Mirtazepine mechanism of action
alpha 2 anTagonist
*causes weight gain & sedation. Good for Elderly
Which antidepressants is lethal in overdose
TCAs
TCA overdose treated with
Sodium Bicarbonate (IV)
Monoamine Oxidase Inhibitor mechanism of action
IRREVERSIBLY inhibits MAO A/B to stop the inactivation of NE, 5HT, Dopamine & Tyramine to increase their availability in the synaptic cleft.
Enuresis treated with
Desmopressin (1st line)
Imipramine (TCA)
Chronic pain/ Neuropathic pain treated with (2)
SNRI
TCAs
The only ((mood stabilizer)) shown to decrease suicidality
Lithium
2 mood stabilizers/ anticonvulsants that can cause Stevens Johnson Syndrome
Carbamazepine
Lamotrigine
Medication helps with impulse control, but causes cognitive slowing and kidney stones
Topiramate
a weak, non-competitive antagonist of the NMDA receptor, which increases dopamine release and prevents dopamine re-uptake.
Used for drug induced Parkinson’s
Amantadine
A cholinesterase inhibitor used to reverse the toxic CNS effects caused by anticholinergic drugs.
Physostigmine
SSRI with anticholinergic SE & weight gain
Paroxetine
3 side effects of Trazadone
Sedation
Priapism
Orthostatic hypotension
Which drugs go HAM
anti- Histamine, Alpha1, Muscarinic
TCA
1st gen Low pot. antipsychotics
Clozapine, Olanzapine, Risperidone, Quetiapine
SSRI with the shortest half-life
Paroxetine (2 weeks or less)
Suvorexant is an ____ inhibitor
orexin
insomnia
What is the Black Box warning for antipsychotics?
Increased Mortality in pts w/ Dementia
still used, but 2nd gen like Quetiapine
Competitive inhibition of histamine at H2 receptors of the gastric parietal cells, which inhibits gastric acid secretion
Famotidine
(GERD)
*watch for delirium in elderly
