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general knowledge medicine > Psych drugs USMLE > Flashcards

Psych drugs USMLE Flashcards

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1
Q

haloperidol class

A

antipsychotic

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2
Q

trofluoperazine

A

antipsychotic

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3
Q

fluphenazine

A

antipsychotic

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4
Q

thioridazine

A

antipsychotic

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5
Q

chlorpromazine

A

antipsychotic

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6
Q

antipsychotic mechanism

A

block dopamine D2 receptors (so increase cAMP)

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7
Q

antipsychotic use

A

schizophrenia, psychosis, acute mania, Tourette’s

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8
Q

antipsychotic toxicity

A

slow removal from body (highly lipid soluble), extrapyramidal side effects, hyperprolactinemia, muscarinic, histamine and and alpha blockade side effects; neuroleptic malignant syndrome, tardive dyskinesia

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9
Q

clorpromazine specific toxicity

A

corneal deposits

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10
Q

thioridazine specific toxicity

A

retinal deposits

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11
Q

high potency antipsychotics and effects

A

haloperidol, triofluoperazine, fluphenazine; extrapyramidal symptoms

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12
Q

low potency antipsychotics and effects

A

thiorizadine, chlorpromazine; anti-autonomic side effects (alpha, muscarinic, histamine blockade)

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13
Q

extrapyramidal effect timeline

A

4 hr acute dystonia, 4 days akinesia, 4 weeks akathisia, 4 mo tardive dyskinesia

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14
Q

neuroleptic malignant syndrome features

A

fever, encephalopathy, muscle rigidity, unstable vitals, elevated enzymes

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15
Q

olanzapine class

A

atypical antipsychotic

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16
Q

clozapine class

A

atypical antipsychotic

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17
Q

quetiapine

A

atypical antipsychotic

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18
Q

risperidone class

A

atypical antipsychotic

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19
Q

aripiprazole class

A

atypical antipsychotic

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20
Q

ziprasidone class

A

atypical antispychotic

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21
Q

atypical antipsychotic mechanism

A

block serotonin, dopamine, alpha and H1 receptors

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22
Q

atypical antipsychotic use

A

schizophrenia (treats both positive and negative symptoms)

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23
Q

olanzapine use

A

schizophrenia, also OCD, anxiety disorder, depression, mania, Tourette’s

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24
Q

risperidone toxicity

A

prolonged QT; most likely atypical antipsychotic to have extrapyramidal side effects

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25
Q

olanzapine toxicity

A

weight gain

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26
Q

clozapine toxicity

A

weight gain, seizures, agranulocytosis

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27
Q

butyrophenone class

A

peridol antipsychotic

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28
Q

lithium mechanism

A

unknown; maybe phosphinositol cascade

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29
Q

lithium use

A

bipolar (mood stabilizer)–blocks relapse and acute mania, seizures, SIADH

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30
Q

lithium toxicity

A

tremor, nephrogenic DI, hypothyroidism, teratogen (Ebstein anomaly, great vessel malformation), narrow therapeutic window, level increased by thiazides, edema, heart block

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31
Q

buspirone mechanism

A

stimulates serotonin receptors

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32
Q

buspirone use

A

GAD

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33
Q

buspirone toxicity

A

minimal (no sedation, addiction, tolerance, alcohol interaction)

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34
Q

buspirone consideration

A

response is delayed so can’t be used for situational anxiety like performance anxiety

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35
Q

imipramine class

A

TCA

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36
Q

amitryptyline class

A

TCA

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37
Q

desipramine class

A

TCA

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38
Q

nortryptyline class

A

TCA

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39
Q

clomipramine class

A

TCA

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40
Q

doxepine class

A

TCA

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41
Q

amoxapine class

A

TCA

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42
Q

TCA mechanism

A

block reuptake of NE and serotonin (inhibit fast Na channels)

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43
Q

TCA use

A

major depression, bed-wetting (imipramine), OCD (clomipramine), fibromyalgia, diabetic neuropathy

44
Q

TCA toxicity

A

sedation, alpha blocking effects, anti-cholinergic side effects; QRS widening–venticular tachyarrhythmias; convulsions, coma, respiratory depression, hyperpyrexia. confusion and hallucinations in elderly

45
Q

TCA toxicity treatment

A

NaHCO3 for CV toxicity

46
Q

fluoxetine class

A

SSRI

47
Q

paroxetine class

A

SSRI

48
Q

sertraline class

A

SSRI

49
Q

citalopram class

A

SSRI

50
Q

SSRI mechanism

A

serotonic specific reuptake inhibitors

51
Q

SSRI use

A

depression, OCD, bulemia, social phobias

52
Q

SSRI toxicity

A

sexual dysfunction, GI distress, serotonin syndrome

53
Q

serotonin syndrome

A

hyperthermia, cardiovascular collapse, myoclonus (vs. muscle rigidity in neuroleptic malignant), flushing, diarrhea, seizures

54
Q

serotonin syndrome treatment

A

cyproheptadine (serotonin receptor antagonist), supportive

55
Q

vanlafaxine class

A

SNRI

56
Q

duloxetine class

A

SNRI

57
Q

SNRI mechanism

A

inhibit serotonin and NE reuptake (but different from TCAs that block Na channels)

58
Q

SNRI use

A

depression, venlafaxine for GAD, duloxetine for diabetic peripheral neuropathy

59
Q

SNRI toxicity

A

increased BP is most common; stimulant effects, sedation, nausea

60
Q

phenelzine class

A

MAOI (irreversibly binds MAO)

61
Q

tranylcypromine class

A

MAOI

62
Q

isocarboxazid class

A

MAOI

63
Q

selegiline

A

MAOI (selective for MAO-B)

64
Q

MAOI mechanism

A

MAO inhibition increases levels of amine neurotransmitters (NE, serotonin, dopamine)

65
Q

MAOI use

A

atypical depression, anxiety, hypochondriasis, resistant depression; selegiline for Parkinson’s

66
Q

MAOI toxicity

A

hypertensive crisis with tyramine ingestion or beta agonists, CNS stimulation; contraindicated with SSRIs or meperidine to prevent serotonin syndrome

67
Q

bupropion mechanism

A

presynaptic selective NE reuptake inhibition (increases NE and dopamine)

68
Q

bupropion use

A

depression, smoking cessation

69
Q

bupropion toxicity

A

tachycardia, insomnia (stimulant effects), seizures in bulimic patients, headache (no sexual side effects)

70
Q

mirtazapine mechanism

A

alpha 2 antagonist (increases release of NE and serotonin) and serotonin receptor antagonist

71
Q

mirtazapine use

A

atypical antidepressant

72
Q

mirtazapine toxicity

A

sedation, increased appetite, weight gain, dry mouth

73
Q

maprotiline mechanism

A

blocks NE uptake

74
Q

maprotiline use

A

atypical anti-depressant

75
Q

maprotiline toxicity

A

sedation, orthostatic hypotension

76
Q

trazodone

A

primarily inhibits serotonin reuptake

77
Q

trazodone use

A

usually with fluoxetine, for insomnia

78
Q

trazodone toxicity

A

priapism, sedation, nausea, postural hypotension

79
Q

nonspecific depressant drug intoxication

A

mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression

80
Q

nonspecific depressant drug withdrawal

A

anxiety, tremor, seizures, insomnia

81
Q

alcohol intoxication

A

ataxia, emotional lability, slurred speech, coma, blackouts, elevated GGT, AST

82
Q

alcohol withdrawal

A

delirium tremens if severe: autonomic hyperactivity (tachy, seizures, anxiety), psychotic symptoms (hallucinations, delusions), confusion

83
Q

treatment for severe alcohol withdrawal

A

benzos

84
Q

opioid intoxication

A

pinpoint pupils, respiratory depression, constipation, seizures, CNS depression

85
Q

opioid intoxication treatment

A

naloxone, naltrexone

86
Q

opioid withdrawal

A

dilated pupils, diarrhea, sweating, piloerection, fever, rhinorrhea, nausea, stomach cramps (flulike)

87
Q

barbituate intoxication

A

marked respiratory depression

88
Q

barbituate intoxication treatment

A

supportive

89
Q

barbituate withdrawal

A

delirium, cardiovascular collapse

90
Q

benzodiazepine intoxication

A

ataxia, respiratory depression

91
Q

benzodiazepine intoxication treatment

A

flumenzil

92
Q

nonspecific stimulant intoxication

A

mood elevation, psychomotor agitation, insomia, arrhythmias, tachycardia, anxiety

93
Q

nonspecific stimulant withdrawal

A

post use “crash” with depression, weight gain, lethargy, headache

94
Q

amphetamine intoxication

A

impaired judgment, violent behavior, dilated pupils, prolonged wakefulness and attention, delusions, hallucinations, fever, rapid HR, sweating, dry mouth (NE effects)

95
Q

amphetamine withdrawal

A

hypersomnia, hunger, stomach cramps

96
Q

cocaine intoxication

A

dilated pupils, arrhythmias, tremors, paranoid ideations, hallucination, impaired judgment

97
Q

cocaine withdrawal

A

suicidality, hypersomnolence, malaise, severe psychological craving

98
Q

caffeine intoxication

A

restlessness, increased diuresis, muscle twitching

99
Q

nicotine intoxication

A

restlessness

100
Q

nicotine withdrawal

A

irritability, anxiety, craving

101
Q

PCP intoxication

A

feeling of detachment, belligerence, impulsiveness, fever, psychomotor agitation, horizontal nystagmus, tachycarida, homocidality, pyschosis, delirium

102
Q

PCP mechanism

A

inhibits NMDA receptor activation

103
Q

LSD intoxication

A

flashbacks, marked anxiety or depression, delusions, visual hallucinations, pupillary dilation

104
Q

LSD mechanism

A

serotonin receptor agonist

105
Q

marijuana intoxication

A

euphoria, laughter, paranoid delusions, slowed time perception, impaired judgment, social withdrawal, increased appetite, dry mouth, impaired coordination, short term memory loss

106
Q

marijuana withdrawal

A

irritability, depression, insomnia, nausea, anorexia

general knowledge medicine (9 decks)

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