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First Aid Facts > Psych First Aid Pharm > Flashcards

Psych First Aid Pharm Flashcards

1
Q

Treatment for ADHD?

A

Methylphenidate

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2
Q

Treatment for Alcohol withdrawal?

A

Benzodiazepines

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3
Q

Treatment for Anxiety?

A

SSRI, SNRI, Buspirone

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4
Q

Treatment for Bipolar Disorder?

A

“Mood stabilizers” (Lithium, valproic acid, carbamazepine), Atypicals

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5
Q

Treatment for Bulimia?

A

SSRI (Fluoxetine)

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6
Q

Treatment for Depression?

A

SSRI, SNRI, TCA,Bupropion, Mirtazapine (especially with insomnia)

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7
Q

Treatment for OCD?

A

SSRI, Clomipramine

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8
Q

Treatment for Panic Disorder?

A

SSRI, venlafaxane, benzodiazepines

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9
Q

Treatment for PTSD?

A

SSRI

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10
Q

Treatment for Schizophrenia?

A

Antipsychotics

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11
Q

Treatment for Social Phobias?

A

SSRI, B-blockers (propanolol for social speaking, don’t forget, if they have asthma/COPD, give them a cardioselective = A-M)

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12
Q

Treatment for Tourette syndrome?

A

Antipsychotics (haloperidol, risperidone) (DIT said Fluphenazine, Pinozide, and Tetrabenazine

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13
Q

What are the CNS Stimulants?

A

Methylphenidate, dextroamphetamine, methamphetamine, phentermine

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14
Q

MOA CNS stimulants?

A

Increase catecholamines at the synaptic cleft, especially NE and Dopa

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15
Q

Clinical use CNS stimulants?

A

ADHD, narcolepsy, appetite control

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16
Q

What are the antipsychotics (neuroleptics)?

A

Haloperidol, Trifluoperazine, fluphenazine, thioridazine, chlorpromazine (Group of Haloperidol + azines)

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17
Q

What is the mechanism of all the typical antipsychotics (Haloperidol + Azines)?

A

Block Dopamine D2 Receptors (Increases cAMP)

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18
Q

What are the high potency antipsychotics and side effects?

A

Try to Fly High = High potency (Trifluoperazine, Fluphenazine, Haloperidol)
Neurologic, EPS symptoms

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19
Q

What are the low potency antipsychotics and side effects?

A

Cheating Thieves are Low = Low potency (Chlorpromazine, Thioridazine)
Non-neurologic side effects like anticholinergic, antihistamine, and alpha1 blockade

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20
Q

What are the antipsychotics used for? (4 uses listed)

A

Psychosis
Acute Mania
Tourette Syndrome
Schizophrenia (primarily positive symptoms)
(Spells PATS if you’re interested in that… PATS down Dopamine? work with me here)

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21
Q

What are the general toxicities of Antipsychotics?

A

They are highly lipid soluble so stored in body fat, and are slowly removed from body
EPS from high potency
Non-neurologic side effects (antichol, antirust, anti alpha 1 from low potency
Endocrine side effects (remember dopamine antagonism = hyperprolactinemia and all that good shit)

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22
Q

What are the side effects of Chorpromazine, Thioridazine, and Haloperidol?

A

Chlorpromazine - Corneal Deposits (C’s)
Thioridazine - reTinal deposits
Haloperidol - NMS (dantrolene), Tardive dyskinesia

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23
Q

What is the evolution of EPS side effects? (4 hours, days, weeks, months)

A

4 hours - acute dystonia = muscle spasm, stiffness, oculogyric crisis
4 days - akathisia = restlessness
4 weeks - bradykinesia = parkinsonism
4 mo - tardive diskinesia

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24
Q

What is NMS?

A

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia

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25
Q

What is the FEVER mnemonic for NMS?

A 
Fever
Encephalopathy
Vitals unstable
Enzymes increased
Rigidity of muscle (leads to myoglobinuria)
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26
Q

What is the treatment for NMS?

A

Dantrolene, D2 agonists (bromocriptine)

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27
Q

What is tardive diskinesia?

A

Stereotypic oral-facial movements as a result of long term-psychotic use (maybe irreversible)

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28
Q

What are the atypical antipsychotics?

A

Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone
(FA Mnemonic: It is Atypical for Old CLOZets to QUIETly RISPER from A to Z)

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29
Q

What is the MOA of atypical antipsychotics?

A

Not 100% known, but varied effects on 5-HT2, dopamine, alpha and H1 receptors

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30
Q

What are the atypical antipsychotics used for?

A

Schizo - both the positive and negative symptoms
Bipolar, OCD, anxiety, depression, mania, Tourette
DIT = Olanzapine - OCD and Anxiety

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31
Q

What are the toxicities of atypical antipsychotics?

A

Fewer EPS and anticholinergic than traditionals.

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32
Q

What can Olanzapine/Clozapine cause? What additional for Clozapine?

A

Olanzapine/Clozapine - Weight gain!

Clozapine - Agranulocytosis and seizures

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33
Q

What does Risperidone cause?

A

Increased prolactin –> GnRH, LH, and FSH (irregularity in menstruation/fertility)

34
Q

What does Ziprasidone cause?

A

Prolong QT interval

35
Q

What is the MOA of lithium?

A

Who the fuck knows, who the fuck cares? Something about a phosphoinositol cascade

36
Q

What is Lithium used for?

A

Mood stabilizer for bipolar disorder and mania; blocks relapse and acute manic events, Also SIADH.

37
Q

What is the Lithium side effects mnemonic?

A 
LMNOP! (not therapy for CHF....)
L - Lithium Side Effects
M - Movement (tremor)
N - Nephrogenic DI (polyuria)
O - hypOthyroidism
P - Pregnancy problems
38
Q

What are some other notable side effects of Lithium?

A

Fetal cardiac defects including Ebstein anomaly and malformation of great vessels, narrow therapeutic window, almost exclusively excreted by kidneys (most reabs at PCT following Na reabsorption)

39
Q

What is Busiprone’s MOA?

A

Stimulate 5-HT1A receptors

40
Q

What are the uses of Busiprone?

A

ONLY FOR GENERALIZED ANXIETY DISORDER: Does NOT cause sedation, addiction, or tolerance. Takes a few weeks to take effect and does NOT interact with alcohol (vs barbs and benzos)

41
Q

Mnemonic for Busiprone?

A

Im always anxious if the BUS will be ON time, so I take BUSpirONE

42
Q

What are the SSRI’s?

A

Fluoxetine, Paroxetine, Setraline, Citalopram (FLashbacks PARalyze SEnior CITizens)

43
Q

What is the MOA of SSRIs……

A

5-HT specific reuptake inhibitors

44
Q

What is the clinical use of SSRI’s?

A

Depression, GAD, panic, OCD, bulimia, social phobias, PTSD; generally take 4-8 weeks to work

45
Q

What is the long acting vs short acting SSRI?

A 
Fluoxetine = long
Paroxetine = short
46
Q

What are the toxicities of SSRI’s?

A

Less than TCAs (TCA’s suck). Gi distress, sexual disfunction (anorgasmia and decreased libido). Serotonin Syndrome!

47
Q

What is Serotonin Syndrome?

A

Looks like carcinoid but from a drug; It is from any drug that increases 5-HT, causes hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures

48
Q

Treatment of SS?

A

Cyproheptadine (5-HT2 receptor antagonist), cooling, benzos.

49
Q

What don’t you give SSRI’s with?

A

SNRI or MAOI

50
Q

What can cause SS?

A

SSRI, SNRI, MAOI, St. Johns Wort, Kava Kava, Sibutramine, L-Tryptophan, Cocaine, Amphetamines (DIT)

51
Q

What are the SNRI’s?

A

Venlafaxane and Duloxetine

52
Q

What do SNRI’s do?

A

Inhibit 5-HT and NE reuptake

53
Q

SNRI Uses?

A

Depression; Venlafaxane for GAD and panic disorder; Duloxetine is for diabetic peripheral neuropathy

54
Q

SNRI tox?

A

Increased BP MC; also stimulant effects, sedation, nausea

55
Q

What are the TCA’s

A

Any -triptyline/ipramine + doxepin + amoxapine

56
Q

MOA TCA?

A

Block reuptake of NE and 5-HT, they are older with 3 ring structure

57
Q

Use of TCAs?

A

Major Depression, OCD (Clomipramine), Fibromyalgia (amytriptyline)

58
Q

TCA Tox?

A

Sedation, alpha 1 blocking effects including postural hTN + atropine like (antichoinergic) side effects (mad was a hatter, dry as a bone… etc.)

59
Q

What TCA’s have more AntiACh effects?

A

3 TCA’s (amitryptiline) have more than 2 TCA (nortriptyine)

60
Q

Which is the least sedating TCA? What consequence?

A

Desipramine is less sedating but has higher seizure incidence

61
Q

What are the Tri-C’s of TCA?

A

Convulsions, Coma, Cardiotox (+resp depression, hyperpyrexia)

62
Q

What can happen in elderly with TCA?

A

Confusion and hallucinations due to anticholinergic side effects

63
Q

What TCA do you use in elderly to avoid hallucinations?

A

Nortriptyline

64
Q

What is the treatment for TCA cardiotox?

A

NaHCO3

65
Q

What are the MAOI’s?

A

Trancylcypromine, Phenelzine, Isocarboxazid, Selegiline (MAO Takes Pride In Shanghai)

66
Q

MOA MAOI’s?

A

NS MAO inhibition to increase levels of amine NT’s (NE, 5-HT, Dopamine)

67
Q

Use of MAOI’s?

A

Atypical depression, anxiety, hypochondriacs

68
Q

MAOI Tox?

A

Hypertensive crisis most notably with the ingestion of Tyramine (stimulates NE release from nerve terminals) = AGED FOODS (Brown bananas, wine, beer, cheese, beef, etc, etc, etc, etc) CNS Stimulation. HTN crisis can occur w/ Beta agonist too.

69
Q

Why does tyramine ingestion on an MAOI cause toxicity?

A

MAOI usually is found in gut and prevents tyramine from acting, but it’s not there anymore, so NE is released

70
Q

What are MAOI’s CI’d with?

A

SSRI, TCA, St. Johns Wort, meperidine, Dextromethorphan (all to prevent SS)

71
Q

What is the MAO-B inhibitor?

A

Selegiline

72
Q

What is Selegiline used for?

A

Not depression, used for parkinsonism

73
Q

What are the Atypical Antidepressants?

A

Bupropion, Mirtazapoine, Trazodone

74
Q

What is Bupropion used for?

A

Smoking cessation

75
Q

Bupropion MOA?

A

Increase NE/D via unknown mech

76
Q

Bupropion Tox?

A

Stimulant effects (tachycardia/insomnia), H/A, seizure in bulimic patients, NO SEXUAL SIDE EFFECTS YAY!

77
Q

What class of drugs does Bupropion work well with?

A

SSRI or SNRI

78
Q

What is Mirtazapine (MOA)?

A

Alpha2 antagonist (increase release of NE and 5-HT), patent 5-HT2 and 5-HT3 receptor antagonist

79
Q

Mirtazapine tox?

A

Sedation (may be desirable in depressed insomniacs), appetite, weight gain (may be desirable in elderly/anorexics), dry mouth, antihistamine AEs

80
Q

What is Trazodone (MOA)? What is it used for and why?

A

Blocks 5-HT2 and alpha1 adrenergics; used for insomnia because high doses are needed for antidepressant effects

81
Q

Trazodone tox?

A

TrazoBONE b/c priaprism; sedation, nausea, postural hTN

82
Q

If trazodone is combined with SSRI or SNRI what can happen for sleep?

A

Increased REM sleep

First Aid Facts (20 decks)

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