Psych Medications

Question 1

Most psych meds take (how long?) to work.

Answer 1

4-6

Question 2

xanax, ativan, valium, and buspirone are all benzodiazepines and anti-anxiety drugs. Which one is unique and why?

Answer 2

-buspirone: doesn’t have sedative side effects, reduce CNS activity

Question 3

If you’re giving someone lithium carbonate for ______, what labs would you check? What would you advise your patient?

Answer 3

-mania/BPD
-lithium (0.5-1.6) and Na labs
-don’t change fluid intake

Question 4

Signs of lithium toxicity include:

Answer 4

slurred speech, cardiac dysrhythmia, issues w/ movement and coordination

Question 5

What class of medications has a black box for suicidal ideation?

Answer 5

antidepressants

Question 6

4 classes of antidepressants (2 new, 2 old)

Answer 6

old:
-tricyclic (TCAs)
-MAOIs
new:
-SSRIs
-SNRIs

Question 7

tricyclic antidepressants: examples, use, MOA, side effects

Answer 7

-amitriptyline, nortriptyline
-MOA: block NT reuptake
-use: depression, nerve pain
SFX: anticholinergic (drying), OT HS, impotence
-NO ANTIDOTE for OD

Question 8

MAOI examples, MOA, use, side effects/considerations

Answer 8

-NPMs (no popular meds): Nardil, Parmate, Marplan, Selegiline
-MOA: monoamine oxidase inhibitor (block serotonin re-uptake)
-use: mostly Parkinson’s
-SFX: siezure, HT crisis

Question 9

You can’t have what food/drink while on MAOIs?

Answer 9

-fermented/preserved foods with tyramine–cheese, wine, kimchi, pickles

Question 10

SSRIs examples and uses

Answer 10

-celexa, lexapro, paxil, prozac, zoloft
-use: anxiety, EDs, depression, PMDD

Question 11

SSRI MOA and side effects/considerations

Answer 11

-MOA: block serotonin re-uptake (selective serotonin re-uptake inhibitor)
-SFX: insomnia, weight gain, impotence, serotonin syndrome, suicide
-consider: don’t take w/ other protein bound drugs (warfarin, phenytoin) as there will be too much free drug in the body, consider “washout period” for switching drugs

Question 12

SNRIs examples and uses

Answer 12

-duloxetine, venlafaxine, desvenlafaxine
-uses: anxiety, depression, pain from fibromyalgia

Question 13

SNRI MOA and side effects

Answer 13

-MOA: block serotonin and Norepinephrine re-uptake
-SFX: N/V, drowsy, SS, suicide

Question 14

Bupropion MOA, use, side effects

Answer 14

-MOA: releases dopamine, epinephrine
-uses: depression, SAD, nicotine addiction
-SFX: N/V, dry mouth

Question 15

1st gen antipsychotics examples, use, MOA, side effects

Answer 15

-pro/chlorpromazine, haldol
MOA: reduces dopamine in CNS, block Ach receptors
use: “calm pts down”, schizophrenia
SFX: anticholinergic (drying), EPS, NMS

Question 16

Define EPS and NMS. These conditions are potential symptoms of what?

Answer 16

EPS: tardive dyskinesia–uncontrolled movement
NMS: neuroleptic malignant syndrome–fever, unstable BP, rigidity
-1st/2nd gen antipsychotics can cause EPS and NMS, 3rd gen antipsychotics can cause NMS

Question 17

Anticholinergic effects include

Answer 17

drying: dry mouth, cough, constipation, sedation/drowsy/dizzy

Question 18

2nd gen antipyschotics–examples, use, MOA, side effects

Answer 18

-“one-pines”: quetiapine, risperidone, olanzapine
MOA: block D2 and serotonin re-uptake
use: MDD, BPD, schizophrenia
SFX: weight gain, agranularcytosis, sedation, EPS, NMS

Question 19

Haldol is a more _____-_____ medication as opposed to other 1st gen antipsychotics

Answer 19

long-term

Question 20

3rd gen antipsychotics: examples, MOA, side effects

Answer 20

-“azoles”: brexpiprazole (rexulti), aripiprazole (abilify)
-MOA: D2 and serotonin agonists
-SFX: akathisia (jitters), weight gain, suicide, NMS

Question 21

Kids over ___ can take lexapro, for _______ and ______.

Answer 21

12, anxiety, depression

Question 22

Children over age __ can take prozac for depression, OCD, and other off-label disorders (bulimia, social anxiety, PTSD)

Answer 22

10