Psych medications Flashcards
What are the mainline treatment drugs for anxiety and why
Benzodiazepines because they have a rapid onset of action
What are adverse effects of benzos? How long are they used for?
Sedation, ataxia, decreased cognitive function. DEPENDANCE
What are other drug examples used to treat anxiety
Beta blockers to recude HR related to anxiety, antihistamines, and anticonvulsants
What is a significant result of stopping benzodiazepine use abruptly? What is benzo antidote?
Withdrawal symptoms and the antidote is flumazenil
What medications are used for depression?
SSRIs/SNRIs, MAOIs, TCAs,
How do MAOIs work and what are two examples?
They inhibit the enzyme monoamine which causes increase in serotonin and NE. The two examples are phenelzine and tranylcypromine
Why dont we give MAOIs with otehr antidepressants and what are the major adverse effects?
It causes serotnin syndrome when givne with other antidepressants. Adverse effects are hypertensive crisis and it can’t be given with tyramine containing foods
WHat is treatment for hypertensive cirsis?
Antidote is CCB and other things are activated charcoal, gastric lavage, antihypertensive
What do tricyclics do and what are examples?
They inhibit serotonin and NE reuptake. Examples are amitryptyline, clomipramine, and notriptyline.
What are most important TCA adverse effects and other ones?
URINARY RETENTION, CONSTIPATION, anticholinergic effects.
What do SSRIs and SNRIs do?
SSRI blocks serotonin reuptake SNRI blocks serotonin and NE reuptake.
What are examples of SSRIs and what is the main adverse effect?
Examples of this medication are citalopram, escitalopram, fluoxetine, fluvoxamine. The main adverse effect is serotonin syndrome
What should SSRI be avoided with and what is serotonin syndrome?
Should be avoided with MAOIs. Serotonin syndrome happens with too much serotonin in blood. It looks like tachycardia, high BP, fever, restless,
How is serotonin syndrome treated?
Treated with holding SSRI and MOAIs, serotonin receptor blocker, cooling blankets,
What are symptoms of serotonin syndrome?
FLUSH: Flu like (fever, fatigue, loose stools), lightheaded, uneasy/restless, sleep disturbance, and headache
What are examples of SNRIs and what are adverse effects?
Venlaflexine and duloxetine. adverse effects are hypertension sexual dysfunction, dry mouth and serotonin syndrome
What is the therapeutic range for lithium? WHat level becoems toxic?
0.6-1.2 mmol/L. Toxic past 1.5 mmol/L
What are other medications used for bipolar disorder?
exampleof each category?
Anticonvulsants like valproic acid, carbamazepine and lamotrigine. Other medication is antipsychotics like olanzapine risperidone and aripiprazole
How does lithium work?
It works similar to sodium and regulates the electrical conductivity of brain.
Why is hyponatremia and kidney function improtant for lithium?
Hyponatremia measn kidneys will extrete sodium which will increase levels of lithium in blood causing lithium toxicity
What are the toxic signs of lithium use?
Diahrrhea sweating vomiting, ataxia, convulsions. There is no treatment other than symptom managing
What are examples of typical antipsychotics and what did they treat?
Chlorpromazine, haloperidol, trifluperazine, zuclopenthixol. They treated positive symptoms like delusions, hallucinations.
What are the main adverse effects of typical antipsychotics?
EPS, and tardive dyskinesia
What are the three things seen with EPS?
PAA: Pseudoparkinsonism, akathisia, and acute dystonia.
What is acute dystonia a result of and how is it treated?
It is a result of typical antipsychotics. It is treated with IM benadryl or congentin
What is tardive dyskinesia?
Involuntary muscle contraction of tounge, fingers and other parts of body. It is irreversible and has no treatment.
How do typical antipsychotics work?
They prevent dopamine from working on receptors since psychosis is seen with too much dopamine in system.
Which psych drug causes agranulocytosis?
Second gen antiphsychotics specifically clozaril
What are 5 examples of second gen antipsychotics
Risperidone, lurasidone, olanzapine, quetiapine, and ziprasidone
What are two main side effects of second gen antipsych and other adverse effects
Weight gain and sedation are main two. The rest are sexual dysfunction, anticholinergic effects, orthostatic hypotensio
What are two examples of 3rd gen antipsychotics?
Aripiprazole, brexpiprazole
Which set of antipsychotics causes metabolic syndrome?
Second and third generation.
What is NMS and what causes it
NMS is caused by a significant decrease in dopamine.
What medications NMS and what does it look like?
All antipsychotics can cuase NMS. It looks like decreased consciousness, muscle rigidity, fever
How is NMS treated?
Hold antipsychotic, bromocriptine to stop muscle rigidness, decrease temperature
