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Pharmacology > Psych medications > Flashcards

Psych medications Flashcards

1
Q

Haloperidol MOA

A
  • produce strong blockade of dopamine in CNS
  • block receptors to varying degree (dopamine, each, histamine, norepinephrine)
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2
Q

Haloperidol Use

A

schizophrenia

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3
Q

Haloperidol class

A

first generation antipsychotic (EGA), high potency

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4
Q

Haloperidol adverse effects

A

EPS - extrapyramidal symptoms
- acute dystonia (tongue/neck spasm)
- pseudo parkinsonism (TRAP)
- akathisia (pacing, restlessness)
- tardive dyskinesia (TD)

Neuroleptic Malignant Syndrome
- life threatening emergency
- high grade fever, dysrhythmias, mm rigidity, BP fluctuations
- change in level of consciousness

General
- orthostatic hypotension
- anticholinergic effects

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5
Q

Tardive dyskinesia

A

twisting or worm-like movement of tongue or lip-smacking

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6
Q

Haloperidol Implications

A
  • high potency cause more early EPS but fewer of above symptoms
  • neuroleptic malignant syndrome: give dantrolene, ASA, tylenol, cooling blankets, stop meds
  • schizophrenia patients often non-compliant and require interdisciplinary team
  • anticholinergic agents + benzodiazepines commonly used to reverse/reduce symptoms of acute dystonia (diphenhydramine)
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7
Q

Olanzapine Class

A

2nd generation antipsychotic, atypical

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8
Q

Olanzapine MOA

A

moderate blockade of dopamine receptors, strong blockade of serotonin receptors

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9
Q

Olanzapine adverse effects

A

General: sedation, orthostatic hypotension, anticholinergic effects

Metabolic effects: weight gain, diabetes, dyslipidemia

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10
Q

Olanzapine implications

A
  • report weight gain >30lbs, chest pain, dyspnea, tachycardia
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11
Q

Olanzapine facts

A
  • serotonin > dopamine = less incidence of EPS and TD
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12
Q

Sertraline class

A

SSRI

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13
Q

Sertraline MOA

A

inhibits serotonin reuptake

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14
Q

Sertraline use

A

depression, bipolar, OCD, panic disorder, bulimia nervosa

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15
Q

Sertraline adverse effects

A

General: sexual dysfunction, weight gain, sleepiness, hyponatremia

Serotonin syndrome
- caused by increasing serotoninergic transmission in CNS
- usually begins 2-72 hrs after treatment onset
- altered mental status, incoordination, myoconus, hyperreflexia, excessive sweating, tremor, fever

Withdrawal syndrome: dizzy, headache, nausea, sensory disturbances, tremor, anxiety, dysphoria

Neonatal affect from use in pregnancy
- Neonatal abstinence syndrome: irritability, abnormal crying, tremor, respiratory distress, seizures
- persistent pulmonary hypertension of the newborn

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16
Q

Sertraline implications

A
  • therapeutic effects seen in 10-20 days
  • wean off slowly
  • take with food
  • monitor for hyponatremia
  • report serotonin syndrome
  • MAOIs increase risk of serotonin syndrome
17
Q

Duloxetine class

A

SNRI

18
Q

Duloxetine MOA

A

inhibits serotonin and norepinephrine uptake

19
Q

Duloxetine use

A

depression

20
Q

Duloxetine adverse effects

A

dry mouth, constipation, blurry vision, nausea, insomnia, somnolence, fatigue, diaphoresis, headache, anorexia

21
Q

Duloxetine implications

A
  • risk of SS with MAOI use
  • wean
  • 2-4 weeks for therapeutic effects
22
Q

Amitriptyline class

A

tricyclic antidepressant

23
Q

Amitriptyline MOA

A

blocks reuptake of norepinephrine and serotonin

24
Q

Amitriptyline use

A

depression, bipolar, fibromyalgia, neuropathic pain

25
Q

Amitriptyline adverse effects

A

orthostatic hypotension, anticholinergic effects, sedation, seizures, cardiac toxicity, hypomania, confusion in elderly, suicide risk

26
Q

Amitriptyline implications

A
  • 1-3 weeks for results
  • take at bedtime
  • black box warning
  • need ECG prior to starting drug
27
Q

Selegiline Class

A

MAOI

28
Q

Selegiline MOA

A

block MAO-A in brain, increasing norepinephrine and serotonin

29
Q

Selegiline Use

A

depression, bulimia nervosa, agoraphobia, ADHD, OCD

30
Q

Selegiline adverse effects

A

CNS stimulation, orthostatic hypotension, hypertensive crisis (most dangerous, from eating tyramine)

31
Q

Selegiline implications

A
  • not first choice because danger
  • therapeutic effects 1-3 weeks
  • avoid foods containing tyramine (beer, wine, yeast extracts, cheese, fermented sausages, aged fish/meat, avocados, figs, bananas)
  • caution with caffeine and chocolate

Pharmacology (9 decks)

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