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Psychiatric Drugs > Psych meds > Flashcards

Psych meds Flashcards

1
Q

Fluoxetine

A

SSRI, anti-depressant, long half life

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2
Q

Sertraline

A

SSRI

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3
Q

Paroxetine

A

SSRI, more drug interactions: anti-cholinergic, more wt gain, short half life, usually mroe sedating

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4
Q

Fluvoxamine

A

SSRI: used for OCD. has more drug interactions, shrot half life

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5
Q

Citalopram

A

SSRI

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6
Q

Escitalopram

A

SSRI

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7
Q

SSRI’s

A

Indicated for Depression, Anxiety, Bulimia (fluoxetine), Premenstrual Dysphoric Disorder, off label for pre mature ejactulation, paraphilias, PDD/Autism

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8
Q

SSRI side effects

A

Sexual Dysfunction, GI and jittery syndrome= main
Sometimes emotional blunting, hyponatremia (SIDAH), Weight Gain
Serotonin Syndrome
SSRI w/drawl: flu like sx

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9
Q

Serotonin Syndrome

A

hyperreflexia, myoclonus, hyperthermia

watch with multiple serotenergic medications

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10
Q

Venlafaxine

A

(effexor); SNRI; need to monitor BP, higher risk of w/drawl

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11
Q

Duloxetine

A

(Cymbalta); cautin in liver diesease or alcoholics

FDA approved for diabetic neuropathy, chronic MSK pain, fibromyalgia

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12
Q

SSRI and agonist for 5HT-1A:

A

similar to SSRI with buspirone- indicated for MDD

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13
Q

Bupropion

A

NE, DA reuptake inhibition
MDD, smoking cessation, ADHD, no sexual side effects
Seizure risk, avoid in eating disorder, can make some more anxious (Dr Whitters saying: ‘energy, concentration and motivation’)
can get headache, tachycardia, insomnia

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14
Q

Mirtazapine

A

alpha 2 and 5HT2 antagonist–actions on serotonin and NE

use for depresssion (off label-sleep, appetite, stimulation, anxiety), low dose sedation, wt gain, dry mouth

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15
Q

Trazadone

A

blocks 5HT2 and alpha 1 receptors

primarily for sleep, risk of priapism, next-sleepiness and dry mouth, postural hypotension

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16
Q

Buspirone

A

5HT1A and D2 actions– anxiety and depression augmentation

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17
Q

TCA

A

inhibit NE and 5HT reuptake, inexpensive
can be lethal in overdose (arrhythmias!!, QTc)
some used in neuropathic pain, sleep, migraines, previously ADHD, nocturnal enuresis

18
Q

Tertirary Amine

A 
class of TCA; have active metabolites
imipramine, amytripyine, doxepin, clomipromine (OCD)
anticholinergic side effects: dry mouth, constipation, confustion,
orthostatic hypotension: anti-adrenergic
antihistaminic--sedation and wt gain assoc
19
Q

Secondary amines

A

TCA class; more NE
Nortriptyline–(amytriptyline metabolite)
Desipramine–metabolite of imipramine
usually better tolerated

20
Q

MAOIs

A

prevent NE, DA and 5HT breakdown
Phenelxine, Selegiline
Can have tyramine rxn–hypertensive crisis
serotenergic syndrome

21
Q

Typical (1st gen) Psychotics

A

(haloperidol + ‘azines’
block DA, increase cAMP
use for schizophrenia, acute mania, psychosis, tourettes
highly lipid soluble

22
Q

Atypical Psychotics

A

Dual mechanism: block DA receptors and block some serotonin receptors which may impart additional therapeutic benefits and reduce some ADR risk
–use in schizophrenia, bipolar, OCD, anxiety, depression, mania, tourette

23
Q

Adverse reactions to first generation psychotics

A

Extra pyramidal: Dystonic reaction andakathesia–more quickly (hours to days); tremor, parkinsonism, tardive dyskinesia (more long term),
Hyperprolactinemia
Neuroleptic Malignant Syndrome
side effects from blocking muscarinic receptors

24
Q

Clozapine:

A

atypical antipsychotic, probably most effective but also most side effects: agranulocytosis (weekly CBC!), seizure, anticholinergic,

25
Q

Atypical psychotic side effects

A

hyperphagia–causing wt gain, insulin resistance

26
Q

Olanzapine

A

atypical antipsychotic: more anticholinergic, higher metabolic effects–more weight gain

27
Q

Quetiapine

A

atypical antipsychotic: sedating, (not an indication!)

28
Q

Risperidone

A

atypical antipsychotic: higher DA blockade–may increase prolactin causing lactation and gynecomastia

29
Q

Ziprasidone

A

atypical antipsychotic: prolong QTc. relatively wt neutral, must take with food otherwise v. little absorbed

30
Q

Aripipazole

A

also D2 partial agonist, relatively wt neutral

31
Q

Paliperidone

A

(Invega) atypical antipsychotic, newer, metabolite of risperidone

32
Q

Some newer agents

A

Asenapine, Lurasidone, Iloperidone

33
Q

Lithium

A

indicated for bipolar mania, maintenance and depression
also indicated for MDD augmentation
need to check labs: TSH, Cr, BUN, Hcg prior in females,
blood level .8-1.2, steady state 4 days

34
Q

Lithium adverse reactions

A

Hypothyroidism, Kidney (diabetes insipidus, intersititial renal fibrosis), problem with pregnancy, also tremor

35
Q

Valproic Acid (depakote)

A

bipolar mania,
labs: LFTs, CBC, Hcg in female, want blood level >50
steady state 4-5 days
Adverse effects: transaminitis, hepatotoxicity

36
Q

Carbamazapine

A

indicated for mania,
labs: LFTs, CBC, Na, blood leve 8-12
adverse reactions: Hyponatremia

37
Q

Lamotrigine

A

bipolar depression, approved for maintenance but not mania

adverse: rash, Steven Johnson’s

38
Q

High potency 1st gen antipsychotics

A

Trifluoperazine, fluphenazine, haloperidol

High potency have more EPS, less histamine and anticholinergic side effects

39
Q

Low potency 1st gen anti psychotics

A

Chlorpromazine, Thioridazine

low potency have less EPS, more histminic/anticholinergic

40
Q

Neuroleptic malignant syndrome

A

rigidity, myoglobinuria, autonomic instability, hyperpyrexia, encephalopathy
treat with dantrolene, D2 agonists

Psychiatric Drugs (1 decks)

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