Psych Meds Flashcards
Mood Stablizers
- Lithium (1st line)
- Divalproex (Depakote)
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
Lithium SEs
- Hypothyroidism**
- Increased urination & thirst
- DI
**narrow therapeutic index = toxicity!
Lamotrigine (Lamictal) SEs
-rash, SJS
Lamotrigine Black Box Warning
Do NOT use in <16 yo
“Typical” 1st Generation Antipsychotics
- Butyrophenones
- Phenothiazines
Butyrophenone Medications
- “Typical” 1st Generation Antipsychotics
- Haloperidol (Haldol)
- Droperidol
Phenothiazine Medications
- “Typical” 1st Generation Antipsychotics
- Chlorpromazine (Thorazine)
- Fluphenazine
- Promethazine (Phenergan)
“Typical” 1st Generation Antipsychotics MOA
Blocks CNS dopamine receptors (dopamine antagonists)
“Typical” 1st Generation Antipsychotics SEs
-EPS sx: rigidity, tremor, akathisia (restlessness)
What class of antipsychotics has a greater risk of EPS?
“Typical” 1st Generation Antipsychotics
Haloperidol**, Chlorpromazine, Fluphenazine, Promethazine
Dystonic Reaction (Dyskinesia)
- EPS syndrome
- Hours-days after initiation of “Typical” 1st Generation Antipsychotics
Dystonic Reaction (Dyskinesia) Symptoms
- Tongue protrusion
- Facial grimacing
- Torticollis
- Difficulty speaking
Treatment of Dystonic Reaction (Dyskinesia)
-IV Diphenhydramine OR anticholinergic agent (Benztropine)
Tardive Dyskinesia
- EPS syndrome
- Seen with LONG-TERM use
Tardive Dyskinesia Symptoms
- Lip smacking
- Teeth grinding
- Rolling of tongue
Chlorpromazine (Thorazine) PEARLS
- anticholinergic - DRY MOUTH
- **causes sedation!
- Used mostly as antiemetic
“Atypical” 2nd Generation Antipsychotics
- Clozapine (Clozaril)
- Quetiapine (Seroquel)
- Olanzapine (Zyprexa)
- Risperidone(Risperdal)
- Ariraprazole (Abilify)
“Atypical” 2nd Generation Antipsychotics MOA
Blocks CNS dopamine receptors (dopamine antagonists) AND serotonin (5HT2) receptors
“Atypical” 2nd Generation Antipsychotics Indication
1st line for psychotic D/O’s!
Clozapine (Clozaril) Caution
- *Agranulocytosis! = monitor CBC weekly
- weight gain
- *Only used in pts resistant to other psych meds!
Olanzapine (Zyprexa) SEs
**DM & weight gain!
Risperidone (Risperdal) SEs
**increased prolactin!
Serotonin Syndrome
- SSRI used in combo with MAOI (wash out period)
- restlessness, agitation, diaphoresis, tremor, N/V, mydriasis (dilation)
Neuroleptic Malignant Syndrome
- a/w 1st gen antipsychotics
- d/t dopamine inhibition
- EXTREME MUSCLE RIGIDITY, tremor, tachy, fever*
- MC after dose increase
