Psych Pharm Flashcards
4 psychoactive depressant drugs
EtOH, Opiodes, Barbiturates, Benzodiazepines
pt is emotional, slurs, ataxia, then coma. high serum GGT (gamma-glutamyl transferase). AST 2x the ALT.
Alcohol intoxication
pt with anxiety, tremors, seizures. when severe has autonomic hyperactivity, and DTs.
Alcohol withdrawal
Tx for DTs
Benzodiazepines
pt with euphoria, CNS and resp depression, decreased gag reflex, miosis, seizures (OD)
Opioid intoxication
opiod intoxication tx
Naltrexone or Naloxone
pt with sweating, mydriasis, piloerection, fever, rhinorhea, yawning, nausea, stomach cramps, diarrhea.
Opioid withdrawal
opioid withdrawal tx
long-term support, methadone, buprenorphine
pt with delirium and life threatening CV collapse
Barbiturate withdrawal
pt with severe respiratory depression, attending concerned bc of the narrow therapeutic window associated.
barbiturate intoxication
Pt with ataxia and minor respiratory depression. greater safety margin than barbs
benzodiazepine intoxication
competitive benzodiasepine antagonist
flumazenil
pt with sleep disturbance, depression, rebound anxiety and in severe cases, seizure.
benzodiazepine withdrawal.
acute barb intoxication management.
symptome management; assist resp and increase BP
psychoactive stimulants
amphetamines, cocaine, caffeine, nicotine
Pt with mydriasis, anorexia, paranoia, HTN, tachycardia, cardiac arrest or seizures.
amphetamine intoxication
Pt with increased diuresis, restlessness, twitching
caffeine tox
impaired judgement, mydriasis, tactile hallucinations (others), paranoia, sudden cardiac death
cocaine tox
Cocaine tox tx
benzodiazepines
pt with anhedonia, increased appetite, hypersomnolence, and existential crisis.
amphetamine withdrawal
pt with hypersomnolence, malaise, psychological craving, depression and suicidality.
cocaine withdrawal
pt with lack of concentration and headache
caffeine withdrawal
pt with irritability, anxiety, and craving.
nicotine withdrawal
treatment for nicotine withdrawal
bupropion/varenicline
hallucinogens
PCP, LSD, Cannabis
pt with belligerence, psycho, analgesia, vert and horiz nystagmus, homicidal, tachycardia, seizures
PCP
PCP tox tx
benzodiazepines, rapid acting anti-psychotics
pt with anergia, depression, anxiety, thought and sleep disturbance.
PCP withdrawal
pt with perceptual distortion, depersonalization, anxiety, paranoia, psychosis, flashbacks.
LSD
antiemetic in chemotherapy and stimulates apetite in AIDS.
dronabinol (cannabis)
paranoid delusions, dry mouth, and conjunctival injections.
cannabis
long acting oral opiate, heroin detox and long-term maintenance
methadone
heroine withdrawal treatment with abuse potential
oral naloxone with buprenorphin
wernicke triad
confusion, ophthalmoplegia, and ataxia
irreversible memory loss, confabulation, and personality change.
korsakoff
Mallory-weiss syndrome
longitudinal lacerations of esophagus, vomiting associated with alcoholism
painful esophageal bleeding
mallory weiss as opposed to esopha varices
DTs
2-5 days after last drink. ANS hyperactivity, hallucinations, confusion
DT Tx
benzodiazepine
induces vomiting from alcoholic byproduct buildup
disulfiram
AnxietyTx
SSRIs, SNRIs, buspirone
ADHD tx
methylphenidate, and amphetamines
bipolar Tx
mood stabilizers: lithium, valproic acid, carbamazapine. and atypicals
bulimia tx
SSRIs
depression tx
SSRI, SNRI, TCA, buspirone, mirtazapine
depression with insomnia tx
mirtazapine
OCD tx
SSRIs, clomipramine
panic disorder tx
SSRIs, venlafaxine, benzodiazepines
PTSD Tx
SSRI
schizophrenia
antipsychotics
social phobias tx
SSRIs
Tourrette’s Syndrome Tx
antipsychotics - haldol, risperidone
3 CNS stimulants
Methylphenidate, dextroamphetamine, methamphetamine
MOA of CNS stimulants and use
increase synaptic catecholamines - ADHD, narcolepsy, appetite control
neuroleptics (antipsychotics) 5
haloperidol + -azines (trifluoperazine, fluphenazine, thioridazine, chlorpromazine)
MOA of typical neuroleptics
block D2 receptors; increase cAMP
Try to Fly High
in ref to high potency neuroleptics: trifluoperazine, fluphenazine, and haloperidol
Cheating Thieves are Low
ref to low potency neuroleptics: Chlorpromazine and Thiaridazine
side effects of high potency neuroleptics
extrapyramidal - tardive dyskinesia
side effects of low potency neuroleptics
non-neurologic - alpha1 blockade, anticholinergic and antihistamine
neuroleptic that leaves corneal deposits
chlorpromazine
neuroleptic that leaves retinal deposits
thioridazine
EPS evolution of effects with neuroleptics
4hr, days, wks, mos. acute dystonia, akathisia, bradykinesia, tardive dyskinesia.
It’s atypical for OLd CLOSets to QUIETly RISPER from A to Z.
Olanzapine, Clozapine, Quetiapine, Risperidone, aripiprazole, ziprasidone
Tx of possitive and negative symptoms of schizophrenia
atypical antipsychotics
clinical use of atypical antipsychotics
schizo, bipolar, OCD, anxiety, depression, mania, tourettes
atypicals associated with weight gain
olanzapine and clozapine
requires weekly WBC monitoring
clozapine - due to agranulocytosis and seizure
