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Psych Pharm Flashcards

1
Q

medication category for:

first generation- haloperidol

second generation- risperidone

A

antipsychotics

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2
Q

medication category for:

MAOIs

tricyclics, tetracyclics

SRIs or SRAs

SSRIs, SNRIs

atypical’s or NDRI’s

5HT1a agonist/5HT3 antagonist

SSRI/5HT1a partial agonist

A

antidepressants

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3
Q

medication category for:

lithium

anti-seizure drug- valproate

anxiolytics-antihistamine, anti-hypertensive, benzodiazepine

A

mood stabilizers

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4
Q

medication category for:

zolpidem

ramelteon

temazepam

suvorexant

ADHD meds

A

hypnotics

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5
Q

can neural circuits “learn” over time?

A

yes

over-stimulated circuits become dysregulated

  • circuit activity breaks down resulting in dysfunction
  • circuit dysfunciton is seen as symptoms
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6
Q

stimulate receptors

A

agonist

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7
Q

stimulate with ceiling & occupy receptor (which precludes other NT’s from attaching)

A

partial agonists

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8
Q

block agonist from receptor

A

antagonist

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9
Q

blocks agonists at receptor & reduce activity below baseline constitute activity

A

inverse agonist

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10
Q

psychiatric symptoms related to _______ _______

A

related to neural circuits

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11
Q

circuit contains ________ and ________

A

neurotransmitters and receptors

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12
Q

_______ activity drives symptoms

A

receptor

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13
Q

modulate receptor activity with ______

A

drugs

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14
Q

excess stimulation of the portions of the CNS that control motor function that are outside of the pyramidal tract

group of syndromes w/ signs of abnormal motor movement result from D2 antagonism (bradykinesia, incoordination, spasms)

A

extrapyramidal syndrome (EPS)

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15
Q

“late appearing dyskinesias”

a form of EPS

primarily orofacial dyskinesia

D2 receptor blockade

may be permanent

A

tardive dyskinesia

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16
Q

excess level of 5HT producing akithesia, muscle twitching, hyper-reflexia, penile erection, seizures, coma

A

serotonin syndrome

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17
Q

excess antagonism of D2 receptor producing muscle rigidity, fever, unstable BP, myoglobinemia

may be fatal

an extreme manifestation

A
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18
Q

genetically determined hypersensitivity to anesthetic agents resulting in severe hyperthermia, accelerated muscle metabolism, metabolic acidosis

A

malignant hypertension

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19
Q

syndrome including:

at a minimum, hallucinations, delusions

frequently also disorganized speech and behavior, gross distortions of reality testing

A

psychosis

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20
Q

drug class for haloperidol

A

first generation antipsychotic

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21
Q

indications for haloperidol

A

psychotic symptoms

(defining & associative symptoms)

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22
Q

MoA for haloperidol

A

D2 antagonist

inhibits alpha1, but not M1, H1

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23
Q

drug class for risperidone

A

SGA

atypical antipsychotic

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24
Q

indications for risperidone

A

psychosis (positive & negative symptoms)

mania

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25
Q

MoA for risperidone

A

5HT and DA antagonist

mild alpha1, alpha2, H1 antagonism

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26
Q

drug class for quetiapine

A

SGA

atypical antipsychotic

D2 & 5HT antagonist

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27
Q

indications for quetiapine

A

bipolar disorder

schizophrenia

adjunct in MDD

off-label: GAD, OCD, PTSD

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28
Q

MoA for quetiapine

A

D2 and 5HT2 antagonism

high affinity for M1 muscarinic receptors

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29
Q

drug class for lurasidone

A

SGA

atypical antipsychotic

D2, 5HT2, 5HT7 antagonist

5HT1a partial agonist

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30
Q

indications for lurasidone

A

schizophrenia

bipolar 1 disorder

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31
Q

MoA for lurasidone

A

D2, 5HT2, 5HT7 antagonist

5HT1 partial agonist

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32
Q

drug class for ziprasidone

A

SGA

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33
Q

indications for ziprasidone

A

bipolar disorder

schizophrenia

acute agitation in schizophrenia

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34
Q

MoA for ziprasidone

A

D2, 5HT2a, 5HT1d antagonist

5HT1a agonist

moderate 5HT and NE reuptake inhibition

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35
Q

what do we want to rule out before treating what looks like depression?

A

mania

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36
Q

what is the black box warning for all young adults for all antidepressants?

A

suicide risk

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37
Q

treatment goals:

what is the success rate w/ antidepressants?

A

60-80%

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38
Q

after starting antidepressants, how long does it take to see improvements in emotions?

A

2-4 weeks

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39
Q

how long does it take to see the full impact of antidepressants?

A

6-8 weeks

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40
Q

drug class for phenelzine

A

monoamine oxidase inhibitor (MAOI)

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41
Q

indications for phenelzine

A

depression refractory to other Rx, ECT

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42
Q

MoA for phenelzine

A

inhibition of MAO producing increased NE, DA, 5HT

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43
Q

drug class for nortriptyline

A

tricyclic antidepressant

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44
Q

indications for nortriptyline

A

depressive disorders

off-label: chronic pain, anxiety, enuresis, ADHD

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45
Q

MoA for nortriptyline

A

inhibit SERT, NET

block 5HT2A receptors

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46
Q

drug class for mirtazapine

A

tetracyclic

alpha2 antagonist

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47
Q

indications for mirtazapine

A

depression

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48
Q

MoA for mirtazapine

A

antagonism of alpha2 receptors dishibits 5HT, NE release;

blocks NE negative feedback inhibits of NE, 5HT release

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49
Q

drug class for trazadone

A

SARIs

5HT2A, 5HT2C antagonist & reuptake inhibitors

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50
Q

indications for trazadone

A

MDD

insomnia (lower doses)

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51
Q

MoA for trazadone

A

antagonist of 5HT2A, 5HTC and inhibits reuptake serotonin via SERT, reduces number of 5HT receptors & increasing 5HT flow in neuron

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52
Q

drug class for fluoxetine

A

selective serotonin reuptake inhibitor (SSRI)

53
Q

indications for fluoxetine

A

MDD

dysphoric disorder

anxiety

eating disorders

OCD

54
Q

MoA for fluoxetine

A

inhibit reuptake serotonin via SERT reducint number 5HT receptors & increasing 5HT flow in neuron;

mild NRI, DRI, 5HT2C inhibition, CYP2D6 & 3A4 inhibition

55
Q

drug class for sertraline

A

SSRI antidepressant

56
Q

indications for sertraline

A

MDD
PMDD

PD

PTSD

social anxiety disorder

OCD

57
Q

MoA for sertraline

A

selectively inhibits SERT & increases 5HT level in synapse

58
Q

drug class for citalopram

A

SSRI antidepressant

59
Q

indications for citalopram

A

depression

60
Q

MoA for citalopram

A

selectively inhibits SERT & mild antihistamine (H1) activity

61
Q

drug class for venlafaxine

A

serotonin & NE reuptake inhibitors (SNERIs)

62
Q

indications for venlafaxine

A

MDD
GAD

SAD

panic disorder

off-label: pain, OCD, hot flashes

63
Q

MoA for venlafaxine

A

inhibits SERT at lower doses, NET at high doses

64
Q

drug class for duloxetine

A

SNERI antidepressant

65
Q

indications for duloxetine

A

MDD

DPNP

fibromyalgia

GAD

chronic MSK pain

66
Q

MoA for duloxetine

A

elevates levels of 5HT, NE, and DA

elevates DA levels in PFC

67
Q

drug class for buproprion

A

NE, DA reuptake transporter inhibitors (NDRIs)

68
Q

indications for buproprion

A

depression

smoking cessation

69
Q

MoA for buproprion

A

NE, DA reuptake inhibition

70
Q

drug class for vortioxetine

71
Q

indications for vortioxetine

72
Q

MoA for vortioxetine

A

inhibits SERT, partial agonist at 5HT1a and 5HT3 antagonist

73
Q

drug class for vilazodone

A

SPARI (serotonin partial agonist reuptake inhibitor)

74
Q

indications for vilazodone

75
Q

MoA for vilazodone

A

inhibits SERT with elevatio of 5HT levels & has 5HT1a partial agonist activity

76
Q

drug class for lithium

A

mood stabilizer

77
Q

indications for lithium

A

bipolar disorder

mania

78
Q

possible SE/ADR of lithium

A

diabetes insipidus

79
Q

drug class for valproate

A

anti-seizure med

mood stabilizer

80
Q

indications for valproate

A

seizure disorder

mania

aggression

81
Q

MoA for valproate

A

increase GABA concentration

82
Q

drug class for hydroxyzine

A

antihistamine (H1)

anxiolytic

83
Q

indications for hydroxyzine

A

anxiety, pruritis, sedation

84
Q

MoA for hydroxyzine

A

inhibits H1 receptors

85
Q

drug class for propanolol

A

beta blocker

anxiolytic

86
Q

indications for propanolol

A

HTN

anxiety

tremor

hyperthyroidism

87
Q

MoA for propanolol

A

nonselective beta blocker

88
Q

drug class for diazepam

A

benzodiazepine anxiolytic

89
Q

indications for diazepam

A

bridge therapy in anxiety disorders

sedative, status epilepticus, alcohol withdrawal

90
Q

MoA for diazepam

A

binds to & stabilizes BZD receptor on post-synaptic GABA neuron in limbic system & reticular formation enhancing GABA impact

91
Q

drug class for oxazepam

A

benzodiazepine anxiolytic

92
Q

indications for oxazepam

A

bridge therapy in anxiety disorders

sedative, alcohol withdrawal

93
Q

MoA for oxazepam

A

binds to & stabilizes BZD receptor on post-synaptic GABA neuron in limbic system & reticular formation enhancing GABA

94
Q

drug class for buspirone

A

miscellaneous anxiolytic

95
Q

indications for buspirone

96
Q

MoA for buspirone

A

5HT1A partial agonist modulates 5HT levels

97
Q

drug class for zolpidem

A

non-benzodiaepine hypnotic

98
Q

indications for zolpidem

A

short-term treatment insomnia

99
Q

MoA for zolpidem

A

selective agonist for alpha1 subunit of BZD receptor of GABA receptor complex -> increase GABA impact

100
Q

drug class for esopiclone

A

hypnotic, nonbenzodiazepine

101
Q

indications for esopiclone

102
Q

drug class for zaleplon

A

hypnotic

nonbenzodiazepine

103
Q

indications for zaleplon

A

short-term treatment insomnia

104
Q

drug class for ramelteon

A

hypnotic

miscellaneous

105
Q

indications for ramelteon

106
Q

drug class for temazepam

A

hypnotic

benzodiazepine

107
Q

indications for temazepam

A

short-term treatment of insomnia

108
Q

drug class for suvorexant

A

hypnotic

orexin receptor antagonist

109
Q

indications for suvorexant

110
Q

MoA for suvorexant

A

blockes wake-promoting orexin-A and orexin-B to receptors OX1R and OXR2 which suppresses wake drive

111
Q

what are the 2 ADHD meds?

A

methylphenidate

atomexetine

112
Q

drug class for methylphenidate

A

CNS stimulant

113
Q

indications for methylphenidate

A

symptomatic treatment of ADHD, narcolepsy

off-label: depression in terminally ill

114
Q

drug class for atomexetine

115
Q

indications for atomoxetine

116
Q

drug class for acamprosate

A

GABA agonist/glutamate antagonist

117
Q

indications for acamprosate

A

maintenance of alcohol abstinence

118
Q

drug class for disulfram

A

aldehyde dehydrogenase inhibitor

119
Q

indications for disulfram

A

maintenance of alcohol abuse

120
Q

drug class for naltrexone

A

opioid antagonist

121
Q

indications for naltrexone

A

maintenance of alcohol or opioid absitnence

off-label: cholestatic pruritis

122
Q

drug class for methadone

A

opioid analgesic

123
Q

indications for methadone

A

low doses- analgesia

treatment of opioid addiction

124
Q

drug class for buprenorphine

A

opioid partial agonist

125
Q

indications for buprenorphine

A

analgesia

opioid withdrawal

dependence

126
Q

drug class for naloxone

A

opioid antagonist

127
Q

indications for naloxone

A

opioid overdose

128
Q

drug class for buprenorphine & naloxone

A

opioid partial agonist & opioid antagonist

129
Q

indications for buprenorphine & naloxone

A

maintenance herapy for opioid dependence

*not for induction of abstinence

Psych: SD & Pharm (5 decks)

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