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Behavioral Medicine EOR > psych pharm > Flashcards

psych pharm Flashcards

1
Q

chlorpromazine

A

1st gen APS

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2
Q

fluphenazine

A

1st gen APS

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3
Q

haloperidol

A

1st gen APS

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4
Q

perphenazine

A

1st gen APS

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5
Q

1st gen APS MOA

A

D2 antag

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6
Q

1st gen APS SE

A

EPS, NMS, tardive dyskinesia

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7
Q

EPS

A

dystonia
oarkinsonism
akathesia

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8
Q

tx for EPS

A

anticholinergics (benztropine, diphenhydramine), benzos/betablockers

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9
Q

Tx for tardive dyskinesia

A

d/c meds

benzoa, botox, vit E

mvts may persist even with removal of the drug

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10
Q

NMS

A

change in mental status, fever, labile BP, lead pipe rigidity, elevated CPK

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11
Q

aripiprazole

A

2nd gen APS

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12
Q

asenapine

A

2nd gen APS

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13
Q

clozapine

A

2nd gen APS

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14
Q

iloperidone

A

2nd gen APS

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15
Q

lurasidone

A

2nd gen APS

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16
Q

olanzapine

A

2nd gen APS

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17
Q

quetiapine

A

2nd gen APS

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18
Q

risperidone

A

2nd gen APS

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19
Q

ziprasidone

A

2nd gen APS

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20
Q

2nd gen APS MOA

A

antag 5HT2 and D4>D2

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21
Q

SE of 2nd gen APS

A

metabolic syndrome

agranulocytosis with clozapine

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22
Q

metabolic syndrome

A

inc BP, inc blood sugar levels, excess body fat around the waist, abnormal cholesterol levels, inc risk for CV, stroke and type II diabetes

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23
Q

serotonin syndrome

A

autonomic instability, diaphoresis, , tachycardia, fever, hyperreflexia, seizures, coma, death

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24
Q

what 2 drugs combined are high risk for serotonin syndrome

A

SSRI and MAOI

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25
Q

What meds cause HAM SE?

A

TCAs and low potency APS

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26
Q

What meds cause HTN crisis?

A

MAOI with tyramine rich foods

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27
Q

Blockage of what tract is crucial to the efficacy of APS and why?

A

mesolimbic tract bc excessive dopamine transmission in this area causes pos sx of schizophrenia

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28
Q

APS blockage of dopamine in what tract causes cognitive dysfunction

A

mesocortical tract

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29
Q

APS blockage of dopamine in what tract causes hyperprolactinemia

A

tuberoinfundibular tract

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30
Q

APS blockage of dopamine in what tract causes EPS

A

nigrostriatal tract

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31
Q

Antagonism of histamine 1

A

sedation and weight gain

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32
Q

Muscarinic receptor blockade

A

blurred vision, dry mouth, urinary retention, constipation, and decreased cognition

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33
Q

Inhibition of alpha-1 adrenergic receptors

A

sedation, orthostatic hypotension, and reflex tachycardia

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34
Q

What meds have HAM SE?

A

TCA and low potency APS

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35
Q

What APS cause hyperprolactinemia

A

typicals and risperidone

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36
Q

Paroxetine

A

SSRI- short HL causing withdrawal sx

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37
Q

Fluvoxamine

A

SSRI- only approved for OCD

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38
Q

Fluoxetine

A

SSRI- longest HL, safe in children and in pregnancy

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39
Q

Sertraline

A

SSRI- higher risk for GI disturbances

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40
Q

venlafaxine

A

SNRI

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41
Q

duloxetine

A

SNRI

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42
Q

Mirtazpine

A

alpha 2 adrenergic antagonist- good for depression in elderly with insomnia and anorexia

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43
Q

Tx for TCA overdose

A

IV sodium bicarbonate

44
Q

Amitriptyline

A

TCA- good for chronic pain and insomnia

45
Q

Imipramine

A

TCA- good for enuresis and panic d/o

46
Q

Clomipramine

A

TCA- good for OCD

47
Q

Doxepine

A

TCA

48
Q

Nortriotyline

A

TCA

49
Q

Desipramine

A

TCA

50
Q

TCA SE

A

HAM- sedation, wt gin, CV SE, dry mouth, seizures, lethal in OD

51
Q

Phenelzine

A

MAOI

52
Q

Tranylcypromine

A

MAOI

53
Q

Isocarboxazid

A

MAOI

54
Q

Selegiline

A

MAOI

55
Q

Chlorpromazine

A

1st gen APS

deposits in lens and cornea, blue-gray skin discoloration

56
Q

thioridazine

A

1st gen APS

associated with retinitis pigmentosa

57
Q

thiothixene

A

mid potency 1st gen APS

58
Q

loxapine

A

mid potency 1st gen APS

59
Q

molindone

A

mid potency 1st gen APS

60
Q

perphenazine

A

mid potency 1st gen APS

61
Q

fluphenazine

A

high potency 1st gen APS

62
Q

pimozide

A

high potency 1st gen APS

63
Q

tx for akathesia SE

A

beta blockers or benzos

64
Q

Tx of EPS SE

A

benztropine or diphenhydramine

sometimes amantadine

65
Q

Onset of NMS SE

A

usually early but can be anytime

66
Q

Onset of acute dystonia

A

hrs to days

67
Q

Onset of parkinsonism/akathesia

A

days to weeks

68
Q

onset of TD

A

6 months to years

69
Q

clozapine

A

2nd gen APS
agranulocytosis- stop if ANC < 1500
ONLY APS shown to dec risk of suicide

70
Q

risperidone

A

2nd gen APS

increased prolactin

71
Q

quetiapine

A

2nd gen APS

72
Q

olanzapine

A

2nd gen APS

weight gain and sedation

73
Q

ziprasidone

A

2nd gen APS

QTc prolongation, must be taken with food at least 300 cal

74
Q

aripiprazole

A

2nd gen APS

less potential for weight gain

75
Q

What is the only mood stabilizer shown to decrease suicidality

A

lithium

76
Q

SE of APS

A

metabolic syndrome- monitor with baseline weight, BP, fasting glucose and fasting lipids
weight gain, hyperlipidemia and hyperglycemia
some anti-HAM effects
elevated LFTs
QTc prolongation

77
Q

What should you monitor with lithium

A

lithium levels, creatine and thyroid function tests

78
Q

SE of lithium

A

tremor, nephrogenic diabetes insipidus, GI disturbance, weight gain, sedation, thyroid enlargement, hypothyroidism, ecg changes, benign leukocytosis, Ebsteins anolomy in babies of mothers taking lithium

79
Q

Carbamazepine class and SE

A

anticonvulsant/mood stabilizer

SE- GI and CNS, can cause SJS, agranulocytosis and teratogenic

80
Q

valproic acid

A

anticonvulsant/mood stabilizer

must monitor LFT and CBC, CI in pregnancy

81
Q

lamotrigine

A

anticonvulsant/mood stabilizer

SE- dizziness, sedation, HA, SJS

82
Q

Gabapentin

A

anticonvulsant good for neuropathic pain, anziety and sleep

83
Q

preganalin

A

anticonvulsant food for GAD and fibromalagia

84
Q

Toprimate

A

anticonvulsant good for impulse control disorders with beneficial SE of weight loss

85
Q

SE of anticonvulsants

A

hepatotoxic and teratogenic, alopeica, GI sx, pancreatitis

86
Q

What benzos are good for chronic alcoholics or liver dz pts

A

Lorazepam
Oxazepam
Temazepam

87
Q

How do BZD work

A

potentiate effects of GABA

88
Q

diazepam

A

BZD LA

detox from alc

89
Q

clonazepam

A

BZD LA
anxiety and panic attacks
avoid with renal fn pts

90
Q

alprazolam

A

BZD intermediate

anxiety/PA

91
Q

lorazepam

A

BZD intermediate

anxiety, alc detox

92
Q

oxazepam

A

BZD intermediate

alc detox

93
Q

temazepam

A

BZD intermediate

94
Q

triaozolam

A

BZD SA

incomnia tx

95
Q

midazolam

A

BZD SA

96
Q

BZA toxicity

A

respiratory depression esp when combined with alcohol

97
Q

zolpidem

A

non-BZD hypnotic

insomnia

98
Q

diohenhydramine and ramelteon

A

non-BZD hypnotic

99
Q

buspirone

A

non-BZD anxiolytics

used in combo with SSRI for GAD

100
Q

hydroxyzine

A

non-BZD anxiolytics

101
Q

propranolol

A

non-BZD anxiolytics good for performance anxiety

102
Q

atomoxetine

A

psychostimulant less abuse but less effective in ADHD

103
Q

modafinil

A

psychostimulant used in narcolepsy

104
Q

doneppezil

A

ach inhibitor used in mild to mod neurocog d/o

105
Q

galantamine

A

ach inhibitor used in mild to mod neurocog d/o

106
Q

rivastigmine

A

ach inhibitor used in mild to mod neurocog d/o

107
Q

memantine

A

NMDA receptor antag mod to severe neurocog d/o

Behavioral Medicine EOR (11 decks)

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