Psych Pharm

Question 1

Name 4 antipsychotics (neuroleptics).

Answer 1

thioridazine, haloperidol, fluphenazine, chlorpromazine

Question 2

What is the MOS of antipsychotics?

Answer 2

block dopamine D2 receptors

Question 3

Drug class used to treat excess dopamine connected with schizophrenia?

Answer 3

antipsychotics

Question 4

Adverse effects of antipsychotics?

Answer 4

extrapyramidal symptoms, gynacomastia, dry mouth, constipation, hypotension, sedation. Important: neuroleptic malignant syndrome and tardive dyskinesia!

Question 5

Symptoms of neuroleptic malignant syndrome?

Answer 5

rigidity, myoglobinuria, autonomic instability, hyperpyrexia

Question 6

How do you treat neuroleptic malignant syndrom?

Answer 6

dantrolene and dopamine agonists

Question 7

What are EPS side effects?

Answer 7

acute dystonia, akinesia, akathisia, tardive dyskinesia (often irreversible)

Question 8

Name 3 atypical antipsychotics.

Answer 8

clozapine, olanzapine, riserperidone

Question 9

MOA of clozapine?

Answer 9

blocks 5-HT2 and dopamine receptors

Question 10

Clinical use of olanzapine?

Answer 10

schizo positive and neg. symptoms, OCD, anxiety disorder, depression, mania, tourettes

Question 11

Side effects of atypical antipsychotics?

Answer 11

fewer EPS and fewer anticholinergic side effects than typical antipsychotics. Clozapine may cause agranulocytosis.

Question 12

Clinical use of lithium?

Answer 12

mood stabilizer for bipolar affective disorder; blocks relapse and acute mania events

Question 13

Side effects of lithium?

Answer 13

tremor, hypothyroidism, nephrogenic diabetes insipidus, teratogenesis. Narrow therapeautic window!!

Question 14

Buspirone MOA?

Answer 14

stimulates 5-HT1a receptors

Question 15

Buspirone clinical use?

Answer 15

generalized anxiety disorder

Question 16

Name the 4 main classes of antidepressants.

Answer 16

SSRIs, TCAs, Heterocyclic antidepressants, MAOIs

Question 17

Name 4 SSRIs.

Answer 17

fluoxetine, sertraline, paroxetine, citalopram

Question 18

Toxicity of SSRIs?

Answer 18

fewer side effects than TCAs. GI distress, sexual dysfunction, serotonin syndrome” if used with MAOIs (= hyperthermia, muscle rigidity, CV collapse)”

Question 19

Do antidepressants work immediately?

Answer 19

No, usually takes 2-3 weeks

Question 20

What drug class do the following belong to: imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin?

Answer 20

TCAs

Question 21

How do TCAs work?

Answer 21

block reuptake of NE and serotonin

Question 22

Which TCAs have more anticholinergic side effects?

Answer 22

tertiary TCAs (amitriptyline) have more than secondary TCAs (nortriptyline)

Question 23

What are the major toxixities associated with TCAs?

Answer 23

Tri-C’s” = Convulsions, Coma, Cardiotoxicity (arrhythmias). Also resp. depression and hyperpyrexia (extremely high fever)”

Question 24

Name the 5 heterocyclic antidepressants.

Answer 24

Bupropion, Venlafaxine, Mirtazapine, Maprotiline, Trazodone

Question 25

Which antidepressant is also used for smoking cessation?

Answer 25

Bupropion

Question 26

MOA of Venlafaxine?

Answer 26

inhibits serotonin, NE, and dopamine reuptake

Question 27

MOA of Mirtazapine?

Answer 27

alpha-2 antagonist (increases release of NE and serotonin), 5-HTs and 5-HT3 receptor antagonist

Question 28

MOA of Maprotiline?

Answer 28

blocks NE reuptake

Question 29

MOA of trazodone?

Answer 29

inhibits serotonin reuptake

Question 30

Name 2 MAOIs

Answer 30

phenelzine, tranylcypromine

Question 31

Clinical use of MAOIs?

Answer 31

atypical depression with psychotic or phobic features, anxiety, hypochondriasis

Question 32

Important toxicity of MAOIs?

Answer 32

Hypertensive crisis with tyramine ingestion (red wine, cheese, fava beans) and meperidine.