Psych Pharm EC

Question 1

Alcohol withdrawal treatment

Answer 1

Benzodiazepines

Question 2

Anxiety preferred treatment

Answer 2

SSRIs, SNRIs, Buspirone

Question 3

ADHD preferred treatment

Answer 3

Methylphenidate, amphetamines

Question 4

Bipolar disorder preferred drugs

Answer 4

Lithium
Valproic acid
Carbamazepine
Atypical antipsychotics

Question 5

Bulimia preferred drugs

Answer 5

SSRIs

Question 6

Depression preferred drugs

Answer 6

SSRIs
SNRIs
TCAs
Buspirone
Mirtazapine (esp. w/ insomnia)

Question 7

OCD preferred drugs

Answer 7

SSRI

Clomipramine

Question 8

Panic disorder preferred drugs

Answer 8

SSRIs
Venlafaxine
Benzodiazepines

Question 9

PTSD preferred drugs

Answer 9

SSRIs

Question 10

Schizophrenia preferred drugs

Answer 10

Antipsychotics

Question 11

Social phobias preferred drugs

Answer 11

SSRIs

Question 12

Tourette’s syndrome preferred drugs

Answer 12

Antipsychotics (esp. haloperidol, risperidone)

Question 13

Methylphenidate, Dextroamphetamine, Methamphetamine (MOA, Use)

Answer 13

CNS stimulants
Increase catecholamines at synaptic cleft, (NE and dopamine)

ADHD, narcolepsy, appetite control

Question 14

Haloperidol, Fluphenazine, Thioridazine, Chlorpromazine (MOA, Use, Tox)

Answer 14

Antipsychotics
Block D2 receptors (increase cAMP)

Schizophrenia (positive symptoms)
Psychosis
Acute mania
Tourette’s

Causes dyskinesias, galactorrhea, dry mouth, constipation, hypotension, and sedation

Question 15

Which antipsychotics are high potency? What kind of side effects do they primarily produce?

Answer 15

Trifluoperazine, Fluphenazine, and Haloperidol “Try to Fly High)

Neurologic side effects

Question 16

Which antipsychotics are low potency? What kind of side effects do they primarily produce?

Answer 16

Chlorpromazine, Thioridazine (Cheating Thieves and Low)

Anticholinergic, Antihistamine, and a-1 blockade effects

Question 17

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia,

Answer 17

Neuroleptic malignant syndrome

Treat w/ Dantrolene + Bromocriptine

Question 18

Stereotypic oral-facial movements as a result of long-term antipsychotic use.

Answer 18

Tardive dyskinesia

Often irreversible

Question 19

Antipsychotic causing corneal deposits

Answer 19

Chlorpromazine

Question 20

Antipsychotic causing retinal deposits

Answer 20

Thioridazine

Question 21

Olanzapine, Clozapine, Risperidone, Quetiapine, Aripiprazole, Ziprasidone (MOA, Use, Tox)

Answer 21

Atypical antipsychotics
5-HT2 and dopamine blockers

Schizophrenia (both positive and negative symptoms)
Bipolar disorder
OCD
Anxiety disorder
Depression
Mania
Tourette's 

Fewer extrapyramidal and anticholinergic side effects

Question 22

Atypical antipsychotics causing weight gain/diabetes

Answer 22

Olanzapine/Clozapine

Question 23

Atypical antipsychotic that may cause agranulocytosis and seizure

Answer 23

Clozapine

Question 24

Atypical antipsychotic that may prolong QT interval

Answer 24

Ziprasidone

Question 25

Lithium (Use, Tox)

Answer 25

Mood stabilizer for bipolar disorder Blocks relapse and acute manic events Also treats SIADH ``` Movement (tremor) Nephrogenic diabetes insipidus Hypothyroidism Pregnancy problems Teratogen (Ebstein anomaly) ```

Question 26

Buspirone (MOA, Use)

Answer 26

Stimulates 5-HT1a receptors Generalized anxiety disorder * does not cause sedation, addiction, or tolerance * takes 1-2 weeks to take effect * Does not interact with alcohol

Question 27

Fluoxetine, Paroxetine, Sertraline, Citalopram (MOA, Use, Tox)

Answer 27

SSRIs Depression, GAD, Panic disorder, OCD, Bulimia, Social phobia, PTSD GI distress, sexual dysfunction, Can cause Serotonin syndrome with any drug that increases serotonin

Question 28

Serotonin syndrome (Cause, Findings, Treatment)

Answer 28

Caused by combo of SSRI w/ MAO inhibitors, SNRIs, or TCAs Hyperthermia, Confusion, Myoclonus, CV collapse, Flushing, Diarrhea, Seizures Treatment: Cyproheptadine (5-HT2 receptor antagonist)

Question 29

Venlafaxine, Duloxetine (MOA, Use, Tox)

Answer 29

SNRIs (5-HT and NE) Depression GAD (Venlafaxine) Panic disorder (Venlafaxine) Diabetic peripheral neuropathy (Duloxetine) Increases BP, Stimulant effect, nausea

Question 30

Amitriptyline, Nortriptyline, Imipramine, Desipramine, Clomipramine, Doxepin, Amoxapine (MOA, Use, Tox)

Answer 30

TCAs (block NE and serotonin reuptake) Major depression Bedwetting (Imipramine) OCD (Clomipramine) Fibromyalgia Sedation, a-1 blocking effects, anticholinergic effects, CONVULSIONS, COMA, CARDIOTOXICITY

Question 31

Treatment for TCA induced cardio toxicity

Answer 31

NaHCO3

Question 32

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (MOA, Use, Tox, Contraindications)

Answer 32

Selective MAO-B inhibitors (MOA Takes Pride In Shanghai) Increase NE, Serotonin, Dopamine Atypical depression Anxiety Hypochondriasis ``` Hypertensive crisis (esp. w/ tyramine food ingestion) CNS stimulation ``` CONTRAINDICATED W/ SSRIs, TCAs, St. John's Wort, MEPERIDINE, & DEXTROMETHORPHAN (to prevent serotonin syndrome)

Question 33

Bupropion (MOA, Use, Tox)

Answer 33

Atypical antidepressant Increase NE and Dopamine (unknown MOA) Depression Smoking cessation Stimulant effects, headache, seizure in bulimic NO SEXUAL SIDE EFFECTS

Question 34

Mirtazapine (MOA, Use, Tox)

Answer 34

Atypical antidepressant alpha-2 antagonist (increase NE/5HT release) Depression (w/ insomnia, elderly, anorexic) Sedation (used in insomnia), Increase appetite/weight gain (desirable in elderly and anorexic), Dry mouth

Question 35

Maprotiline (MOA, Use, Tox)

Answer 35

Atypical antidepressant Blocks NE reuptake Depression Sedation, Orthostatic hypotension

Question 36

Trazodone (MOA, Use, Tox)

Answer 36

Atypical antidepressant Inhibits 5-HT reuptake Insomnia (primary use) Depression (high doses) Sedation, Nausea, PRIAPISM, Postural hypotension