Psych: Psychiatric Drugs Flashcards by James Wren

Anxiolytic Benzodiazepine Drugs?

Benzodiazepines (“azepam” or “azolom”)
- Diazepam
- Lorazepam
- Midazolam
- Clonazepam

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What is the mechanism of action for Benzodiazepines?

Potentiate GABA_A– mediated inhibition

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What are the side effects of Benzodiazepines?

Ataxia
Dizziness
Somnolence
Fatigue
Memory difficulties

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Name the Anxiolytic Barbiturate drug?

Phenobarbital

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What is the mechanism of action of Phenobarbital?

Potentiate GABA_A – mediated inhibition

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What are the side effects of Phenobarbital?

Sedation
Ataxia
Confusion
Dizziness
Decreased Libido
Depression

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What class of drug is Buspirone
and what is the mechanism of action?

What class of drug is Buspirone
and what is the mechanism of action?

Anxiolytic
Serotonin 5-HT_1A receptor
Partial Agonist

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What are the side effects of Buspirone?

Dizziness
Confusion
Headache
Blurred vision
Nervousness

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What are the Typical Antipsychotics?

Try to Fly High (High potency)
- Trifluoperazine
- Fluphenazine
- Haloperidol (NMS, Tardive dyskinesia)
  - NMS - “FEVER!”
Cheating Thieves are Low (Low potency)
Cholarpromazine (Corneal deposits)
Thioridazine (reTinal deposits)

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What is the mechanism of action

for Typical Antipsychotics?

What is the mechanism of action

for Typical Antipsychotics?

Antagonize Dopamine D₂ receptors (↑ [cAMP])
Chlorpromazine
- Antagonize α-adrenergic
- Antagonize Cholinergic

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What are the side effects to Typical Antipsychotics?

Parkinsonian symptoms
Neuroleptic malignant syndrome
Tardive dyskinesia (involuntary, repetative, body movements)
Anticholinergic symptoms
Orthostatic HyoTN, Hyperprolactinemia (esp. w/ Halo.)
Weight gain

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What are some Atypical Antipsychotic drugs?

Its Atypical for Old Clozets to Quitetly Risper from A to Z
Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole (Dopamine system stabilizer)
Ziprasidone

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What is the mechanism of action

for Atypical Antipsychotics?

What is the mechanism of action

for Atypical Antipsychotics?

Antagonize Dopamine D₂ and Serotonin 5-HT₂ receptors
Clozapine and Olanzapine also antagonize Dopamine D₄receptors
Quetiapine / Ziprasidone also blocks H₁ Histamine
Aripiprazole is a D₂ and 5-HT₁ partial Agonist

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What are the side effects of Atypical Antipsychotics?

Mild extrapyramidal symptoms
- Tardive symptoms, Dystonia (cont. spasm), Akathesia (motor restlessness), Parkinsonism
Anticholinergic symptoms
- Flushing, Dry skin, Mydriasis (pupil dilation), Loss of Accomodation, Altered Mental Status (AMS), Fever
Sedation
Ziprasidone = Long QT
Weight gain (Olanzapine and Clozapine)
Agranulocytosis (Clozapine, req’s weekly monitoring)

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What are the SSRI drugs?

(Selective Serotonin Re-Uptake Inhibitors)

What are the SSRI drugs?

Sertraline
Paroxetine
Fluoxetine (can also be used for Bulimia Nervosa)
Citalopram
Escitalopram

(Selective Serotonin Re-Uptake Inhibitors)

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What is the mechanism of action of SSRIs?

Inhibit re-uptake of Serotonin –> Increase Synaptic Serotonin lvls
Takes 4-6 weeks before start to see the effect

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What are the side effects of SSRIs?

Serotonin syndrome (when used concomitantly with an MAOI, other SSRIs, or SNRIs, St. John’s Wart, Kava Kava, Tryptophan, Cocaine, Amphetamines)
Sexual dysfunction (loss of Labidio, Anorgasmia)
GI distress

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What is the clinical presentation of Serotonin syndrome?

Hyperthermia
Hyperreflexia
Myoclonus
Autonomic instability
Flushing
Diarrhea
Mental status change

How do you Tx Serotonin syndrome?

Cool the pt. down
Benzodiazepines
Cyproheptadine

What are the SNRI drugs?

(Serotonin-Norepinephrine Re-uptake Inhibitors)

What are the SNRI drugs?

Venlafaxine
Duloxetine (also used for Chronic Pain conditions, Neuropathic pain, Fibromyalgia)
Desvenlafaxine

(Serotonin-Norepinephrine Re-uptake Inhibitors)

What is the mechanism of action of SNRIs?

Inhibit Serotonin re-uptake at the Synapse
Inhibit Norepinephrine re-uptake at the Synapse

What are the side effects of SNRIs?

HTN
Sweating
Weight Loss
GI distress
Blurred vision
Sexual dysfunction
Neuroleptic malignant syndrome

What is the name of the Atypical Antidepressant drugs?

Bupropion (used for smoking cessation and anti-depressant)
Mirtazapine
Trazadone

What is the mechanism of action of Bupropion (NDRI)?

Weakly inhibit uptake of Serotonin
Inhibit re-uptake of Norepinephrine, and Dopamine

What are the side effects of Bupropion?

What are the side effects of Bupropion? * Tachyarrhythmia * Pruritus * Sweating * Rash * Dyspepsia * Constipation * Dizziness * Seizure risk (Bullimics - mal nutritioned) * BUT it does not cause Sexual dysfunction

What is the mechanism of action of Mirtazapine?

What is the mechanism of action of Mirtazapine? * NaSSA (Noradrenergic and Specific Seretonergic Antidepressant) * α-2 Antagonist * α-2 are on the presynaptic nerve terminals on Adrenergic neurons * Stimulate release of α-2, inhibits further Norepinephrine release * Inhibiting stimulation causes an increase in Norepinephrine

What are the side effects of Mirtazapine?

What are the side effects of Mirtazapine? * Sedation * Increased appetite * Weight gain * Dry mouth

What is the mechanism of action of Trazadone?

What is the mechanism of action of Trazadone? * Inhibits Serotonin re-uptake * Useful for Insomnia

What are the side effects of Trazadone?

What are the side effects of Trazadone? * Sedation * **Priapism** (persitant painful penile erection)

What are the TCA drugs?

What are the TCA drugs? * Amitriptyline (also used for Fibromyalgia and Neuropathic pain) --\> Nortriptyline * Imipramine (also used for Enuresis – bed wetting) --\> Desipramine * Clomipramine (also used for OCD) * Doxepin * Amoxapine

What is the mechanism of action for TCAs?

What is the mechanism of action for TCAs? * Inhibit Serotonin and Norepinephrine re-uptake

What are the side effects of TCAs?

What are the side effects of TCAs? * Heart Block * Bloating * Constipation * Xerostomia * Dizziness * Somnolence * Urinary retention

What is the Clinical presentation of TCA overdose?

What is the Clinical presentation of TCA overdose? * Convulsions * Coma * Cardiotoxicity * Respiratory depression * Hyperpyrexia (super high fever) * Confusion and Hallucination (Delirium) * Tx: Sodium Bicarbonate to excrete in Urine

What are the MAOI drugs?

What are the MAOI drugs? * "MAOi Takes Pride in Shang-hi" * Iproniazid * Moclobemide * Befloxatone * Brofaromine * Tranylcypromine * Phenelzine * Isocarboxazid * Selegiline (only breaks down MAO-B -\> increase in Dopamine -\> Tx: Parkinsonims)

What is the mechanism of action of MAOIs?

What is the mechanism of action of MAOIs? * Increase Serotonin and Norepinephrine LVLs in Presynaptic Neurons and Synapses by Inhibiting their breakdown of Mono-amine oxidase * MAO breaks down catecholamines (Seretonin, Norepinehprine, Dopamine)

What are the side effects of MAOIs?

What are the side effects of MAOIs? * Tyramine toxicity – Food aging, Brown bananas, Wine, Aged cheeses, Soy sauce -\> stimulated NE release -\> HTN --\> inhibiting Tyramine breakdown by cause HTN crysis * Dizziness * Somnolence (sleepiness) * Orthostatic Hypotension * Weight gain

What are the names of the Mood Stabilizing drugs?

What are the names of the Mood Stabilizing drugs? * Lithium * Lamotrigine

What is the mechanism of action of Lithium?

What is the mechanism of action of Lithium? * Inhibits Adrenergic, Muscarinic, and Serotonergic Neurotransmission in the Brain * Alters Serotonin, Norepinephrine, and Dopamine neurotransmission

What are the side effects of Lithium?

What are the side effects of Lithium? * Acute Lithium Intoxication * Nausea, Vomiting, diarrhea, Renal failure, Ataxia, Tremor * Bradyarrhythmia * Hypotension * Hyperkalemia * Nephrogenic Diabetes Insipidus * Hypothyroidism * Goiter * ECG and EEG abnormalities * Acne

What is the mechanism of action of Lamotrigine?

What is the mechanism of action of Lamotrigine? * Inhibit neurotransmission by blocking Neuronal Na+ channels

What are the side effects of Lamotrigine?

What are the side effects of Lamotrigine? * Rash * Ataxia (lack of ordered movements) * Somnolence (sleepiness) * Blurred vision

What are names of the Stimulant drugs?

What are names of the Stimulant drugs? * Amphetamine * Methylphenidate

What is the mechanism of action of the Stimulants drugs?

What is the mechanism of action of the Stimulants drugs? * Increase Catecholamine release from Synaptic terminal * Block Catecholamine re-uptake * Weakly inhibit MAOIs

What are the side effects of Stimulant drugs?

What are the side effects of Stimulant drugs? * HTN * Tachyarrhythmia * Restlessness * Loss of appetite * Addiction potential