Psych: Psychiatric Drugs Flashcards
Anxiolytic Benzodiazepine Drugs?
- Benzodiazepines (“azepam” or “azolom”)
- Diazepam
- Lorazepam
- Midazolam
- Clonazepam
What is the mechanism of action for Benzodiazepines?
What is the mechanism of action for Benzodiazepines?
- Potentiate GABAA – mediated inhibition
What are the side effects of Benzodiazepines?
What are the side effects of Benzodiazepines?
- Ataxia
- Dizziness
- Somnolence
- Fatigue
- Memory difficulties
Name the Anxiolytic Barbiturate drug?
Name the Anxiolytic Barbiturate drug?
- Phenobarbital
What is the mechanism of action of Phenobarbital?
What is the mechanism of action of Phenobarbital?
Potentiate GABAA – mediated inhibition
What are the side effects of Phenobarbital?
What are the side effects of Phenobarbital?
- Sedation
- Ataxia
- Confusion
- Dizziness
- Decreased Libido
- Depression
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-HT1A receptor
- Partial Agonist
What are the side effects of Buspirone?
What are the side effects of Buspirone?
- Dizziness
- Confusion
- Headache
- Blurred vision
- Nervousness
What are the Typical Antipsychotics?
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)
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
What are the side effects to Typical Antipsychotics?
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
What are some Atypical Antipsychotic drugs?
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
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 D4 receptors
- Quetiapine / Ziprasidone also blocks H1 Histamine
- Aripiprazole is a D2 and 5-HT1 partial Agonist
What are the side effects of Atypical Antipsychotics?
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)
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)
What is the mechanism of action of SSRIs?
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
What are the side effects of SSRIs?
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
What is the clinical presentation of Serotonin syndrome?
What is the clinical presentation of Serotonin syndrome?
- Hyperthermia
- Hyperreflexia
- Myoclonus
- Autonomic instability
- Flushing
- Diarrhea
- Mental status change
How do you Tx Serotonin syndrome?
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?
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?
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?
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)?
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
