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Psychiatric Flashcards

1
Q

Do Selective Serotonin Reuptake Inhibitors (SSRI) increase or decrease Serotonin (5-HT)?

A

Increase Serotonin (5-HT)

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2
Q

What is the main contraindication of SSRIs?

A

Concurrent use with MAO Inhibitors

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3
Q

Selective Serotonin Reuptake Inhibitor Warnings?

A

QT Prolongation, Syndrome of Inappropriate secretion of ADH (SIADH), Hyponatremia (Low Sodium), Bleeding (w/ NSAID, anticoagulant or antiplatelet use).

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4
Q

What is one major risk of SSRI use?

A

Serotonin Syndrome

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5
Q

What are the main side effects of SSRIs?

A

Somnolence, Insomnia, Nausea, Dry Mouth, Diaphoresis (dose related), Weakness, Tremor, Dizziness, HA, Sexual (decreased libido).

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6
Q

Citalopram

A

Celexa

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7
Q

Citalopram Drug Class

A

SSRI

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8
Q

Citalopram Max Dose

Citalopram Max Dose (elderly)

A

40mg/day

20mg/day

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9
Q

Escitalopram

A

Lexapro

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10
Q

Escitalopram Max Dose

Escitalopram Max Dose (Elderly)

A

20mg/day

10mg/day

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11
Q

Escitalopram Drug Class

A

SSRI

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12
Q

Fluoxetine

A

Prozac

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13
Q

Fluoxetine Drug Class

A

SSRI

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14
Q

Sarafem Use & Generic

A

PMDD (Pre-Menstrual Dysphoric Disorder) & Fluoxetine

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15
Q

What time of day is it best to take Fluoxetine?

A

QAM

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16
Q

Does Fluoxetine require a taper? Why or why not?

A

No, due to it’s long half life.

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17
Q

Why is it recommended to taper SSRIs?

A

To prevent rebound depression

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18
Q

Paroxetine

A

Paxil

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19
Q

Paroxetine Drug Class

A

SSRI

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20
Q

Which SSRI is the most sedating?

A

Paroxetine

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21
Q

What time of day should Paroxetine be taken?

A

QPM

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22
Q

Sertraline

A

Zoloft

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23
Q

Sertraline Drug Class

A

SSRI

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24
Q

Sertraline is preferred in patients with what comorbidity?

A

Cardiac Risk

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25
Q

Fluvoxamine

A

Luvox

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26
Q

Fluvoxamine Drug Class

A

SSRI

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27
Q

Which SSRI has the most drug interactions?

A

Fluvoxamine

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28
Q

What time of day should Fluvoxamine be taken, and why?

A

QPM due to it’s sedating effects.

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29
Q

What SSRI is sometimes used to treat OCD?

A

Fluvoxamine

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30
Q

What is the major contraindication of SSRI/5HT-1A Partial Agonists?

A

Concurrent use, or use within 14 days of MAO Inhibitors.

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31
Q

Main Side Effect of SSRI/5HT-1A Partial Agonists

A

Decreased libido (less sexual se than SSRI or SNRI)

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32
Q

Vilazodone

A

Viibryd

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33
Q

Vilazodone Drug Class

A

SSRI/5HT-1A Partial Agonst

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34
Q

Should Vilazodone be taken with or without food? Why or why not?

A

Take with food; to increases drug absorption

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35
Q

What is the major contraindication of SSRI/5-HT3 Receptor Antagonist/5HT-1A Partial Agonist?

A

Concurrent use, or use within 14 days of MAO Inhibitors.

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36
Q

Main side effect of SSRI/5-HT3 Receptor Antagonist/5HT-1A Partial Agonist

A

Decreased libido (less sexual se than SSRI or SNRI)

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37
Q

Vortioxetine

A

Trintellix

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38
Q

Vortioxetine Drug Class

A

SSRI/5-HT3 Receptor Antagonist/5HT-1A Partial Agonist

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39
Q

What is the major side effect associated with Vortioxetine?

A

Constipation

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40
Q

Vortioxetine is contraindicated for use in patients with what comorbidities?

A

IBS and IBD

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41
Q

What actions should be taken if a patient is on a strong CYP2D6 inhibitor (such as bupropion, fluoxetine, or paroxetine) and adds Vortioxetine as drug therapy?

A

Decrease the Vortioxetine dose by 50%

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42
Q

What is the major contraindication of Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)?

A

Concurrent use, or use within 14 days of an MAOI.

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43
Q

What two drug classes have similar side effects?

A

SSRIs & SNRIs

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44
Q

What specific side effects are associated with SNRIs?

A

Increased NE, Increased HR, Dilated Pupils, Dry Mouth, Excessive Sweating, Constipation, and Increased BP.

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45
Q

Desvelafaxine

A

Pristiq

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46
Q

Desvelafaxine Drug Class

A

SNRI

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47
Q

Duloxetine

A

Cymbalta

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48
Q

What are the main uses for Duloxetine?

A

Neuropathy, Fibromyalgia, General Anxiety Disorder (GAD).

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49
Q

Duloxetine Drug Class

A

SNRI

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50
Q

Venlafaxine

A

Effexor

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51
Q

Venlafaxine Drug Class

A

SNRI

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52
Q

What is Venlafaxine used to treat?

A

General Anxiety Disorder (GAD), Panic Disorder, Seasonal Affective Disorder (SAD).

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53
Q

What is the major side effect associated with Venlafaxine?

A

QT Prolongation

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54
Q

Which SNRI tends to increase BP to a higher extent?

A

Venlafaxine

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55
Q

What type of patients are not suited for treatment with SNRIs?

A

Patients with uncontrolled Hypertension

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56
Q

How do Tricyclic Antidepressants (TCAs) work?

A

Inhibit NE and 5-HT, also block Acetylcholine and histamine receptors.

57
Q

What is the major contraindication of TCAs?

A

Concurrent use, or use within 14 days of MAOIs.

58
Q

What Anticholinergic side effects are associated with TCAs?

A

Dry mouth, Urinary Retention, and Constipation.

59
Q

What cardiac side effects are associated with TCA use?

A

Cardiotoxicity, QT Prolongation, and Arrhythmias.

60
Q

Tertiary Amines are associated with increased or decreased Anticholinergic Properties?

A

Increased Anticholinergic Properties

61
Q

Amitriptyline

62
Q

Amitriptyline Drug Class

A

TCA - Tertiary Amine

63
Q

Doxepin Drug Class

A

TCA - Tertiary Amine

64
Q

Doxepin brand for treatment of Insomnia

65
Q

Doxepin brand of cream formulation

A

Zonalon & Prudoxin

66
Q

What additional properties does Doxepin have?

A

High Anticholinergic & Antihistamine Properties

67
Q

Nortriptyline

68
Q

Nortriptyline Drug Class

A

TCA - Secondary Amine

69
Q

What major contraindications are associated with Dopamine & Norepinephrine Reuptake Inhibitors (NDRI)?

A

Seizure Disorders, H/O Anorexia/Bulimia, Concurrent use with MAOIs.

70
Q

What side effects are associated with NDRIs?

A

Dry Mouth, Insomnia, Tremors/Seizures (dose-related), Weight loss, Sexual Dysfunction (rare), CNS Stimulation (anxiety, restlessness, insomnia).

71
Q

Bupropion

A

Wellbutrin

72
Q

Bupropion brand for treatment of smoking cessation only

73
Q

Bupropion Drug Class

74
Q

What is the maximum dose for Bupropion?

75
Q

Why do some patients switch from SSRIs to NDRIs?

A

To help with weight loss, or for relief of sexual dysfunction side effects.

76
Q

Which Antidepressant is usually used in elderly patients?

A

Mirtazapine

77
Q

Mirtazapine

78
Q

Mirtazapine Drug Class

A

TCA/Alpha-2-Agonist

79
Q

How does Mirtazapine affect NE and 5HT?

A

Mirtazapine increases both NE and 5HT

80
Q

What is Mirtazapine indicated for?

A

Primarily sleep and to increase appetite

81
Q

What side effects are associated with Mirtazapine?

A

Anticholinergic Effects, Weight Gain, Increased Appetite, and Sedation.

82
Q

Trazodone

83
Q

Trazodone Drug Class

A

SSRI/Alpha-1-Agonist/Histamine Blocker

84
Q

How does Trazodone work?

A

Inhibits 5-HT reuptake, blocks Histamine & Alpha-1

85
Q

What is the primary indication for Trazodone?

86
Q

What side effects are associated with Trazodone?

A

Sedation and Priapism (prolonged erection)

87
Q

What is the MOA of First Generation Antipsychotics?

A

Block Dopamine and 5HT-2A

88
Q

What effects are associated with High Potency First Generation Antipsychotics?

A

High risk of EPS (Extrapyramidal Symptoms - Uncontrolled body movements), Moderate risk of Sedation, Low risk of CV Effects (orthostatic hypotension, tachycardia), and Anticholinergic Effects.

89
Q

What effects are associated with Low Potency First Generation Antipsychotics?

A

Low risk of EPS, High risk of Sedation, High risk of CV Effects, and Anticholinergic Effects.

90
Q

What general side effects are associated with First Generation Antipsychotics?

A

Moderate Weight Gain, Low risk of Metabolic Effects, High risk of Sexual Side Effects.

91
Q

What is the MOA of First Generation Antipsychotics?

A

Block Dopamine and 5HT-2A

92
Q

Haloperidol

93
Q

Haloperidol Drug Class

A

First Generation Antipsychotics

94
Q

Is Haloperidol a high or low potency First Generation Antipsychotic?

A

High Potency

95
Q

What major side effect is associated with Haloperidol?

A

QT Prolongation

96
Q

What is the MOA of Second Generation Antipsychotics?

A

Block Dopamine and 5HT-2A

97
Q

What type of side effects are associated with Second Generation Antipsychotics?

A

Metabolic Side Effects?

98
Q

What specific side effects are associated with Second Generation Antipsychotics?

A

Weight Gain, Lipid Abnormalities, Hyperglycemia, EPS (dose-related).

99
Q

What CV Effects are associated with Second Generation Antipsychotics?

A

QT Prolongation

100
Q

Increased Prolactin associated with Second Generation Antipsychotics can cause what?

A

Gynecomastia & Irregular Periods

101
Q

Aripiprazole

102
Q

Aripiprazole Drug Class

A

Second Generation Antipsychotics

103
Q

What side effects are associated with Aripiprazole?

A

Akathisia & Insomnia

104
Q

Lurasidone

105
Q

Lurasidone Drug Class

A

Second Generation Antipsychotics

106
Q

What major side effect is associated with Lurasidone?

A

Extrapyramidal Symptoms (EPS)

107
Q

What is a major counseling point for Lurasidone? Why?

A

Take with food ( >350kcal) to help with drug absorption.

108
Q

Olanzapine

109
Q

Olanzapine Drug Class

A

Second Generation Antipsychotics

110
Q

What side effects are associated with Olanzapine?

A

Somnolence, Weight Gain, Increased Lipids, Increased Glucose.

111
Q

Clozapine

112
Q

Clozapine Drug Class

A

Second Generation Antipsychotics

113
Q

What Black Box Warning is noted on Clozapine bottles?

A

May cause Neutropenia/Agranulocytosis; REMS Program Drug; May cause Myocarditis, Cardiomyopathy, and Seizures.

114
Q

What side effects are associated with Clozapine?

A

Weight Gain, Increased Lipids, Increased Glucose, Sialorrhea, & Agranulocytosis.

115
Q

What should be monitored throughout the duration of Clozapine Therapy?

A

Baseline ANC ( >1,500)

116
Q

At what ANC should Clozapine Therapy be stopped?

A

ANC < 1,000

117
Q

Paliperidone

118
Q

Paliperidone Drug Class

A

Second Generation Antipsychotics

119
Q

What dose related side effect is associated with Paliperidone?

A

Extrapyramidal Symptoms (EPS)

120
Q

What non-dose related symptoms are associated with Paliperidone?

A

Increased Prolactin

121
Q

Quetiapine

122
Q

Quetiapine Drug Class

A

Second Generation Antipsychotics

123
Q

Does Quetiapine have a high or low EPS risk?

A

Low EPS Risk

124
Q

What symptom is caused by Quetiapine use in Parkinson’s patients?

125
Q

Should Quetiapine be taken with or without food?

A

Without food, or with a light meal ( <300kcal)

126
Q

Risperidone

127
Q

Risperidone Drug Class

A

Second Generation Antipsychotics

128
Q

What dose related side effect is associated with Risperidone use?

A

Extrapyramidal Symptoms (EPS) - Typically seen with higher doses

129
Q

Ziprasidone

130
Q

What major side effect is associated with Ziprasidone?

A

QT Prolongation

131
Q

Should Ziprasidone be taken with or without food?

132
Q

Lithium

133
Q

Lithium Drug Class

A

Mood Stabilizer

134
Q

How should Lithium be dosed?

135
Q

What side effects are associated with Lithium use?

A

GI Upset, Cognitive Effects, Cogwheel Rigidity, Fine Hand Tremor, Weight Gain, Polyuria/Polydipsia, & Hypothyroidism.

136
Q

At what point has Lithium toxicity produced irreversible damage?

A

> 2.5 mEq/L

137
Q

Lithium is contraindicated in patients with what comorbidity? Why?

A

Renal Failure, because Lithium is 100% renally cleared.

138
Q

What side effects are associated with Stimulant Drugs for ADHD?

A

Nausea, Insomnia, Headache, Irritability, Blurry Vision, & Dry Mouth.

Top 200 Drugs (1 decks)

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