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Pharm - Amy > Psychiatric Agents > Flashcards

Psychiatric Agents Flashcards

1
Q

antipsychotics action

A

blocks D2 (dopamine) receptors

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2
Q

three subcategories of phenothiazines

A
  • aliphatic
  • piperazine
  • piperidine
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3
Q

aliphatic phenothiazines side effects (4)

A
  • strong sedative effect
  • decreases blood pressure
  • causes moderate EPS
  • orthostatic hypotension
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4
Q

piperazine phenothiazines side effects (4)

A
  • low sedative effect
  • little effect on blood pressure
  • greater EPS than other phenothiazines
  • strong antiemetic effect (effective against nausea/vomiting)
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5
Q

piperidine phenothiazines side effects (4)

A
  • strong sedative effect
  • causes few EPS
  • low-moderate effect on blood pressure
  • can cause life-threatening dysrhythmia
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6
Q

why do typical antipsychotics have increased incidence of EPS?

A

they have a stronger affinity for D2 receptors

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7
Q

nonphenothiazines side effect

A

prolongs QT segment - can cause arrhythmia

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8
Q

antipsychotics adverse reactions (7)

A
  • extrapyramidal syndrome (EPS): pseudoparkinsonism, acute dystonia, akathisia, tardive dyskinesia
  • neuroleptic malignant syndrome (NMS)
  • orthostatic hypotension
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9
Q

pseudoparkinsonism symptoms (7)

A
  • stooped posture
  • masklike face
  • rigidity
  • tremors at rest
  • shuffling gait
  • pill-rolling hand motion
  • bradykinesia
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10
Q

acute dystonia symptoms (4)

A
  • muscle spasms of face, tongue, neck, back
  • facial grimacing
  • involuntary upward eye movement
  • laryngeal spasms
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11
Q

akathisia symptoms (4)

A
  • trouble standing still
  • restless
  • pacing the floor
  • feet is in constant motion
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12
Q

tardive dyskinesia symptoms (4)

A
  • protrusion and rolling of tongue
  • sucking and smacking movements of lips
  • chewing motion
  • involuntary movement of body and extremities
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13
Q

acute dystonia treatment (2)

A
  • anticholinergics - benztropine (Cogentin)

- anti-parkinsonism drugs - benzodiazepines/Lorazepam (Ativan)

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14
Q

akathisia treatment (2)

A
  • Benzodiazepines - lorazepam (Ativan)

- beta blockers - propranolol (Inderal)

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15
Q

tardive dyskinesia treatment (5)

A
  • benzodiazepines
  • calcium channel blockers
  • beta blockers
  • high doses of vitamin E may be helpful
  • (anticholinergics may have little effect)
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16
Q

neuroleptic malignant syndrome symptoms (10)

A
  • sudden high fever
  • muscle rigidity
  • altered metal status
  • BP fluctuations
  • tachycardia
  • dysrhythmia
  • seizures
  • rhabdomyolysis (skeletal muscle destruction)
  • respiratory failure
  • coma
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17
Q

neuroleptic malignant syndrome treatment (4)

A
  • immediate withdrawal of antipsychotics
  • adequate hydration
  • hypothermic blankets
  • medications: antipyretics, benzodiazepines, muscle relaxants
18
Q

how long does it take antipsychotics to take effects?

A

3-6 weeks

19
Q

do not combine antipsychotics with (3):

A
  • alcohol
  • narcotics
  • CNS depressants
20
Q

Lorazepam

A
  • trade: Ativan

- a benzodiazepine, anxiolytic

21
Q

lorazepam uses (4)

A
  • anxiolytics
  • anticonvulsants
  • sedative-hypnotics
  • pre-op drugs
22
Q

lorazepam withdrawal symptoms (5)

A
  • agitation
  • muscle tremors
  • cramps
  • nausea
  • sweating
23
Q

lorazepam action

A
  • enhances gamma-aminobutyrate (GABA) effects – inhibitory neurotransmitter within the CNS
  • binds to specific benzodiazepine receptors → postsynaptic receptor becomes more sensitive to GABA → inhibition of rapid neurotransmission → decreases signs and symptoms of anxiety
24
Q

lorazepam side effects (8)

A
  • drowsiness, dizziness
  • weakness
  • confusion
  • blurred vision
  • anorexia
  • sleep disturbance
  • restlessness
  • hallucinations
25
Q

lorazepam adverse reactions

A

hyper/hypotension

26
Q

types of antidepressants (4)

A
  • tricyclics (TCAs)
  • selective serotonin reuptake inhibitors (SSRIs)
  • atypical antidepressants
  • monoamine oxidase inhibitors (MAOIs)
27
Q

tricyclics (TCAs) action

A

blocks uptake/reuptake (removal of) norepinephrine and serotonin

28
Q

tricyclics (TCAs) uses

A

major depression

29
Q

tricyclics (TCAs) side effects (9)

A
  • sedation
  • dizziness
  • blurred vision
  • dry mouth and eyes
  • urinary retention
  • constipation
  • weight gain
  • GI distress
  • sexual dysfunction
30
Q

tricyclics (TCAs) side adverse reactions (4)

A
  • orthostatic hypotension
  • dysrhythmia
  • EPS
  • blood dyscrasias
31
Q

tricyclics (TCAs) also block (2):

A

histamine and anticholinergic receptors

32
Q

tricyclics (TCAs) cause increased sedation and anticholinergic effects when taken with (2):

A

phenothiazines and haloperidol

33
Q

SSRIs action

A

blocks reuptake of serotonin and enhance transmission

34
Q

SSRIs uses (3)

A
  • MAIN: major depressive disorders

- also used for anxiety disorders and migraines

35
Q

SSRIs compared to TCAs

A
  • more commonly used
  • more costly
  • less side effects
36
Q

SSRIs side effects (8)

A
  • dry mouth
  • blurred vision
  • insomnia
  • nervousness
  • headache
  • nausea, anorexia, diarrhea
  • suicidal ideation
  • sexual dysfunction
37
Q

SSRIs herbal interactions (2)

A
  • feverfew

- St. John’s wort

38
Q

Fluoxetine

A
  • trade: Prozac

- an SSRI antidepressant

39
Q

MAOIs action

A
  • inactivates norepinephrine, dopamine, epinephrine, and serotonin
  • nonselective: inhibit both MAO-A and B → increases levels of neurotransmitters which relieves symptoms of depression
40
Q

MAOIs use

A
  • mild, reactive, and atypical depression

- when unresponsive to TCAs, atypicals

41
Q

hypertensive crisis is caused by taking MAOIs with what?

A
  • CNS stimulants/ sympathomimetics

- tyramine foods

42
Q

tyramine food examples

A

cheese, bananas, raisins, pickled foods, red wine, beer, cream, yogurt, chocolate, coffee, Italian green beans, liver, yeast, soy sauce

Pharm - Amy (3 decks)

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