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Psychiatric Drugs Flashcards

1
Q

What are the HAM side effects?

A

antiHistamine-sedation, weight gain
antiAdrenergic-hypotension
antiMuscarinic-dry mouth, blurred vision, urinary retention

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2
Q

Where are the HAM side effects found?

A

Low potency antipsychotics

TCAs

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3
Q

CYP Inhibitors?

A

Increase drug levels

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4
Q

CYP inhibitors and their corresponding CYP?

A 
Fluvoxamine (1A2, 206, 3A4)
Fluoxetine (2C19, 2C9, 2D6)
Paroxetine (2D6)
Duloxetine (2D6) 
Sertraline(2C19)
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5
Q

CYP Inducers and their corresponding CYP?

A

Smoking (1A2)
Carbamazepine (1A2, 2C9, 3A4)
Barbiturates(2C9)
St. John’s wort (2C19, 3A4)

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6
Q

Most antidepressants require a trial of at least?

A

3-4 weeks for effect

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7
Q

A patient with antidepressants has dizziness, headaches, nausea, insomnia, and malaise. What is this called?

A

Withdrawal phenomenon.

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8
Q

SSRIs are the most commonly prescribed because?

A

Little side effects
No food restrictions
Much safer in overdose

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9
Q

Fluoxetine (Prozac) F’s?

A

Fullest half-life

safe in Full term babies

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10
Q

Sertraline (Zoloft) Main side effect?

A

Certainly GI effects

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11
Q

Paroxetine (Paxil) P’s?

A

Protein bound=> several drug interactions
Puny half-life
More anticholingeric problems=>sedation..

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12
Q

Fluvoxamine (Luvox) is for?

A

OCD

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13
Q

Citalopram (Celexa):

A

cita-LOW-pram

Fewest drug-drug interactions

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14
Q

SSRI AE? (think Blood, Brain, Bowel)

A

Sexual Stopper
GI disturbances
Headache, Seizures, Restlessness
Serotonin Syndrome

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15
Q

What is Serotonin Syndrome?

A

too much serotonin in the brain

Symptoms: fever, diaphoresis, tachycardia, delirium=>death

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16
Q

SSRls should not be used for at least _________ before or after use of an MAOI.

A

2 weeks

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17
Q

Venlafaxine (Effexor) Side effects?

A

Increases BP (Flexes BP)

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18
Q

Duloxetine (Cyrnbalta) use?

A

It DULLs your pain and brain

Neuropathic pain and depression

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19
Q

Bupropion{Wellbutrin) MOA? Use? AE?

A

MOA: NE, D reuptake inhibitor
Use: Less Sexual Side Effects (makes your sexual side effects well)
AE: BUT makes your head RINg (seizures)

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20
Q

Wellbutrin should be decreased in patients who have?

A

Eating Disorder and epilepsy

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21
Q

Trazodone AE?

A

AE: priapism and sedation

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22
Q

Nefazodone AE?

A

Nefarious to Liver

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23
Q

Mirtazapine, Trazodone and Nefazodone are used for?

A

Refractory MDD

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24
Q

Why is Remeron (Mirtazapine) used in the elderly?

A

Remeron helps Sleep (sedation) and appetite (weight gain)

Sleep ON
Weight ON

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25
Tertiary Amines vs Secondary Amines?
highly anticholinergic, more sedating, greater lethality in overdose in Tertiary Amines
26
What are the four tertiary amines?
Amitriptyline, lmipramine (Tofranil), Doxepin, Clomipramine
27
What is Clomipramine used for and why?
Clomipramine (Anafranil): | Most serotonin specific, useful in treatment of OCD.
28
Secondary Amines
Nortriptyline Desipramine 2ND
29
TCA overdose, Tx?
IV sodium bicarb
30
TCAs side effects?
3 C's Cardiotoxicity Convulsions Coma
31
MAOIs MOA?
irreversibly inhibiting the enzymes MAO-A and -B, MAOis increase the number of neurotransmitters available in synapses.
32
MAOa deactivate?
ASS | maoA deactivate Serotonin
33
Which MAO does not require dietary restriction?
Selegiline
34
For refractory depression, which drugs are effective?
MAOIs; for refractory depression-MAO is the best Phenelzine (Nardil) Tranylcypromine (Pamate) Isocarboxazid (Marplan)
35
MAOIs w/SSRI?
Serotonin Syndrome
36
MAOIs w/Tyramine
Hypertensive Crisis
37
TCAs are 1st line for?
imipramine in Enuresis
38
Atypical antipsychotics increase in all causes of?
mortality and stroke
39
Both Typical and atypical treat?
Positive symptoms
40
Atypical antipsychotics treat?
Negative symptoms like flat affect
41
High potency antipsychotics are?
High potency: Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High)
42
Low vs High potency means?
low or high on dopamine receptors
43
High Potency more likely?
EPS symptoms
44
Low Potency more likely?
Non neurologic symptoms
45
Low Potency are?
(Cheating Thieves are low) | Chlorpromazine, Thioridazine
46
Low Potency symptoms are?
Alpha block: orthostatic hypotension | Bluish skin
47
Thioridazine leads to?
reTinal deposits
48
Positive symptoms are due to?
Mesolimbic; "hallucinating that I am limping"
49
Negative symptoms are due to?
Mesocortical
50
Tx of EPS?
Reduce Antipsychotic+Benztropine
51
Symptoms of NMS?
``` FALTERED Fever Autonomic Leukocytosis Tremor Elevated CPK Rigidity Excessive sweating Delirium ```
52
Tx of NMS?
Supportive+ Dantrolene
53
Clozapine is the only antipsychotic shown to | Lithium is the only mood stabilizer shown to
decrease the risk of suicide
54
Clozapine has two AE? What should you watch out for?
1. agranulocytosis 2. seizures ANC
55
Risperidone AE?
Increased prolactin
56
Atypicals in general have what kind of side effects?
Metabolic syndrome and weight gain
57
Therapeutic dose, lethal and toxic dose of lithium?
1. 0.6-1.2 2. Toxic >1.5 3. Toxic >2.0
58
NSAIDs do what to lithium?
NSAIDs decrease lithium levels (everything else increase)
59
Carbamazepine AE?
1. SJS 2. aplastic anemia 3. SIADH
60
Lamotrigine AE?
SJS
61
Lamotrigine effective in?
Bipolar depression
62
Topomax Benefit vs Risk
Benefit: Weight loss (To lose max weight) Risk: Cognitive slowing
63
Depakote AE?
Hepatotoxicity | Hepakote
64
In patients with liver disease and alcoholics, there are a LOT of them to use?
Lorazepam Oxazepam Temazepam
65
Diazepam (valium) used for?
Alcohol detoxification
66
Clonozepam (klonopin)
Anxiety
67
D/C the long acting drugs!
Diazepam, Clonozepam
68
ALOT of intermediate drugs!
Alprazolam Lorazepam Oxazepam Temazepam
69
Zolpidem (Ambien)/zaleplon(Sonata)/eszopiclone (Lunesta): work on BZ?
BZ1
70
Ramelteon (Rozerem) works on
Selective melatonin MTI and MT2 agonist
71
Buspirone MOA?
5HT-1A receptor (partial agonist) for anxiety
72
ECT is treatment of choice in?
Patients who are pregos NMS Catatonic Schizos Refractory mania
73
ECT is effective based on?
postictal suppression: magnitude drop in EEG at the end.
74
ECT side effect?
Amnesia

Psychiatry (10 decks)

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