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YR3 Pharmacology > Psychiatric Drugs: Antidepressants, Anxiolytics, & Antipsychotics > Flashcards

Psychiatric Drugs: Antidepressants, Anxiolytics, & Antipsychotics Flashcards

1
Q

What are Antipsychotics

A

First-generation antipsychotics (also called typical antipsychotics): block D2 receptor → ↑ cAMP
- High-potency antipsychotics have a strong antipsychotic effect even at relatively low doses, but they also more commonly cause neurologic side effects (e.g., extrapyramidal symptoms) than low-potency antipsychotics.
- Low-potency antipsychotics more commonly cause anticholinergic, antihistamine, and sympathetic α1-blockade effects.
- Stored in fat tissue (lipid soluble) and, therefore, only slowly eliminated from the body.
Second-generation antipsychotics (also called atypical antipsychotics): most are 5-HT2 and D2 antagonists with varying α and H1 receptor effects

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2
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Describe the classification of antipsychotic drugs.

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3
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What is the main Mechanism of action of antipsychotic drugs?

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4
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What are some of the Antipsychotic-induced motor disturbances?

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5
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What are the clinical uses of antipsychotic drugs?

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7
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ti

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12
Q

Indications for Antipsychotics - Acute?

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  • All antipsychotics, except for clozapine (used for treatment-resistant schizophrenia), have similar clinical effectiveness.
  • SGAs are preferred in many cases because they carry a lower risk of EPS; however, in some patients (e.g., those with significant metabolic risk factors), FGAs may be more suitable.
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19
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20
Q

Extrapyramidal symptoms (EPS)
- Definition?
- Etiology?
- Pathophysiology?

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21
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What are the Extrapyramidal symptoms (EPS)?

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22
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25
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26
Q

What are the 6 main groups of drugs used to treat anxiety?

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27
Q

Discuss the role of Benzodiazepines in the treatment of anxiety.

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28
Q

Benzodiazepines
- Short acting agents?
- Intermediate acting agents?
- Long acting agents?
- Mechanism of Action?

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29
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Benzodiazepines
- 6 Effects?

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  1. Anxiolysis
  2. Sedation
  3. Hypnotic action
  4. Muscle relaxation
  5. Anticonvulsant action
  6. Amnesia
30
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Benzodiazepines
- 6 Indications?

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31
Q

What are the general adverse effects of benzodiazepines?
Why must they be used with caution in the elderly?

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32
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What are the clinical features of a Benzodiazepine overdose?

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33
Q

How can you diagnose a Benzodiazepine overdose?

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34
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Differential diagnoses of a benzodiazepine overdose?

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35
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What is the treatment for a benzodiazepine overdose? What is the antidote?

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36
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Benzodiazepine dependence
- Definition?
- Withdrawal symptoms?
- Treatment?

A

Treatment:
- Dose tapering
- Seizure prophylaxis (e.g., carbamazepine)

37
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What are 6 Contraindications for benzodiazepines?

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38
Q

What are antidepressants?
What are the 4 most widely used classes of antidepressants?

A
  1. Selective serotonin reuptake inhibitors (SSRIs)
  2. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  3. Monoamine oxidase inhibitors (MAOIs)
  4. Tricyclic antidepressants (TCAs).
39
Q

What are the 3 major mechanisms of action of antidepressants?

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40
Q

Selective serotonin reuptake inhibitors
- Mechanism of Action?
- 6 Examples?
- Indications? For which disorder is it first line therapy?

A

Mechanism of action: inhibition of serotonin reuptake in synaptic cleft → ↑ serotonin levels
Examples
1. Fluoxetine
2. Paroxetine
3. Sertraline
4. Citalopram
5. Escitalopram
6. Fluvoxamine

41
Q

Selective serotonin reuptake inhibitors
- 3 Early Side Effects?
- 4 Late Side Effects?

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42
Q

Selective serotonin reuptake inhibitors
- Drug interactions?
- Contraindications?

A

Drug interactions: increased risk of serotonin syndrome if used concomitantly with other serotonergic drugs (e.g., MAOIs, linezolid, St. John’s wort, dextromethorphan, meperidine, methylene blue)
Contraindications: paroxetine in pregnant patients (may cause fetal cardiovascular malformations in the first trimester and fetal pulmonary hypertension in the third trimester)

43
Q

Serotonin-norepinephrine reuptake inhibitors
- Mechanism of Action?
- 5 Examples?
- Indications? For which disorder is it a second-line therapy?

A

Mechanism of Action: inhibition of serotonin and norepinephrine reuptake in synaptic cleft → ↑ serotonin and norepinephrine levels
Examples
1. Venlafaxine
2. Duloxetine
3. Desvenlafaxine
4. Levomilnacipran
5. Milnacipran

44
Q

Serotonin-norepinephrine reuptake inhibitors
- 6 Side effects?
- Drug interactions?
- Additional information?

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45
Q

Serotonin antagonist and reuptake inhibitors
- Mechanism of Action? (3)
- 2 Examples?
- 2 Indications?

A

Mechanism of action
- Block postsynaptic type 2 serotonin receptors (5-HT2)
- Weak inhibition of serotonin reuptake → ↑ serotonin levels
- Antagonist of H1 and α1-adrenergic receptors
Examples
1. Trazodone
2. Nefazodone
Indications
1. Insomnia
2. Major depressive disorder (high doses required)

46
Q

Serotonin antagonist and reuptake inhibitors
- 4 Side effects?
- Drugs interactions?
- Additional information? (2)

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47
Q

Monoamine oxidase inhibitors
- Mechanism of Action?
- 4 Examples?
- 3 Indications?

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48
Q

Monoamine oxidase inhibitors
- Side effects? (5)

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49
Q

Monoamine oxidase inhibitors
- Drug interactions?
- Additional information? (3)

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50
Q

Tricyclic Antidepressants
- Mechanism of Action?
- 8 Examples?

A

Mechanism of action: inhibition of serotonin and norepinephrine reuptake in synaptic cleft → ↑ serotonin and norepinephrine levels

51
Q

Tricyclic Antidepressants
- 6 Indications?

A
52
Q

Tricyclic Antidepressants
- 5 Side effects?

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53
Q

Tricyclic Antidepressants
- Contraindications?
- Drug interactions? (2)
- Additional information? (2)

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54
Q

Tricyclic antidepressant toxicity
- Mechanism? (5)
- Clinical Features? (6)

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55
Q

Tricyclic antidepressant toxicity
- Diagnosis?
- Management?

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56
Q

List 6 Atypical Antidepressants?

A

Atypical Antidepressants
2. Mirtazapine
2. Bupropion
3. Vilazodone
4. Vortioxetine
5. Buspirone
6. Varenicline

57
Q

Atypical Antidepressants - Mirtazapine
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

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58
Q

Atypical Antidepressants - Bupropion
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

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59
Q

Atypical Antidepressants - Vilazodone
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

A
60
Q

Atypical Antidepressants - Vortioxetine
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

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61
Q

Atypical Antidepressants - Buspirone
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

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62
Q

Atypical Antidepressants - Varenicline
- Mechanism of action?
- Indications?
- Side effects?
- Drug interactions?

A
63
Q

Describe the role of St John’s Wort in the treatment of depression?

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72
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Desribe the use of Antidepressants and 5-HT1A agonists as anxiolytic drugs?

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YR3 Pharmacology (8 decks)

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