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Neurology > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

haloperidol + azines

A

antipsychotics

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2
Q

High potency antipsycotics and type of side effects

A

Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High)–>neurologic side effects (EPS symptoms (dyskinesias)

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3
Q

Treatment for EPS symptoms

A

Benztropine or diphenhydramine

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4
Q

Low potency antipsychotics and side effects

A

Chlorpromazine, Thioridazine (Cheating Thieves are low)–>non-neurologic (anticholinergic (dry mouth, constipation), antihistamine (sedation), and alpha 1 blocking (hypotension)

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5
Q

What drug will cause corenal and retinal deposits respectively

A

chlorpromazine/thiordazine

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6
Q

What are side effects of haloperidol?

A

EPS, NMS, and tardive dyskinesia

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7
Q

Evolution of EPS side effects at 4 hour, 4 day, 4 week, and 4 month

A

4 hour-dystonia (muscle spasm (facial), stiffness) from decreased dopamine
4 day-akathisia (restlessness) from decreased dopamine
4 week-bradykinesia (parkinsonism) with difficulty initiating movement
4 month-tardive dyskinesia (from increased domapine supersensitivity to domaine with increased D2 receptors)–>up dose to temporarily block extra D2 receptors.

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8
Q

What are symptoms of NMS?

A

Fever, Encephalopathy, Vitals unstable (autonomic instability), enzymes increased (creatinine kinase), rigitiy of muscles (catatonia)

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9
Q

What do you treat NMS with?

A

Dantrolene D2 agonist (bromocriptine)

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10
Q

Potency is high or low for highly lipid soluble antipsychotics?

A

high

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11
Q

3 functions of extrapyramidal system?

A

Tone, posture, initiation of purposeful movement

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12
Q

What are endocrine side effects of antipsychotics?

A

dopamine receptor antagonism causes excessprolactin release and galactorrhea because dopamine normally used to prevent prolactin release

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13
Q

Mechanism of atypical antipsychotics?

A

varied effects on 5HT2, dopamine, and alpha and H1 receptors. It is a mild D2 receptor antagonist

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14
Q

Why are there less extrapyramidal side effects and anticholinergic side effects than traditional antipsychotics?

A

Fewer because atypical bind to D2 receptors less than typical and loosely binding at D2 receptor site

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15
Q

What are atypical antipsychotics?

A

It is atypical for old closets to quietly risper from A to Z

OLanzapine, CLOZapine, QUETIapine, RISPERidone, Ariprazole, Ziprasidone

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16
Q

Olanzapine/clozapine side effects?

A

significant weight gain

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17
Q

Clozapine side effects that require monitoring clozely.

A

agranulocytosis (weekly WBC monitoring) and seizure

18
Q

Risperidone side effects?

A

may increase prolactin (causing lactation and gynecomastia) decreased GnRH, LH, and FSH (causing irregular menstruation and fertility issues)

19
Q

Ziprasidone side effects and it blocks efflux of what ion?

A

May prolong QT interval by blocking K+ efflux (Torsades de pointes)

20
Q

What is mechanism of lithium/use?

A

Not established may be due to inhibition of phosphoinositol cascade
Mood stabilizer for bipolar disorder; blocks relapse and acute/manic events

21
Q

Lithium side effects?

A

LMNOP
Lithium
Movement (Tremor)
Nephrogenic diabetes insipidus (polyuria b/c lithium is an ADH antagonist)
hypOthyroidism
Pregnancy problems (Epstein anomaly and malformation of great vessels)

22
Q

Buspirone mechanism/use

A

stimulates 5-HT1a partial agonist. generalized anxiety disorder (I’m always anxious if the bus will be on time, so i take buspirone)

does not cause sedation, addiction, or tolerance

23
Q

name the SSRI

A

Fluoxetine, paroxetine, sertraline, citalopram (Flashbacks paralyze senior citizens)

24
Q

toxicity with SSRI

A

Fewer than TCA, but GI distress, sexual dysfunction, serotonin syndrome (with other drug increasing 5-HT)–> (MAO inhibitor, SNRI, TCA)–>hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea

25
Q

Treatment for serotonin syndrome

A

cyproheptadine (5-HT2 receptor antagonist)

26
Q

name SNRI

A

venlafaxine (in indian accent, When la fax NRI card), duloxetine

27
Q

SNRI/ TCA mechanism?

A

NE and 5-HT specific inhibition

28
Q

uses of venlafaxine and duloxetine

A

Venlafaxtine-depression, GAD, panic disorder

Duloxetine-depression+diabetic peripheral neuropathy

29
Q

TCA

A

-triptyline and ipramine and doxepine and amoxapine

30
Q

TCA uses

A

major depression, OCD, fibromyalgia

31
Q

TCA toxicity?

A

Three C’s: Convulsions, coma, cardiotoxicity; also respiratory depression and hyperpyrexia. posural hypertension, anticholinergic effects (urinary retention, dry mouth, tachycardia)

32
Q

Elderly person has Confusions and hallucinations in elderly due to anticholinergic side effects from TCA, what should you use?

A

Notriptyline

33
Q

Treatment for CV toxicity when using TCAs

A

NaHCO3

34
Q

Which TCA is less sedating but has higher seizure incidence?

A

desipramine (desis dont do anything, but they will drive you crazy (seizures))

35
Q

MOA inhibitiors/mechanism?

A

MOA Takes Pride in Shanhai (Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline)

Increases levels or amine neurotransmitters (NE, 5-HT, dopamine)

36
Q

Uses for MAO?

A

Atypical depression, anxiety, hypochondriasis

37
Q

Toxicity for MAO?

A

Hypertensive crisis (due to ingestion of tyramine in many foods such as wine and cheese) CNS stimulation.

38
Q

Bupropion use (s)/mechanism/side effects

A

Antidepressants/smoking cessation. Increase NE and dopamine. Toxicity: tachycardia, insomnia, headache, seizure in bulimic patients NO SEXUAL side effects

39
Q

Mirtazapine use (s) mechanism/side effects

A

a2-agonist (increase NE and 5-HT) and potent 5-HT2 and 5-HT3 receptor antagonist. Toxicity: sedation (which may be desirable in depressed patients with insomnia), increased appetite, weight gain (which may be desirable in elderly or anorexic patients) dry mouth

40
Q

What is the first line treatment for narcolepsy?

A

Modafinil

41
Q

What is the treatment for tourette syndrome?

A

Antipsychotics

Neurology (7 decks)

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