Psychiatry Flashcards
haloperidol + azines
antipsychotics
High potency antipsycotics and type of side effects
Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High)–>neurologic side effects (EPS symptoms (dyskinesias)
Treatment for EPS symptoms
Benztropine or diphenhydramine
Low potency antipsychotics and side effects
Chlorpromazine, Thioridazine (Cheating Thieves are low)–>non-neurologic (anticholinergic (dry mouth, constipation), antihistamine (sedation), and alpha 1 blocking (hypotension)
What drug will cause corenal and retinal deposits respectively
chlorpromazine/thiordazine
What are side effects of haloperidol?
EPS, NMS, and tardive dyskinesia
Evolution of EPS side effects at 4 hour, 4 day, 4 week, and 4 month
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.
What are symptoms of NMS?
Fever, Encephalopathy, Vitals unstable (autonomic instability), enzymes increased (creatinine kinase), rigitiy of muscles (catatonia)
What do you treat NMS with?
Dantrolene D2 agonist (bromocriptine)
Potency is high or low for highly lipid soluble antipsychotics?
high
3 functions of extrapyramidal system?
Tone, posture, initiation of purposeful movement
What are endocrine side effects of antipsychotics?
dopamine receptor antagonism causes excessprolactin release and galactorrhea because dopamine normally used to prevent prolactin release
Mechanism of atypical antipsychotics?
varied effects on 5HT2, dopamine, and alpha and H1 receptors. It is a mild D2 receptor antagonist
Why are there less extrapyramidal side effects and anticholinergic side effects than traditional antipsychotics?
Fewer because atypical bind to D2 receptors less than typical and loosely binding at D2 receptor site
What are atypical antipsychotics?
It is atypical for old closets to quietly risper from A to Z
OLanzapine, CLOZapine, QUETIapine, RISPERidone, Ariprazole, Ziprasidone
Olanzapine/clozapine side effects?
significant weight gain
Clozapine side effects that require monitoring clozely.
agranulocytosis (weekly WBC monitoring) and seizure
Risperidone side effects?
may increase prolactin (causing lactation and gynecomastia) decreased GnRH, LH, and FSH (causing irregular menstruation and fertility issues)
Ziprasidone side effects and it blocks efflux of what ion?
May prolong QT interval by blocking K+ efflux (Torsades de pointes)
What is mechanism of lithium/use?
Not established may be due to inhibition of phosphoinositol cascade
Mood stabilizer for bipolar disorder; blocks relapse and acute/manic events
Lithium side effects?
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)
Buspirone mechanism/use
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
name the SSRI
Fluoxetine, paroxetine, sertraline, citalopram (Flashbacks paralyze senior citizens)
toxicity with SSRI
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
