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Psychiatry Flashcards

1
Q

Anxiety NT

A
  • increased: NE - decreased: GABA, serotonin
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2
Q

Depression NT

A
  • decreased: NE, serotonin, dopamine
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3
Q

Alzheimer’s NT

A
  • decreased; ACh
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4
Q

Huntington’s NT

A
  • increased: dopamine - decreased: GABA, ACh
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5
Q

Schizophrenia NT

A
  • increased: dopamine
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6
Q

Parkinson’s NT

A
  • increased: serotonin, ACh - decreased: dopamine
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7
Q

Methylphenidate

  • Class - MOA - Use
A
  • CNS stimulant
  • MOA: increased catecholamines esp NE + dopamine
  • Use: ADHD, narcolepsy, appetite control, depression in terminally ill with short time to live
  • toxicity: leukopenia, anemia, increased LFT - monitor laps
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8
Q

Dextroamphetamine

  • Class - MOA - Use
A
  • CNS stimulant
  • MOA: increased catecholamines esp NE + dopamine
  • Use: ADHD, narcolepsy, appetite control
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9
Q

Methamphetamine

  • Class - MOA - Use
A
  • CNS stimulant
  • MOA: increased catecholamines esp NE + dopamine
  • Use: ADHD, narcolepsy, appetite control
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10
Q

Haloperidol

  • Class - MOA - Potency - Use - Toxicity
A
  • Antipsychotic
  • MOA: block dopamine D2 receptor (increase cAMP)
    • decanoate available
  • High potency (Try to Fly High)
  • Use:
    • Schizophrenia - positive symptoms
    • psychosis
    • acute mania
    • Tourette’s syndrome
  • Toxicity
    • Extrapyramidal symptoms- dyskinesia (parkinson like)
    • Endocrine- hyperprolactinemia
    • Antimuscarinic- dry mouth, constipation
    • A1 R blocker- hypotension
    • Histamine R blocker- sedation
    • Neuroleptic Malignant Syndrome
      • Fever, Encephalopathy, Vitals, Elevated enzymes (CK), Rigidity of muscles
        • rigidity, myoglobinuria, autonomic instability, hyperpyrexia
      • Treatment: dantrolene, bromocriptine
    • Tardive Dyskinesia
      • stereotypic oral favial movements
      • due to long term antipsychotic use
      • irreversible
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11
Q

EPS side effects

A
  • 4 hr = dystonia (muscle spasm, studd, oculogyric crisis)
    • benztropine or diphenhydramine
  • 4 day = akathisia (restless)
    • beta blocker
  • 4 week = bradykinesia (parkinosnism)
    • benztropine or diphenhydramine
    • amantidine or bromocriptine NOT Ldopa
  • 4 month = tardive dyskinesia
    • no treatment
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12
Q

Trifluoperazine

  • Class - MOA - Potency - Use - Toxicity
A
  • Antipsychotic
  • MOA: block dopamine D2 receptor (increase cAMP)
  • High potency (Try to Fly High)
  • Use:
    • Schizophrenia - positive symptoms
    • psychosis
    • acute mania
    • Tourette’s syndrome
    • reduce anxiety
  • Toxicity
    • Extrapyramidal symptoms- dyskinesia (parkinson like)
    • Endocrine- hyperprolactinemia
    • Antimuscarinic- dry mouth, constipation
    • A1 R blocker- hypotension
    • Histamine R blocker- sedation
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13
Q

Fluphenazine

  • Class - MOA - Potency - Use - Toxicity
A
  • Antipsychotic
  • MOA: block dopamine D2 receptor (increase cAMP)
    • **decanoate available **
  • High potency (Try to Fly High)
  • Use:
    • Schizophrenia - positive symptoms
    • psychosis
    • acute mania
    • Tourette’s syndrome
  • Toxicity
    • Extrapyramidal symptoms- dyskinesia (parkinson like)
    • Endocrine- hyperprolactinemia
    • Antimuscarinic- dry mouth, constipation
    • A1 R blocker- hypotension
    • Histamine R blocker- sedation
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14
Q

Thioridazine

  • Class - MOA - Potency - Use - Toxicity
A
  • Antipsychotic
  • MOA: block dopamine D2 receptor (increase cAMP)
  • Low potency (Cheating Thieves are Low)
  • Use:
    • Schizophrenia - positive symptoms
    • psychosis
    • acute mania
    • Tourette’s syndrome
  • Toxicity
    • Extrapyramidal symptoms- dyskinesia (parkinson like)
    • Endocrine- hyperprolactinemia
    • Antimuscarinic- dry mouth, constipation
    • A1 R blocker- hypotension
    • Histamine R blocker- sedation
    • **Retinal deposits **
    • Prolonged QTc
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15
Q

Chlorpromazine

  • Class - MOA - Potency - Use - Toxicity
A
  • Antipsychotic
  • MOA: block dopamine D2 receptor (increase cAMP)
  • Low potency (Cheating Thieves are Low)
  • Use:
    • Schizophrenia - positive symptoms
    • psychosis
    • acute mania
    • Tourette’s syndrome
    • **N/V/intractable hiccups **
  • Toxicity
    • Extrapyramidal symptoms- dyskinesia (parkinson like)
    • Endocrine- hyperprolactinemia
    • Antimuscarinic- dry mouth, constipation
    • A1 R blocker- hypotension
    • Histamine R blocker- sedation
    • **Corneal deposits **
    • **purple grey metallic rash over sun exposed areas and jaundice **
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16
Q

Olazapine

  • Class - MOA - Use - Toxicity
A
  • Atypical antipsychotic
  • MOA: not understood
  • Use:
    • Schizophrenia- positive/negative symptoms
    • Bipolar disorder
    • OCD - if moderate response to SSRI
    • Depression
    • Anxiety disorder
    • Mania
    • Tourette’s
  • Toxicity:
    • weight gain
    • sedation
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17
Q

Quetiapine

  • Class - MOA - Use - Toxicity
A
  • Atypical antipsychotic
  • MOA: not understood
  • Use:
    • Schizophrenia- positive/negative symptoms
    • Bipolar disorder
    • OCD- if moderate response to SSRI
    • Depression
    • Anxiety disorder
      • best atypical for anxiety
    • Mania
    • Tourette’s
  • Toxicity
    • sedation
    • orthostatic hypotension
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18
Q

Clozapine

  • Class- MOA - Use - Toxicity
A
  • Atypical antipsychotic
  • MOA: not understood
  • Use:
    • Schizophrenia- positive/negative symptoms
      • refractory to other meds
      • best antipsychotic but serious side effects
      • only antipsychotic to decrease risk of suicide
    • Bipolar disorder
    • OCD - if moderate response to SSRI
    • Depression
    • Anxiety disorder
    • Mania
    • Tourette’s
  • Toxicity:
    • weight gain
    • agranulocytosis - need weekly WBC monitor
    • seizure
    • less likely to cause EPS
    • doesc not affect prolactin
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19
Q

Risperidone

  • Class- MOA- Use- Toxicity
A
  • Atypical antipsychotic
  • MOA: not understood
  • Use:
    • Schizophrenia- positive/negative symptoms
    • Bipolar disorder
    • OCD - if moderate response to SSRI
    • Depression
    • Anxiety disorder
    • Mania
    • Tourette’s
  • Toxicity:
    • hyperprolactinemia
    • highest risk EPS of atypicals
    • orthostatic hypotension + reflex tachy
    • long acting injectable
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20
Q

Aripripazole

  • Class- MOA- Use - Toxicity
A
  • Atypical antipsychotic
  • MOA: D2 partial agonist
  • Use:
    • Schizophrenia- positive/negative symptoms
    • Bipolar disorder
    • OCD - if moderate response to SSRI
    • Depression
    • Anxiety disorder
    • Mania
    • Tourette’s
  • Toxicity:
    • more activating (akathisia) and less sedating
    • weight neutral
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21
Q

Ziprasidone

  • Class- MOA - Use- Toxicity
A
  • Atypical antipsychotic
  • MOA: not understood
  • Use:
    • Schizophrenia- positive/negative symptoms
    • Bipolar disorder
    • OCD - if moderate response to SSRI
    • Depression
    • Anxiety disorder
    • Mania
    • Tourette’s
  • Toxicity:
    • prolong QT interval
    • weight neutral
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22
Q

Lithium

Class- MOA- Use- Toxicity

A
  • Mood stabilizer
  • MOA: inospital triphosphate suppressor
  • Use:
    • Mood stabilizer - bipolar disorder
      • only one to decrease suicide
    • cyclothymia
    • unipolar depression
    • blocks relapse and acute manic events
    • SIADH
  • Toxicity:
    • Movement (tremor)
    • Nephrogenic Diabetes insipidus (polyuria)
    • hypOthyroidism
    • Pregnancy - ebstein anomoly and malformation of great vessels
      • apical displacement of tricupsid valve
    • AMS, convulsions, death
    • GI disturbance, weight gain, sedation, leukocytosis
  • Excretion
    • kidneys
    • onset of action 5-7 days
    • reabsorbed in proximal tubule following nA+
    • renal injury, drugs, drigs that increase proximal tubule na+ absorption can increase lithium levels (Thiazide, NSAID, ACE inhibitor)
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23
Q

Valproic Acid

  • MOA - Use- Toxcity
A
  • MOA: increase Na+ channel inactivation, increase [GABA]
  • Use: mood stabilizer- bipolar disorder
    • esp use if poor kidney fxn
  • Toxicity
    • GI distress
    • hepatotoxicity- fatal
    • Pancreatitis
    • tremor
    • wt gain
    • sedation
    • alopecia
    • thrombocytopenia
    • Spina bifida
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24
Q

Carbamazapine

  • MOA- Use- Toxicity
A
  • MOA: increase na+ channel inactivation
    • 5-7 day onset of action
  • Use:
    • mood stabilizer- bipolar
      • esp mixed episodes and rapid cycling
    • trigeminal neuralgia
  • Toxicity:
    • most common: GI and CNS (drosiness, ataxia, sedation, confusion)
    • leukopenia, hyponatremia, thrombocyopenia
    • diplopia
    • ataxia
    • agranulocytosis, aplastic anemia
    • liver toxicity
    • teratogenesis - neural tube defect
    • CYP P450 inducer
    • SIADH
    • Steven johnson syndrome
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25
Buspirone - MOA- Use- Toxicity
* MOA: 5HT R stimulator * Use: * Generalized anxiety disorder * 1-2 weeks to have effect * Toxicity: * NO sedation, addiction, or tolerance * does NOT interact with alcohol
26
Fluoxetine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SSRI * longer half life with active metabolite so SSRI discontinuation syndrome less common * no tapering necessary * Use: * depression * generalized anxiety disorder * panic disorder * OCD - SSRI better then antipsychotics * bulimia * social phobias * PTSD * Toxicity * GI distress * **Sexual dysfunction** (decrease libido) * **Serotonin syndrome** * with any drug that increase serotonin * MAO inhibitor, SNRI, TCA * hyperthermia / confusion / myoclonus / CV collapse / flushing / diarrhea / seizures / Treatment * treatment: *cyproheptadine* * Class C - potentially harmful in pregnancy according to animal studies * need to discuss risk and benefits with patient * **approved in children ** * **More common sleep changes and anxiety ** * **can increase level of neuroleptics ** * Extra * - 4-8 weeks to have effect
27
Paroxetine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SSRI * shortest hald life = **withdrawal phenomenon most common ** * Use: * depression * generalized anxiety disorder * panic disorder * OCD * bulimia * social phobias * PTSD * Toxicity * GI distress * **Sexual dysfunction** (decrease libido) * **Serotonin syndrome** * with any drug that increase serotonin * MAO inhibitor, SNRI, TCA * hyperthermia / confusion / myoclonus / CV collapse / flushing / diarrhea / seizures / Treatment * treatment: cyproheptadine * Teratogenic- persistent pulmonary hypertension of the newborn * avoid in patients with dementia * Extra * 4-8 weeks to have effect * **most drug drug interactions** * **more anticholinergic effects **
28
Setraline - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SSRI * Use: * depression * generalized anxiety disorder * panic disorder * OCD * bulimia * social phobias * PTSD * Toxicity * **GI distress** * **sleep changes ** * Sexual dysfunction (decrease libido) * Serotonin syndrome * with any drug that increase serotonin * MAO inhibitor, SNRI, TCA * hyperthermia / confusion / myoclonus / CV collapse / flushing / diarrhea / seizures / Treatment * treatment: cyproheptadine * Teratogenic- persistent pulmonary hypertension of the newborn * Extra * 4-8 weeks to have effect
29
Citalopram - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SSRI * Use: * depression * generalized anxiety disorder * panic disorder * OCD * bulimia * social phobias * PTSD * Toxicity * GI distress * **Sexual dysfunction** (decrease libido)-- fewer * **Serotonin syndrome** * with any drug that increase serotonin * MAO inhibitor, SNRI, TCA * hyperthermia / confusion / myoclonus / CV collapse / flushing / diarrhea / seizures / Treatment * treatment: cyproheptadine * Teratogenic- persistent pulmonary hypertension of the newborn * Extra * 4-8 weeks to have effect * fewest drug drug interactions
30
Venlafaxine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SNRI (serotonin and NE reuptake inhibitor) * Use: * depression * generalized anxiety * panic disorders * Toxicity: * **increase BP** * sedation * nausea * esp increase risk of mania if given to bipolar
31
Duloxetine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: SNRI (serotonin + NE reuptake inhibitor) * greater NE effect * Use: * Depression * Diabetic peripheral neuropathy * Toxicity: * increase BP * sedation, dry mouth, constipation more due to NE effects * nausea * liver side effects in patients with liver disease
32
Amitriptyline - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * fibromyalgia, chronic pain, migrains, insomnia * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery
33
Nortriptyline - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * use in elderly * fibromyalgia * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * **LESS confusion and hallucination in eldery** * **Least likely to cause orthostatic hypotension**
34
Imipramine - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * fibromyalgia * **bedwetting ** * **panic disorder ** * **PTSD** * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery
35
Despiramine - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * fibromyalgia * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery * **\*\* less sedating and higher seizure threshold **
36
Clomipramine - Class- Use- MOA- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * fibromyalgia * **OCD** - bc has greater serotonin effect * panic * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery
37
Doxepin - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * Use: * major depression * fibromyalgia, chonic pain * PTSD * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery
38
Amoxapine - Class- MOA- Use- Toxicity
* Tricyclic antidepressant * MOA: block NE and serotonin reuptake * blocks post synaptic dopamine receptors * Use: * major depression * **monotherapy for major depression with psychotic features ** * fibromyalgia * Toxicity: * H1 antagonist = sedation * a1 blocking = postural hypotension * anticholinergic = tachy, urinary retention, dry mouth * **Convulsion** * **Coma** * **Cardiotoxicity** - arrythmia * treat = NaHCO3 * respiratory depression * hyperpyrexia * confusion and hallucination in eldery * may cause EPS due to dopamine block * **Do NOT use in depressed patient with parkinson **
39
Tranylcypromine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: MAOI * Increase levels of NE, Serotonin, Dopamine * Use: * atypical depression * anxiety * hypochondriasis * Toxicity: * toxic in overdose - rhabdomyolysis * **hypertensive crisis** * esp with ingestion of tyramine foods * cheese, wine * treat = phentolamine = alpha receptor blocker * CNS stimulation * Serotonin syndrome * dont give with- SSRI, TCA, St. John's Wort, Meperidine, Dextromethorphan
40
Phenelzine - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: MAOI * Increase levels of NE, Serotonin, Dopamine * Use: * atypical depression * anxiety * hypochondriasis * Toxicity: * toxic in overdose * **hypertensive crisis** * esp with ingestion of tyramine foods * cheese, wine * treat = phentolamine = alpha receptor blocker * CNS stimulation * Serotonin syndrome * dont give with- SSRI, TCA, St. John's Wort, Meperidine, Dextromethorphan
41
Isocarboxazid - Class- MOA- Use- Toxicity
* Anti-depressant * MOA: MAOI * Increase levels of NE, Serotonin, Dopamine * Use: * atypical depression * anxiety * hypochondriasis * Toxicity: * toxic in overdose - rhabdomyolysis * **hypertensive crisis** * esp with ingestion of tyramine foods * cheese, wine * treat = phentolamine = alpha receptor blocker * CNS stimulation * Serotonin syndrome * dont give with- SSRI, TCA, St. John's Wort, Meperidine, Dextromethorphan
42
Selegiline - Class- MOA - Use- Toxicity
* Anti-depressant * MOA: selective MAO-B inhibitor * Increase levels of NE, Serotonin, Dopamine * **NO DIET RESTRICTIONS** * Use: * atypical depression * anxiety * hypochondriasis * *comes in patch form* * Toxicity: * toxic in overdose - rhabdomyolysis * **hypertensive crisis** * esp with ingestion of tyramine foods * cheese, wine * treat = phentolamine = alpha receptor blocker * CNS stimulation * Serotonin syndrome * dont give with- SSRI, TCA, St. John's Wort, Meperidine, Dextromethorphan
43
Buproprion * Class- MOA- Use- Toxicity
* Atypical antipsychotic * MOA: increase NE + dopamine * Use: * Depression * Smoking sessation * Toxicity: * tachycardia * insomnia * headache * seizures in bulemic patient * NO sexual side effects
44
Mirtazapine - Class- MOA- Use- Toxicity
* Atypical antidepressant * MOA: * alpha-2 antagonist * increase NE and serotonin release * Use * depression * think skinny old woman who can't sleep * Toxicity * sedation * increased appetite * weight fain * dry mouth
45
Maprotiline - Class- MOA- Use- Toxicity
* Atypical antidepressant * MOA: block NE reuptake * Use: depression * Toxicity: * sedation * orthostatic hypotension * seizures, arrythymia
46
Trazadone - Class- Use- MOA- Toxicity
* Atypical antidepressnat * MOA: primarily inhibits serotonin reuptake * Use: * insomnia * depression * Toxicity * priapism * sedation * nausea * postural hypotension * no sexual side effects of SSRI * no effect on REM sleep
47
Methadone - MOA- Use
* long acting oral opiate * heroin detoxification or long term maintanence * when discontinued has slow release from tissues at low levels to extend withdrawal but lessen symptoms
48
Naloxone + Buprenorphine -MOA- Use- Toxicity
* **Buprenorphine = partial agonist** * **Naloxone = antagonist** * **together = suboxone ** * long acting * Use: heroin addition * fewer withdrawal symptoms then methadone * not active hwen oral so no withdrawal symptoms
49
Phenobarbital / Pentobarbital/ secobarbital - Class- MOA- Use- Toxicity
* Barbituate * MOA: increase _duration_ of Cl- channel opening decreasing neuron firing * Use: * sedation for - * anxiety * seizures * insomnia * Toxicity: * respiratory depression * CV depression * CNS depression * dependence * induce P450
50
Diazepam - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * long 1/2 live * metabolized by liver * Use: * anxiety * spasticity * status epilecticus * detoxification * night terrors * sleep walking * insomnia * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
51
Lorazepam - Class- MOA- Use- Toxivity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * long 1/2 live * metabolization not dependent on liver * Use: * panic attacks * alcohol and sedative hynotic detox * agitation * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
52
Triazolam - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * *short 1/2 live (TrOM)* * Use: * anxiety * spasticity * status epilecticus * detoxification * night terrors * sleep walking * insomnia * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
53
Oxazepam - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * *short 1/2 live (TroM)* * *metabolization not dependent on liver * * Use: * sedative * alcohol or sedative detox * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
54
Midazolam - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * *short 1/2 live (TrOM)* * Use: * anxiety * spasticity * status epilecticus * detoxification * night terrors * sleep walking * insomnia * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
55
Temazepam - Class- MOA- Use - Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * long 1/2 live * not metabolized by liver * Use: * insomnia * primarily used in medical and surgical setting * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
56
Chlordiazepoxide - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * long 1/2 live * metabolized by liver * Use: * anxiety * spasticity * status epilecticus * detoxification * night terrors * sleep walking * insomnia * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil
57
Aprazolam - Class- MOA- Use- Toxicity
* Benzodiazepine * MOA: increase frequebct of Cl- channel opening * long 1/2 live * Use: * anxiety * panic attacks * Toxicity: * dependence * high abuse potential * CNS depression with alcohol * Treat overdose = flumazenil
58
Clonazepam - MOA- Use- Toxicity
* Benzodiazpine * MOA: increase frequebct of Cl- channel opening * Most potent * Use: * anxiety * panic disorder * Toxicity: * dependence * CNS depression with alcohol * Treat overdose = flumazenil * avoid with renal dysfunction
59
Modafenil
* narcolepsy treatment * novel stimulant * preferred over amphetamines because amphatamines cause risk of dependance, abuse, tolerance
60
OCD treatment
* SSRI- fluoxetine, fluvoxamine, paroxetine, setraline * Clomipramine = TCA
61
Tourette
* Atipcal neuroleptics -- Respiridone * Alpha 2 agonist -- clonidine * Severe cases * typical neuroleptics -- haloperidol, primozide
62
PTSD
* SSRI = setraline or paroxetine * alpha blocker = prazosin * TCA = imipramine, doxepin * MAOI
63
Bulemia Nervosa
* Fluoxetine
64
panic disorder
* SSRI = setraline and paroxetine * Imipramine * Clomipramine * benzo = immediate * venlafazine
65
GAD
* antidepressant - SSRI, buspirone, venlafaxine * benzo- clozepam, diazepam
66
esciptalopram
* Anti-depressant * MOA: SSRI * Use: * depression * generalized anxiety disorder * panic disorder * OCD - SSRI better then antipsychotics * bulimia * social phobias * PTSD * Toxicity * GI distress * Sexual dysfunction (decrease libido) * Serotonin syndrome * with any drug that increase serotonin * MAO inhibitor, SNRI, TCA * hyperthermia / confusion / myoclonus / CV collapse / flushing / diarrhea / seizures / Treatment * treatment: cyproheptadine * Teratogenic- persistent pulmonary hypertension of the newborn * Extra * - 4-8 weeks to have effect * expensive * fewer side effects
67
Anorexia nervosa
* cognitive behavioral therapy * nutritional rehab * Olanzapine if not response to others
68
Delusional disorder
* Antipsychotics
69
ADHD
* Stimulants- mehlphenidate, dextroamphetamine, amphetamine salts * atamoxatine - nonstimulant * alpha 2 agonist- clonidine, gunfacine
70
Nefazodone MOA- Use- Toxicity
* SSRI * Benefit: no sexual dysfunction * toxicity: hepatits and liver failure (black box warning) * RARELY USED
71
Lamotrigine
* Antieleptic * Use: depressive episodes of bipolar * Toxicity: * Rash * Steven Jphnson syndrome * ataxia * nausea * sedation
72
fluvoxamine
* SSRI * OCD * side effects: n, v, drug interactions
73
typical antipsychotic
* block dopamine D2 receptors * low potency = higher incidence anticholinergic adn antihistamien effects * high potency = higher incidence of EPS and NMS * more lethality in overdose due to QT prolongation
74
atypical antipsychotic
* blocks dopamien 2A and serotonin 2A receptors * increase risk of all cause mortality and stroke in elderly * decreased risk EPS, tardive dyskinesia, NMS
75
dopamine pathways
* Mesolimbic = (+) symptoms * nucleus accumbens, fornix, amygdala, hippocampus * Mesocortical = (-) symptoma * Nigrostriatal = EPS * Tubuloinfundibular = prolactin
76
diazepam
* Benzo * rapid onset * use * detoxification from alcohol or sedative hyponotics anxyiolytic * seizures
77
hydroxyzine
* antihistamine * side effects: sedation, dry mouth, constipation, urinary retention, blurred vision * use: quick acting anxiolytic but cant take benzo
78
donepezil galantamine rivastigmine tacrine memantine
acetylcholinesterase inhibitors
79
overdose treatment
* Benzo = flumazenil * Barbituate = NaHCO3 * Opiate = Naloxone

third year (1 decks)

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