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USMLE - Pharmacology > Psychiatry > Flashcards

Psychiatry Flashcards

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USMLE® Step 1 flashcards
1
Q

Methylphenidate: Family

A

CNS stimulant

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2
Q

Dextroamphetamine: Family

A

CNS stimulant

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3
Q

Methamphetamine: Family

A

CNS stimulant

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4
Q

CNS Stimulant: Mechanism

A

Increases catecholamines at synaptic cleft (NE and DA)

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5
Q

CNS Stimulant: Use (3)

A

ADHD
Narcolepsy
Appetite control

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6
Q

Haloperidol: Family

A

Antipsychotic (high potency)

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7
Q

Trifluoperazine: Family

A

Antipsychotic (high potency)

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8
Q

Fluphenazine: Family

A

Antipsychotic (high potency)

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9
Q

Thioridazine: Family

A

Antipsychotic (low potency)

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10
Q

Chlorpromazine: Family

A

Antipsychotic (low potency)

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11
Q

Antipsychotics: Mechanism

A

Dopamine D2 receptor antagonist (increases cAMP)

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12
Q

Antipsychotics: Use (4)

A

Schizophrenia (positive symptoms)
Psychosis
Acute mania
Tourette’s syndrome

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13
Q

Antipsychotics: Toxicity (5)

A 
EPS side effects
Endocrine (hyperprolactinemia)
Antimuscarinic
Antihistamine
Alpha 1 blocker (hypotension)
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14
Q

High potency antipsychotics: Toxicity

A

neurologic side effects (EPS)

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15
Q

Low potency antipsychotics: Toxicity (3)

A

Anticholinergic
Antihistamine
Alpha-1 blockade

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16
Q

Evolution of EPS Side Effects:

4hr, 4day, 4wk, 4mo

A

4hr: acute dystonia (muscle spasm, stiffness, oculogyric crisis)
4day: akathisia (restlessness)
4wk: bradykinesia (parkinsonism)
4mo: tardive dyskinesia

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17
Q

Neuroleptic malignant syndrome (4)

A

Rigidity
Myoglobinuria
Autonomic instability
Hyperpyrexia

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18
Q

NMS: treatment

A 
Dantrolene
D2 agonist (bromocriptine)
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19
Q

Olanzapine: Family

A

Atypical antipsychotic

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20
Q

Clozapine: Family

A

Atypical antipsychotic

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21
Q

Quetiapine: Family

A

Atypical antipsychotic

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22
Q

Risperidone: Family

A

Atypical antipsychotic

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23
Q

Aripiprazole: Family

A

Atypical antipsychotic

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24
Q

Ziprasidone: Family

A

Atypical antipsychotic

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25
Q

Atypical antipsychotics: Mechanism

A

Varied effects on 5-HT2, dopamine, alpha and H1 receptors

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26
Q

Atypical antipsychotics: Use (7)

A 
Schizophrenia (positive and negative)
Bipolar
OCD
Anxiety
Depression
ania
Tourette's syndrome
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27
Q

Which atypical antipsychotic most likely cause EPS? Which the least?

A

Risperidone - the most

Clozapine - the least

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28
Q

Clozapine: Side effect (2)

A

Agranulocytosis (weekly WBC monitoring)

Seizures

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29
Q

Clozapine and Olanzapine: Side effect

A

Weight gain

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30
Q

Ziprasidone: Side effect

A

Prolonged QT interval

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31
Q

Lithium: Mechanism

A

Inhibition of phosphoinositol cascade

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32
Q

Lithium: Use (2)

A

Mood stabilizer for bipolar (blocks relapse and acute manic events
SIADH

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33
Q

Lithium: Toxicity (7)

A 
Polyuria (ADH antagonist)
Ebstein anomaly
Heart blcok
Hypothyroidism
Tremor
Sedation
Edema
34
Q

How is lithium cleared in the body?

A

Exclusively kidneys

Most is reabsorbed at proximal tubules following Na+

35
Q

Use of what can increase lithium levels (2)

A

NSAIDS

Thiazide

36
Q

Buspirone: Mechanism

A

Stimulates 5-HT1A receptors

37
Q

Buspirone: Use

A

Generalized anxiety

38
Q

Buspirone: Side effect

A

Does not cause sedation, addiction, tolerance

Does not interact with alcohol

39
Q

Fluoxetine: Family

A

SSRI

40
Q

Paroxetine: Family

A

SSRI

41
Q

Sertraline: Family

A

SSRI

42
Q

Citalopram: Family

A

SSRI

43
Q

SSRI: Use (7)

A 
Depression
Generalized anxiety disorder
Panic disorder
OCD
Bulimia
Social phobias
PTSD
44
Q

SSRI is contraindicated in what?

A

Acute mania

45
Q

SSRI: Side effect (3)

A

Serotonin syndrome
Sexual dysfunction
GI distress

Fewer Side effects than TCAs

46
Q

Serotonin syndrome (7)

A 
Hyperthermia
Confusion
Myoclonus
Cardiovascular collapse
Flushing
Diarrhea
Seizures
47
Q

Serotonin syndrome: Treatment

A

Cyproheptadine (5-HT2 receptor antagonist)

48
Q

Venlafaxine: Family

A

SNRI

49
Q

Duloxetine: Family

A

SNRI

50
Q

SNRI: Use (3)

A

Depression
Generalized anxiety (Venlafaxine)
Diabetic peripheral neuropathy (Duloxetine)

51
Q

Which SNRI has greater effect on NE?

A

Duloxetine

52
Q

SNRI: Side effect (4)

A

Increased BP
Stimulant effects
Sedation
Nausea

53
Q

Amitriptyline, Nortriptyline,: Family

A

TCA

54
Q

Imipramine, Desipramine, Clomipramine: Family

A

TCA

55
Q

Doxepin: Family

A

TCA

56
Q

Amoxapine: Family

A

TCA

57
Q

TCA: Mechanism

A

Blocks reuptake of NE and 5HT

58
Q

TCA: Use (4)

A

Major depression
Bedwetting (imipramine)
OCD (Clomipramine)
Fibromyalgia

59
Q

TCA: Toxicity (5)

A

Convulsion, Coma, Cardiotoxicity
Respiratory depression
hyperpyrexia
Anticholinergic (3 TCA more)

60
Q

Which TCA has higher anticholinergic side effects?

A

Amitriptyline

61
Q

Which TCA has lower anticholinergic side effects?

A

Nortriptyline

62
Q

Which TCA is less sedating but has higher seizure threshold?

A

Desipramine

63
Q

TCA Cardiovascular toxicity: Treatment

A

NaHCO3

64
Q

Tranylcypromine: Family

A

MAO inhibitor

65
Q

Phenelzine: Family

A

MAO inhibitor

66
Q

Isocarboxazid: Family

A

MAO inhibitor

67
Q

Selegiline

A

selective MAO-B inhibitor

68
Q

MAO inhibitors: Use (3)

A

Atypical depression
Anxiety
Hypochondriasis

69
Q

MAO inhibitors: Side effects (2)

A

Hypertensive crisis

CNS stimulation

70
Q

What causes hypertensive crisis of MAO inhibitors?

A

Ingestion of tyramine (wine and cheese)

71
Q

What medications cause serotonin syndrome?

A 
TCA
SSRI
MAO inhibitors
St. John's wort
Meperidine
Dextromethorphan
72
Q

Bupropion: Mechanism

A

Increase NE and DA

73
Q

Bupropion: Use (2)

A

Smoking Cessation

Depression

74
Q

Bupropion: Side effects (3)

A

Stimulant effects (tachycardia, insomnia)
Headache
Seizures in bulimic patients

75
Q

Which depression medication does not cause sexual side effect?

A

Bupropion

76
Q

Mirtazapine: Mechanism

A

Alpha-1 antagonist (Increases NE and Serotonin)

Potent 5-HT2 and 5-HT3 receptor antagonist

77
Q

Mirtazapine: Side effects (4)

A

Sedation (desirable for insomnia)
Increased appetite
Weight gain (desirable for elderly or anorexic)
Dry mouth

78
Q

Maprotiline: Mechanism

A

Blocks NE reuptake

79
Q

Maprotiline: Side effects (2)

A

Orthostatic hypotension

Sedation

80
Q

Trazodone: Mechanism

A

Serotonin reuptake inhibitor

81
Q

Trazodone: Use (2)

A

Low dose: insomnia

High dose: antidepressant

82
Q

Trazodone: Side effects (4)

A

Sedation
Nausea
Priapism
Postural hypotension

USMLE - Pharmacology (6 decks)

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