Psychiatry Flashcards
What class of drugs for anxiety
Benzodiazepines
Duration of action for BZD
Short (midazolam), Intermediate (Alprazolam, lorazepam), Long (Diazepam)
MoA of BZD
Binds to BZD sites in CNS –> increase the frequency of Cl channel opening –> potentiate GABA actions
SE of BZD
CNS (increased drowsiness, anterograde amnesia), CVS (decreased BP, respiration), neonatal (floppy child syndrome), tolerance/dependence/withdrawal
What class of drugs for insomnia?
BZD and non-BZD hypnotics
Non-BZD hypnotics
Zolpidem, zopiclone
BZD-induced sleep
Reduced REM and deep sleep
Non-BZD side effects
Withdrawal anxiety, abuse potential
Classes of antidepressants
SSRI (selective serotonin reuptake inhibitor)
TCA (tricyclic antidepressant)
SNRI (serotonin & norepinephrine reuptake inhibitor)
NaSSA (Noradrenergic & Selective Serotonergic Antidepressants)
SSRI
Fluoxetine, Escitalopram, Sertraline
MoA of SSRI
Block serotonin reuptake –> increase availability at synaptic cleft –> increase post-synaptic reaction –> increase BDNF –> mood elevation
SSRI DDI
P450 inhibition
SE of SSRI
Anxiety, weight loss, no fatality in overdose***
TCAs
Amitriptyline, Imipramine
MoA of TCA
Block reuptake of serotonin and noradrenaline and increases availability at synaptic cleft
SE of TCA
FATALITY in overdose, sedation & fatigue, tachycardia, anticholinergic effects (dry mouth, BoV, urinary retention)
SNRI MoA
Inhibit reuptake of serotonin and noradrenaline
NaSSA
Mirtazapine
MoA of NaSSA
Blocks presynaptic a2-adrenergic autoreceptors on noradrenergic & serotonergic pre-synaptic terminals –> loss of inhibition –> increase NA release –> improvement of symptoms
SE of NaSSA
Anticholinergic effects, agranulocytosis, sedation
Classes of antipsychotics
Typical: chlorpromazine, haloperidol (Ty CHa)
Atypical: quetiapine, olanzapine, risperidone, clozapine, aripipazole (A QuORCA)
MoA of antipsychotics
Blockade of dopamine receptors –> reduce dopamine transmission (opposite of dopamine hypothesis for Psychosis)
Pharmacodynamics of antipsychotics
Typical: Blockade of D2 > 5-HT2
Atypical: Blockade of 5-HT2 > D2
SE of typical vs atypical
Atypicals have less EPSE than typicals but have dose-dependent weight gain
SE of atypicals
Agranulocytosis (clozapine), sedation (clozapine, olanzapine), weight gain (olanzapine»_space; riseperidone), dose-dependent EPSE (risperidone)
