Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Board Studying. > Psychopharm > Flashcards

Psychopharm Flashcards

1
Q

CYP3a4 inducers

A

Carbamazepine, phenytoin, oxcarbmazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

drugs with increased risk of depression

A

oral contraceptinves, resperine, clonidine, levodopa, alcohol, hydralazine, amantadine, benzos, guanethidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

benefits of high potency antipsychotics in pregnancy

A

decreased risk of neonatal hypotension, anticholinergic, antihistaminic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MAOI SE

A

pyridoxine deficiency
sexual SEs, WG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mechanism of sexual SEs in antipsychotics

A

ANTIADRENERGIC
alpha 1 receptor effects, cholinergic antagonism,
dopamine blockade decreases sexual arousal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risks of lithium exposure during pregnancy

A

arrythmias, polyhydramnios, floppy infant syndrome, premature delivery

levels can become toxic due to shifting fluid levels.
draw lithium levels weekly beginning at 34 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

enzyme that metabolizes methylphenidate

A

CES1A1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

st. johns wart

A

CYP inducer, lowers levels of drugs (warfarin, digoxin), ; also acts as SSRI; avoid with MAOs and SSRIs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

donepezil

A

REVERSIBLE ACH esterase inhibitor; SEs of GI upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

carbemazepine

A

blocks Na+ channels;

inhibits voltage dependent sodium channels and presynaptic sodium channels

effect on sodium channels result in inhibition of glutamate release.

p450 3A4; absorption is increased by food, can cause beningn neuropenia, rare agranulocytosis,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cyp2d6 inhibitors

A

wellbutrin, duloxetine, fluoxetine, paroxetine, zoloft, rotanivir, cemitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CYP2D6 inducers

A

rifampin, dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PCOS and depakote

A

PCOS is a SE of depakote, increased risk of SAs.
10% of females develop PCOS every year.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

lithium and the kidneys

A

causes impaired concentrating capacity by reducing ADH.

LOW SALT diet is likely to increase lithium

can cause nephrogenic diabetes inspidus (increased water output in urine) = hypernatremia; competes with ADH receptors; can use amiloride to reduce

CAN MANAGE polyuria and polydipsia with one single bedttime dose, can use thiazide diuretic or amiloride.

10-20% of people on lithium for over 10 years will have renal changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

lithium and insulin

A

lithium has an insulin like effect: lowers BG, increases appetite and WG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

associated with clozapine

A

myocarditis, eosinophilic colitis, neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

antipsychotics that increase risk of seizures

A

clozapine (4% > 600mg), chlorpromazine is MC in causing seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

6 P450 enzymes that are responsible for 70-80% of all drug metabolism

A

1A2, 2C9, 2C19, 2D6, 3A4, 3A5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

clozapine mechanism

A

dopamine, serotonin, alpha receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

abilify mechanism

A

serotonin 5HT1A partial agonist, partial dopamine agonist

antagonist at 5ht2 receptor

NOT D2 blocker!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

atomoxetine

A

selective norepi reuptake inhibitor.
blocks reuptake of norepinephrine

SEs: WL, abdominal pain, decreased appetite, vomiting, nausea, headache, dizziness, fatigue, irritability

SEs worse in slow metabolizers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lithium induced hypothyroidism

A

MC in women. Need TFTs, EKG, and BMP before starting in pts older than 40. Order renal fucntion test q 3 months and TFT once in 1st 6 months. After 6 mo, order BUB, CR and TFTs q 6-12 months.
usually occurs in 1st 6-18 mo

Hypothyroidism is NOT a CI, treat with levothyroixine

Hypothyroidism associated with rapid cycling and increased depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MAOs

A

sexual SEs and weight gain ie. phenelzine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SE of chlorpromazine

A

mild pigmentary changes in retina (large doses)

thioridazine also causes irreversible pigmentary retinopathy in large amounts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mirtazapine drug class

A

tetracyclic antidepressant. noradrenergic and specific serotenergic antidepressant.

alpha 2 adrenergic receptor antagonist,
serotonin 5h2 antagonist

Blocks presynaptic alpha 2 adrenergic receptor, which results in 5-HT-1A activation and increases release of dopamine. 5HT2 antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

antidepressant not metabolized by p450

A

desvenlafaxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CYP enzyme present at birth

A

3A7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CYP 3A4 inihibitors

A

amiodarone, anastrozole, azithromycin, cannabinoids, cimetidine, clarithromycine, clotrimazole, cyclosporine, danazol, delavirdine, diethyldithiocarbamate, diltiazem, dirithromycine, disulfram, entacapone, erythromycin, ethinyl estradiol, fluconazole, fluoxetine, ketoconazole, metronidazole, nefazodone, paroxetine, ranitidine, sertraline, ritonavir, depakote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

galantamine

A

competitive inhibitor of aceytylcholinesterase; allosteric modulator of nicotinic acetylcholine receptors

SE GI disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

SEs of ACHesterase inhibitors

A

PARASYMPATHETIC/LEAKY

n/v, diarrhea, bradyicardia, hypotension, hypersecretion, bronchoconstriction, GI hypermotility, decreased intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

MC clozapine SEs

A

sedation (20-50%)
sialorrhea/drooling (10-40%c)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

sumatriptan

A

5-Ht1D and 5-HT1B agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Topimax and ETOH

A

antagonizes glutamate and suppresses alcohol induced dopamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

SSRI with greatest WG

A

Paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SSRI that increases clozaril levels

A

Fluvoxamine

fluvox also inhibits 3A3/4 which increases xanex, triazolam, trazodone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Meds not safe to use with MAOIs

A

meperidine, epinephrine, loacl anesthetics and decongestants … can cause hypertensive crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Anticholinergic Side effects

A

result from muscarinic cholinergic receptors.

blurred vision, constipation, dry mouth, urinary retention;
tachycardia, ocular crisis in patients with narrow angle glaucoma, confusion, delirium

also ED and impaired vaginal lubcrication (TCA’s MAOIs)

tricyclic antidepressants block muscarinic ACH receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Risks of duloxetine

A

increases hepatic transanimases and may inc levels in patients with liver dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

mood stabilizer that slows cardiac conduction

A

carbamazepine

avoid in pts with high grade atrioventricular block and sick sinus syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

primary OD sx in Clozapine

A

delirium, lethargy, tachycardia, hypotension, respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

increases warfarin levels

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

effect of valproate on lamictal’s metabolism

A

valproate doubles half life. Will have to halve starting dose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

modafinil

A

has histaminergic mechanism in addition to increasing dopamine by binding to transporter.

dopamine reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Topimax MOA

A

inhibits NA+ channels, enhances GABA-a receptors, antagonizes subtype of glutamate receptors

antagonizes kainate and AMPA receptors

1% get stones, metabolic acidosis

associated with acute myopia and secondary closure glaucoma , causing ocular pain andd blurred vision.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

MAO-A vs. MAO-B

A

MAO-A breaks down tyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Memantine

A

glutamatergic NMDA Receptor Antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Varenicline MOA

A

Alpha 4 beta 2 nicotininc acetylcholine receptor partial agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

antipsychotics with highest anticholinergic effects

A

cloazpine, thioridazine, chlorpromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

where melatonin is produced

A

pineal gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

kava kava

A

acts on GABA receptors, long term use linked to liver toxicity. Used for sedative and anesthetic qualities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Ketamine

A

NMDA receptor antagonist; acts at opiod recepters and monoamine transporters; hallucinogen and is similar to PCP

dissociative hallucinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Xyrem

A

sodium salt of gamma-hydroxybutyric acid (GHB); treats cataplexy associated with narcolepsy.

agonizes GABA-b receptor complex and GHB receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

sertraline and CYP2D6

A

sertraline at 200mg is an inhibitor of CYP2D6 and increases levels of tramadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

disulfram

A

blocks dopamine beta hydroxylase in brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

lithium

A

Acute: tremor, polyuria, polydipsia, cognitive problems, poor memory and concentration, GI distress, benign leukocytosis, acne and edema.
Chronic: hair loss, weight gain, possible kidney damage, thyroid disfunction,

EKG: changes in repolarization phase, worsening existing arrhythmias and (less commonly) inducing new ones.

reduces effect of ADH on kidney

associated with hyperplasia and adenomas of parathyroid glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Topimax 200mg or more

A

interferes with OCPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

treat lithium induced polyuria

A

HCTZ or amiloride(K+ sparing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

depakote in mania

A

increases GABA

superior to lithium in mixed sx

superior to lithium in patients with prominent depressive sx during mania or with multiple prior mood episodes

less effective than olanzapine for acute mania

response rates: 48-53%

depakote increased GABA in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

selegiline

A

irreversible MAO-B inhibitor

Contraindicated in pheochromocytoma and surgery- excess norepinephrine can lead to hypertensive crisis

used to target PD sx by increasing levels of dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

SSRIs in bleeding

A

cause dec platelet activation due to reduction of serotnin in platelets. No serotonin in platelets impairs ability of platelets to aggregate.

risk of bleeding is similar to NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

CI for lithium use

A

Sick sinus syndrome.

lithium affects the SA node and atrial node transmissio.

62
Q

TCA CI in breastfeeding

A

doxepin.
causes sedation, hypotonia, respiratory depression,
has long half life.

63
Q

transdermal MPH to oral extended release ratio

A

10mg transdermal to 15mg oral ER

64
Q

things to monitor with tegretol

A

bone marrow suppression sx: bruising, bleeding, aplastic anemia, thrombocytopenia, agranulocytosis

65
Q

common clozaril SEs

A

tremor (6%), hypokinesia (4%), muscle rigidity (3%)

low risk of tarditive dyskinesia

66
Q

hypnotic with 1-2 hr half life and won’t cause grogginess in the AM

A

Zalelpon

67
Q

varenicline (Chantix)

A

partial agonist at alpha4beta2 nicotinic acetylcholine receptors and full agonist at alpha7 nicotinic acetylcholine receptors

68
Q

Fluoxetine increase the drug levels of…

A

TCAs (cardiac risk)
Thioridazine (cardiac risk)
Benzos (sedation)
Tegretol (toxicity)
Phenytoin (toxicity)
Warfarin (toxicity)
Bupropion (seizure)

69
Q

age that abosorption and transportation of drugs are comparable between children and adults

A

4 months

GFR- 1 year

Adult P450 values: 1 year

70
Q

possible SEs of olanzapine

A

DKA and Hyperosmolar Non Ketotic Coma

71
Q

Antidepressants associated with hyponatremia

A

SSRIs

dizziness, light headedness

72
Q

Topimax tetratogenicity

A

cleft lip, palate, hypospadias

73
Q

Drinks that inhibit p450

A

red grapes
grapefruit juice
kava kava
red wine

*antioxidants inhibit p450 enzymes

74
Q

Food that induce CYP1A2 enzyme

and therefore increase cyp450 substrates

A

cauliflower, brussels sprouts, charcoal broiled foods

75
Q

antipsychotic with antidepressant effects

A

geodon

take with food to double bioavailability

works as norepi reuptake inhibitor

76
Q

name for St. Johns Wart

A

Hypericum perforatum

77
Q

p450 inhibitors

A

valproate, fluoxetine, sertraline, fluvox

red grapes, grapefruit, kava kava, red wine

78
Q

p450 inducers

A

phenytoin, carbamazepine, phenobarbital, rifampin

79
Q

strattera MOA

A

inhibit reuptake of norepinehrine

80
Q

xyrem (sodium oxybate)

A

FDA approved for excessive daytime sleepiness and cataplexy associated with narcolepsy.

atomoxetine is also off label for narcolepsy

81
Q

1st line for melancholic depression in geriatrics

A

nortriptyline

82
Q

etoh detox agent used

A

lorazepam

83
Q

quickest nicotine level

A

tobacco cigarette—> spray–>inhaler—>lozenge–>gum–>patch

84
Q

most serious SE of mirtazapine

A

agranulocytosis (1/1000)

mirtazapine has fewer sexual SEs

85
Q

lithium toxicity and SEs

A

> 1.5 tremors, GI, blurred vision, vertigo, confusion, increased DTRs

> 2.5 seizures, comas, arrythmias, permanent neurological damage

treatment: supportive, gastric lavave, emesis
>6 hemodyalisis

86
Q

buspar acts on this receptor

A

5HT1A

87
Q

eosinophilic colitis is associated with these meds

A

clozapine, valproate

88
Q

false positives on UDS

A

PCP- venlafaxine
LSD- amitriptyline
Barbituates- Naproxen
Benzos- Sertraline
Amphetamines- Trazodone

89
Q

time to wait after discontinuing prozac to start MAOI

A

1 month, 5 weeks

90
Q

DR to ER depakote dosing

A

increase ER by 15%

91
Q

MOA of Carbamazepine

A

blocks sodium gated channels (voltage dependent and presynaptic sodium)

food inc absorption
serum level equilibrates after 3-5 weeks
metabolized by p450 3A4
Neutropenia occurs early but is benign

substrate AND inducer of p450 3A4

92
Q

protriptyline

A

inhibits reuptake of serotonin and norepinephrine

energizing. used off label for narcolepsy

93
Q

ginko biloba

A

perceived effects on blood flow and cognitive enhancement

avoid w/ anticoagulants

94
Q

buspar MOA

A

FULL PRE
PARTIAL POST

5ht1a receptor partial agonist at post synaptic receptors in hippocampus and cortex

5HT1A receptor full agonist at presynaptic receptors

mild-moderate presynaptic dopamine antagonist at d2, d3, and d4 receptors

partial alpha 1 receptor agonist

95
Q

tamoxifen

A

lowered by meds that are metabolized by CYP 2D6
like paroxetine, fluoxetine, buproprion

desvenlafaxine is NOT metabolized by p450

96
Q

completes autoinduction in 4-5 weeks

A

carbamazepine

autoinduction due to transcriptional upregulation of genes invovled in metabolism
CYP3a4 and CYP2B6

97
Q

most rapidly absorbed benzo when taken orally

A

diazepam : 100% oral availability, 90% rectal

next is clorazepate 100% bioavailability

98
Q

interacts with MAOIs

A

meperidine, epinephrine, local anesthetics, decongestants can induce hypertensive crises.

99
Q

associated with irreversible pigmentary retinopathy

A

Thioridazine

100
Q

imipramine

A

TCA used to treat nocturnal enuresis in children

serotonin, norepi
downregulates beta adrenergic receptors and serotonin receptors
desensitizes adenyl cyclase

101
Q

keppra

A

excreted by glomerular filtration with subsequent partial tubular reabsorption

clearance reduced in pts with impaired renal function

102
Q

most common SE, EPS, associated with clozapine

A

Tremors

103
Q

enzyme metabolizes alprazolam

A

CYP450 CYP3A4

104
Q

what to do with common lithium SEs

A

nausea (10-20% of patients)- switch to sustained release formulation

diarrhea: switch to immediate release

hypothyroidism- treat with thyroid, continue lithium

edema- administer spironolactone and follow lithium levels

tremor- administer propranolol (10-30mg TID) or primidone (25mg-100mg/day)

polydipsia/polyria- amiloride (5-20mg/day) or HCTZ (50mg/day, use half the lithium dose and follow lithium levels closely)

105
Q

associated with hyponatremia, particularly in elderly females

A

SSRIs like sertraline

106
Q

associated with rise in lithium levels include…

A

diuretics
ACEIs
NSAIDs
COX-2 inhibitors
salt restricting diets
dehydration
high heat
poor oral intake

107
Q

chinese people have lower level of

A

CYP2d6

108
Q

associated with hyperplasia and adenomas of parathyroid gland
aka hyperparathyroidism

A

Lithium

109
Q

causes hypernatremia

A

lithium via inducing nephrogenic diabetes insipidus

competes with ADH hormones, increases water output in urine. causing Nephro diabetic insipidus.
Amelioride blaokcs lithium entry, also partially blocks potassium wasting induced by thiazine

110
Q

meds that REDUCE suicidality

A

lithium in MOOD disorders

Clozapine in schizphrenia/schizoaffective

111
Q

MOA of lamictal

A

inhibits Na+ and Ca2+ channels in addition to weak inhibitor of 5HT3

inhibits glutamate.

112
Q

depakote loading dose in acute mania

A

20mg/kg

113
Q

hypercalcemia

A

lithium long term use
looks like nausea, dry mouth, vomitting, constipation, polyuria, polydips, arrhythmia, short qt interval

114
Q

carbamazapine and depakote

A

inc carbamazepine decreases depakote

carbamazepine induces p450 system.
so decreases depakote

also depakote is inhibitor of p450 system CYP 2c9

115
Q

SSRIs approved for panic attacks

A

zoloft
prozac
paxil

116
Q

med with highest risk of suicide in female patients

A

depakote

117
Q

meds associated with depression

A

clonidine
OCPs
reserpine
xanex
ETOH
hydralazine
amantadine
guanethidine

118
Q

how to stop clonidine

A

dec dose slowly over 1 week

119
Q

risk of liver failure

A

nefazodone

iproniazid
phenelzine
imipramine
amitriptyline
duloxetine
buproprion
trazodone
tianeptine
agomelatine

120
Q

treatment for drug induced psychosis in patients with Parkinson’s disease

A

clozapine

121
Q

foods to avoid on MAO-i

A

cheese (can eat cream cheese and cottage)

caviar
liver
smoked/picked/cured fis and meats
ripe avocados
canned figs
yeast extract
chianti red wine
fava beans
raisins
prunes
beer w/ yeast

122
Q

phenytoin

A

folate antagonist

cleft lip in babies

fetal phenytoin sundrome 10-30% of mothers who took phenytoin while pregnant

orofacial clefts, cardiac malformations, genitourinary defects

123
Q

SSRI greatest weight gain risk

A

paxil

124
Q

production of serotonin

A

raphe nuclei

125
Q

late life depression

A

SSRIS
celexa, max dose is 20mg

126
Q

WEllbutrin

A

dopamine norepi reuptake inhibitor

dose dependent seizure risk

taper off is rec

127
Q

atypical depression

A

emotional reactivity, hypersensitivity to loss or rejection, hypersomnia, hyperphagia

tx. MAOIs like
phenelzine and traylcypromine

128
Q

ebstein’s anomoly

A

malformation of tricupsid valve. downward displacement of septal leaflet and atrialized right ventricle

maternal exposure to benzos and/or lithium.

129
Q

tanner stage for hormone replacement

A

2- secondary sex characteristics begin to present

130
Q

CYP1A2 substrates
(drugs metabolized by this enzyme)

A

caffeine
cloazapine
duloxetine
imipramine
olanzapine
imipramine
ramelteon
anitriptyline

131
Q

cyp1a2 inhibitors

A

fluvoxamine
cimetidine
ciprofloacin
grapefruit juice
ketoconazole

132
Q

CYP1A2 Inducers

A

charcoal-broiled beef

tobacco

marijuana

omeprazole

cruciferous vegetables

133
Q

L dopa

A

precursor to neurotrasmitters dopamine, norepinephrine, epinephrine
(catecholamines)

134
Q

amitriptyline

A

TCA that has anticholinergic effects
inc risk of urinary retention

135
Q

glutamate antagonists

A

ethanol
some epileptic drugs
ketamine

glutamate is main excitatory CNS neurotransmitter

136
Q

keppra

A

excreted renally

least effect on hepatic p450 system

137
Q

p450 enzyme present at birth

A

3A7

138
Q

SE of MAOIs

A

orthostatic hypotension

sedation

fatigue

insomnia

urinary hesitancy

constipation

muscle cramps

arrhythimias

weight gain
phenelzine particularly associated with weight gain of MAOs

HYPERTENSIVe crisis is most serious reaction to MAOI

139
Q

worst combo with serotonin syndrome

A

SSRI + MAOI like phenelzine

MAOIs require 2 week washout following discontinuation of MAOI before starting any serotonergic meds

140
Q

discontinuation syndrome

A

dizziness, nausea, cramps, sweating, dysethesias, irritability

meds with shorter half lives

141
Q

combat hypotension caused by MAOI

A

increase salt

fludrocortisone 0.6-.8mg daily

support stocking

adequate hydration

142
Q

TCA preference

A

desimpramine and nortriptyline are preferred over amitriptyline, imipramine and doxepin due to LESS cholinergic blockage and less orthostatic hypotension

143
Q

zolpidem

A

non benzo hypnotic that is selective agonist of GABA-a/benzo receptors.

half life 2.6 and 2.5 hrs for 5 and 10mb tabs

onset of action 45 min and peak action around 1.6 hours
renal excretion

144
Q

yohimbine

A

adrenergic antagonist that helps SSRI induced sexual dysfunction.

anxiogenic

switching to or adding wellbutrin may be effective

145
Q

associated with irreversible pigmentary retinopathy, blindness can occur

A

thioridazine
>800mg

146
Q

TCA overdose

A

severe sedation

hypotension

anticholinergic delirium

*withdrawal syndrome is result of cholinergic rebound

147
Q

SSRI with less sexual SE

A

fluoxetine!!

148
Q

avoid in AIDS patients taking protease inhibitors, can inc toxicity of protease inhibitors

A

Nefazodone

149
Q

disulfram reaction

A

disulfram inhibits conversion of acetaldehyde to acetyl-coenzyme A by inhibiting aldehyde dehydrogenase

causes 5-10x inc of acetaldehyde upon conusmption of ETO

nausea, vom, HA, flushing, sweating, tachycardia, chest pain, vertigo, blurred vision.

half life is 60-120 hours

reaction stops after pt has stopped taking disulfram for over 2 weeks.

150
Q

amoxapine

A

TCA

a metobolite of LOXAPINE, an antipsychotic and can have dopamine blockign effects.

DONT TAKE in parkinsons.

151
Q

antidepressants in epilepsy

A

celexa

zoloft

remeron

Board Studying. (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions