psychopharmaco Flashcards
What does potency of a drug refer to?
does NOT refer to how effective a drug is, but only to how much of a drug must be taken for it to reach optimal efficacy
What are the side effects of low potency anti-psychotics?
Postural hypotension, dizziness, dry mouth, blurred vision, difficulty urinating (urinary retention), increased ocular pressure, constipation, arrhythmia, tachycardia
What type of antipsychotic has the most extrapyramidal side effects? And give eg
High potency drug
EG.
- Haloperidol: Haldol
- Trifluoperazine: Stelazine
- Fluphenazine / Modecate
What are the side effects of high potency anti-psychotics?
acute dystonia (oculogyric crisis), akathisia, akinesia, dystonia, tardive dyskinesia, parkinsonism, neuroleptic malignant syndrome
Treatments of EPSE
- IM Cogentin: Benztropine
- Tab Artane: Trihexyphenidyl
- Diphenhydramine (Benadryl)
What are 2nd gen/atypical drugs effective for?
-ve/soft symptoms
Clozapine/clozaril may develop _____
agranulocytosis
Olanzapine may develop _____
weight gain or even type 2 DM
Antidepressants (increase/decrease) norepinephrine and serotnin?
increase
What is often used for 1st line drug in depression?
And give eg.
SSRIs
Eg.
- Fluoxetine
- Sertraline HCL
Side effects of SSRIs
Nausea, vomiting, diarrhea, tremors, insomnia, headache, weight loss
Side effects of MAOIs
orthostatic hypotension, abnormal heart rate, drowsiness, headache, dizziness, blurred vision, vertigo, dry mouth, nausea, vomiting
What can cause hypertensive crisis?
Wrong drug & food interactions (with MAOIs)
Side effects of hypertensive crisis + late signs
elevation of diastolic & systolic BP, palpitations, stiff neck, radiating headache, diaphoresis, pupils dilation, intracranial bleeding
late signs: confusion, convulsion, coma
Side effects of Li carbonate
slurred speech, hand tremor, poor memory, severe nausea, polyuria, thirst, risk of hypothyroidism, ECG changes, leukocytosis
What drug blocks the nero-sodium channel and calms neurons?
Anticonvulsant: Carbamazepine
Side effects of Carbamazepine
dizziness, sedation, headache, confusion, nausea, dry mouth, constipation
What type of drug enhances serotonergic & reduces dopaminergic actions?
Anticonvulsant:
Sodium valproate/ valproic acid
Side effects of Sodium valproate/ valproic acid
sedation, tremor, headaches, visual disturbances, tinnitus, agitation, nausea, diarrhoea, abdominal cramps, heartburn
Treatment options for insomnia (5 options)
- Short acting BZP: Triazolam (Halicon)
- Intermediate acting BZP: Lorazepam (Ativan)
- Long acting BZP: Diazepam (Valium)
- Novel non-BZP: Buspirone (BuSpar)
- Sedating antihistamine: Hydroxyzine Hydrochloride (Atarax)
Instruct patient NOT to use ______ together with alcohol
anxiolytics
Signs of tardive diskinesia (at least 6)
- frowning
- lip smacking
- puckering
- sticking out tongue
- rapid movements in the arms, legs
- disfigured facial features such as drooping of the mouth of eyes
- rapid blinking
- difficulty breathing
- difficulty swallowing
- difficulty speaking
What is the most severe form of EPSE?
Neuroleptic Malignant Syndrome
Symptoms of Neuroleptic Malignant Syndrome
- Hyperpyrexia (41 degrees) fever
- Unstable BP
- Stupor; muscle rigidity
- Alteration in consciousness (delirium or agitation)
- Elevated blood creatinine phosphokinase
- Profuse diaphoresis
- Urinary incontinence
- Acute renal failure
