Psychopharmacology Flashcards
What can sertraline cause that can lead to delirium?
Hyponatremia
Olanzapine and quetiapine are known for
Cardio metabolic SE, sedation, weight gain
What is a major risk with clozapine, and how is it monitored + other SE
Agranulocytosis.
Needs weekly FBE for first 18 weeks, Then every 4 weeks after
Seizures, myocarditis, paralytic ileus (causing intestinal onstruction), hypersalivation
Neuroleptic malignant syndrome
Fever, muscle rigidity, mental status change, autonomic instability, rhabdomyolysis, CK elevation
Risperidone SE
Enuresis, reflex tachy, prolactinemia
Ziprasidone SE
Prolonged QT - palpitations, chest discomfort, syncope
Prolonged QT caused by which antidepressants
Escitalopram, citalopram, fluoxetine
SSRI with sedating effects
Fluvoxamine, paroxetine
What drugs can cause serotonin syndrome in combination with SSRI
NSAID
Tramadol
St. john wart
other antidepressant
Which SSRI for back pain
Duloxetine
TCA SE
Cardiotoxicity
Acute urinary retention, blurred vision, constipatin, postural hypotension
Bupropion indications and CI
Patients unable to tolerate SSRI SE
CI: History of seizures, eating disorders, bipolar disorders
Helps in smoking cessation - can reduce craving and withdrawal symptoms
Which SSRI is best for anxiety
Escitalopram
Which AP is most likely to cause EPSE
Haloperidol
Which AP causes the most akathisia but can reduce prolactinemia
Aripiprazole
SSRI for elderly/pregnant with depression
Sertraline (safe for CVS dx)
Amphrtamine induced psychosis drug
Haloperidol
What to give for serotonin syndrome
Cyproheptadine
Managing NMS
Discontinue AP
Admit to ICU for monitoring
Fever: antipyretic, evaporative cooling, ice pack, cooled IV fluids
Prevent acute renal failure and reduce excretion of breakdown products: aggressive fluid resus and alkalisation of urine
Antidote: amantadine/bromocriptine
Rigidity; benzo
ECT
Akathisia management
Propanolol > benztropine > lorazepam
Parkinsonism and dystonia due to AP
Benztropine, diphenhydramine
Tar dive dyskinesia due to AP caused by
Clozapine
Antipsychotic causing sedation, weight gain, orthostatic hypotension and corneal deposits
Chlorpromazine
Which antidepressant requires regular LFT
Agomelatine
Which antidepressant causes severe headache with cheese
Irreversible MOA-i like tranylcypromine, phenctine
Which mood stabilizer causes bone marrow suppression
Carbamazepine
Which mood stabilizers cause a diffuse blustery purple skin rash
Carbamazepine, Lamotrigine
Which benzo causes respiratory depression after getting medicated for aggression
Midazolam
Naltrexone contraindication and benefits
Liver failure
Effective in maintenance phase, person should be opioid free for 7 days at least
Disulfiram effects when take alcohol and CI
Flushing, headache, n&v, SOB
CI in cardiac disease, liver failure
Acamprosate indication and CI
Relapse prevention
Severe renal disease, pregnancy, breastfeedingn
Methadone SE and CI
QTC prolongation
CI in decompensated liver patient
Benefit of bruphenorphine
Lower risk of overdose than methadone
But can ppt withdrawal if patient still has opioids acting on receptors
Serotonin syndrome antidote
Cryptoheptadine
