Psychopharmacology Flashcards
1
Q
antipsychotics are generally…
A
dopamine antagonists (lower Da)
2
Q
antipsychotic suffixes
A
“azine”
“apine”
“idone”
3
Q
side effects of antipsychotics
A
TD, EPS (1st gen), metabolic effects (2nd gen)
when initially starting meds: sedation/drowsiness, dizziness, anticholinergic effects
4
Q
antipsychotics: dependence? OD?
A
no sig concerns
5
Q
antipsychotic withdrawal
A
not bad - some GI distress, insomnia, nightmare, headache if suddenly stopped
6
Q
Thorazine (chlorpromazine)
A
1st gen/typical antipsychotic
7
Q
Prolixin (fluphenazine)
A
1st gen/typical antipsychotic
8
Q
Haldol (haloperidol)
A
1st gen/typical antipsychotic
9
Q
Trilafon (perphanazine)
A
1st gen/typical antipsychotic
10
Q
Clozaril (clozapine)
A
2nd gen/atypical antipsychotic
11
Q
Risperdal (risperidone)
A
2nd gen/atypical antipsychotic
12
Q
Zyprexa (olanzapine)
A
2nd gen/atypical antipsychotic
13
Q
Invega (paliperidone)
A
2nd gen/atypical antipsychotic
14
Q
Seroquel (quetiapine)
A
2nd gen/atypical antipsychotic
15
Q
Geodon (ziprasidone)
A
2nd gen/atypical antipsychotic
16
Q
Abilify (ariprazole)
A
2nd gen/atypical antipsychotic
17
Q
Prozac (fluoxetine)
A
SSRI
18
Q
Paxil (paroxetine)
A
SSRI
19
Q
Zoloft (sertraline)
A
SSRI
20
Q
Lexapro (escitalopram)
A
SSRI
21
Q
Effexor (venlafaxine)
A
SNRI antidepressant
22
Q
MAOIs
A
antidepressants
23
Q
Wellbutrin (buproprion)
A
antidepressant; dopamine agonist (unusual)
24
Q
Strattera (amoxetine)
A
SNRI used for ADHD (unusual)
black box warning for SI in youth
25
Anafranil (clomipramine)
tricyclic antidepressant (TCA)
26
Tofranil (imipramine)
tricyclic antidepressant (TCA)
27
Elavil (amitryptyline)
tricyclic antidepressant (TCA)
28
Sinequan (doxepin)
tricyclic antidepressant (TCA)
29
antidepressant suffixes
"tine"
"line"
"mine"
30
antidepressants are generally...
serotonin and norepinephrine agonists (increase 5-HT and NE)
exception: Wellbutrin is a Da agonist
31
dangers of antidepressants...
-OD w/ TCAs or MAOIs can be fatal (esp. w/ alcohol)
-MAOIs dangerous w/ certain foods/meds
-TCAs contraindicated for pts w/ heart conditions, high BP, seizures
no sig. concerns re: dependence or withdrawal
32
types of antidepressants
SSRIs/SNRIs
MAOIs
tricyclics (TCAs)
all equally effective but SSRIs best tolerated and have minimal lethality
33
antidepressants can also help with...
-bipolar
-anxiety, OCD, PTSD
-chronic pain
-eating disorders
-childhood sleep disorders
34
benzodiazepines are...
-GABA agonists (increase GABA) --> leads to reduced anxiety and seizures, increased muscle relaxation and sedation
-anxiolytics and/or sedatives/hypnotics/sleep agents
35
TCA side effects
-severe anticholinergic effects (dry mouth, blurred vision, constipation, urinary hesitation, confusion)
-sedation
-orthostatic hypotension
-weight gain
-nausea
-sexual dysfx
-greater risk of heart disease-- contraindicated for pts w/ heart conditions, high BP, or seizures
36
agranulocytosis
sudden drop in white blood cell count associated w/ use of Clozaril (clozapine; 2nd gen antipsychotic), increased risk of serious infection
37
Desyrel (trazodone)
an unusual antidepressant
38
MAOI side effects
-orthostatis hypotension
-weight gain
-edema
-sexual dysfx.
-insomnia
-possible tyramine-induced hypertensive crisis
39
side effects of benzos
mainly DROWSINESS and DIZZINESS
also: mild cognitive impairment (incl. memory), nightmares, headache, impaired coordination, upset stomach
40
dangers of benzos...
-high risk for dependence
-withdrawal can be fatal
-cross-tolerance w/ alcohol
-dangerous in combination w/ alcohol or other depressants
-in older adults: increased risk of falls, MVAs, cog imp.
-when used for sedation/sleep and discontinued, can cause rebound insomnia and/or REM rebound w/ vivid, disturbing dreams
41
benzo suffixes
"pam" and "lam"
42
Buspar (buspirone)
non-BZ anxiolytic; takes 2-4 wks to work; low potential for abuse; does NOT cause sedation, cog imp, or withdrawal
43
Inderal (propranalol)
beta-blocker (usually used for high BP, heart stuff) that can also be used as an anxiolytic (esp. for social anxiety disorder)
44
beta-blockers (what is it, side effects)
usually used for high BP, heart stuff but can also be used as an anxiolytic (esp. for social anxiety)
Side Effects:
sexual dysfx
fatigue
dizziness
SoB
angina (chest pain, reduced blood flow to heart)
cold hands/feet
sleep issues
45
Xanax (alprazolam)
benzo - anxiolytic
46
Klonopin (clonazepam)
benzo - anxiolytic
47
Valium (diazepam)
benzo - anxiolytic
48
Ativan (lorazepam)
benzo - anxiolytic
49
Restoril (temazepam)
benzo - sedative/hypnotic
50
Halcion (triazolam)
benzo - sedative/hypnotic
51
Ambien (zolpidem)
non-BZ sedative
(also Lunesta, Sonata)
52
withdrawal from benzos
can be fatal; must be tapered, monitored
Stage 1: tremors, sweating, agitated, anxious
Stage 2: hallucinations, panic
Stage 3: grand mal seizures
53
benzo uses
Anxiolytic use:
-panic disorder
-GAD
-possibly: other anxiety and anxiety-adjacent dxs, acute mania, akathisia, alcohol withdrawal
-should only be used for short periods!
Sedative use:
-short-term sleep problems, e.g., acute stress or jetlag
54
mood stablizers
1) lithium
2) anticonvulsants - originally for tx seizures, used when lithium doesn't work or is contraindicated
mechanism of action unknown
55
lithium side effects
hand tremor
GI distress
weight gain
sedation
hair loss
polyuria
polydipsia
lithium toxicity (potentially fatal!) - mimics the flu, abdominal pain, diarrhea, vomit, tremor, ataxia (can occur on stable dose or due to OD)
56
anticonvulsant side effects
drowsiness
dizziness
headache
nausea, vomit, diarrhea
increase risk of SI/SBx
(used as mood stablizers)
57
dangers of mood stabilizers
lithium contraindications: pregnancy, thyroid disease, heart disease
-no concern for dependence or withdrawal
-biggest concern w/ lithium is nonadherence
58
Eskalith
mood stabilizer (lithium carbonate)
59
Lithobid
mood stabilizer (lithium citrate)
60
Tegretol (carbamazepine)
anticonvulsant mood stabilizer
61
Neurontin (gabapentin)
anticonvulsant mood stabilizer
62
Depakote (divalproex)
anticonvulsant mood stabilizer
63
Depakene (valproic acid)
anticonvulsant mood stabilizer
64
Lamictal (lamotrigine)
anticonvulsant mood stabilizer
65
Trileptal (oxcarbazepine)
anticonvulsant mood stabilizer
66
Ritalin/Concerta (methylphenidate)
stimulant
67
Adderall (amphetamine)
stimulant
68
Dexedrine (dextroamphetamine)
stimulant
69
stimulants are generally...
dopamine and NE (catecholamine) agonists (increase them)
used to tx ADHD, response within first 2 days
70
catecholamines
Da and NE
71
lithium used for...
-bipolar - may be combined w/ atypical antipsychotic (for mania) and/or antidepressant; takes 1-3 wks to tx mania, 6-8 wks for depression
also:
-schizoaffective dx
-schizophrenia (in combo w/ antipsychotics)
-depression
-impulse control disorders
-rarely: cyclothymia, BPD
72
lithium used for...
-bipolar - may be combined w/ atypical antipsychotic (for mania) and/or antidepressant; takes 1-3 wks to tx mania, 6-8 wks for depression
also:
-schizoaffective dx
-schizophrenia (in combo w/ antipsychotics)
-depression
-impulse control disorders
-rarely: cyclothymia, BPD
73
anticonvulsants used for...
-bipolar - when lithium doesn't work or is contraindicated
-depression
-impulse control disorders
-neurological chronic pain
74
stimulants sometimes used for...
-tx-resistant depression
-tx-resistant obesity
-narcolepsy
-chronic, medically debilitating dxs (e.g., AIDS, cancer)
75
side effects of stimulants
decreased appetite
insomnia
headaches
GI distress/nausea
anxiety, irritability, dysphoria
(temporary) growth suppression in kids
increased HR, BP
76
dangers of stimulants (dependence, OD)
potential for abuse, dependence, and withdrawal
OD is rarely lethal
77
stimulant withdrawal
increased appetite
weight gain
increased sleep
low energy
78
tardive dyskinesia
abnormal movements of lips, tongue, jaw (possibly trunk, arms); side effect of tx w/ antipsychotics (esp. 1st gen but also 2nd gen)
-starts after a year+ of tx
-seen in 20-40% of pts treated w/ 1st gen.
-reversible in ~50% of pts; no tx for it
79
extrapyramidal sxs (EPS)
movement-related side effects of 1st gen antipsychotics
-dystonia (muscle spasms)
-parkinsonism (mask-like face, shuffling gait, drool, tremor, rigidity, bradykinesia)
-akathisia (restlessness)
80
akathisia
-restlessness
-side effect of antipsychotics, antidepressants
81
bradykinesia
slowness of movement or speed
hallmark sx of parkinson's
