Psychopharmacology Flashcards by Jackie Davis-Wright | Brainscape

Q

antipsychotics are generally…

A

dopamine antagonists (lower Da)

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Q

antipsychotic suffixes

A

“azine”
“apine”
“idone”

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Q

side effects of antipsychotics

A

TD, EPS (1st gen), metabolic effects (2nd gen)

when initially starting meds: sedation/drowsiness, dizziness, anticholinergic effects

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Q

antipsychotics: dependence? OD?

A

no sig concerns

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Q

antipsychotic withdrawal

A

not bad - some GI distress, insomnia, nightmare, headache if suddenly stopped

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Q

Thorazine (chlorpromazine)

A

1st gen/typical antipsychotic

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Q

Prolixin (fluphenazine)

A

1st gen/typical antipsychotic

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Q

Haldol (haloperidol)

A

1st gen/typical antipsychotic

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Q

Trilafon (perphanazine)

A

1st gen/typical antipsychotic

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Q

Clozaril (clozapine)

A

2nd gen/atypical antipsychotic

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Q

Risperdal (risperidone)

A

2nd gen/atypical antipsychotic

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Q

Zyprexa (olanzapine)

A

2nd gen/atypical antipsychotic

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Q

Invega (paliperidone)

A

2nd gen/atypical antipsychotic

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Q

Seroquel (quetiapine)

A

2nd gen/atypical antipsychotic

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Q

Geodon (ziprasidone)

A

2nd gen/atypical antipsychotic

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Q

Abilify (ariprazole)

A

2nd gen/atypical antipsychotic

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Q

Prozac (fluoxetine)

A

SSRI

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Q

Paxil (paroxetine)

A

SSRI

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Q

Zoloft (sertraline)

A

SSRI

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Q

Lexapro (escitalopram)

A

SSRI

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Q

Effexor (venlafaxine)

A

SNRI antidepressant

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Q

MAOIs

A

antidepressants

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Q

Wellbutrin (buproprion)

A

antidepressant; dopamine agonist (unusual)

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Q

Strattera (amoxetine)

A

SNRI used for ADHD (unusual)

black box warning for SI in youth

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Q

Anafranil (clomipramine)

A

tricyclic antidepressant (TCA)

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Q

Tofranil (imipramine)

A

tricyclic antidepressant (TCA)

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Q

Elavil (amitryptyline)

A

tricyclic antidepressant (TCA)

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Q

Sinequan (doxepin)

A

tricyclic antidepressant (TCA)

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Q

antidepressant suffixes

A

“tine”
“line”
“mine”

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Q

antidepressants are generally…

A

serotonin and norepinephrine agonists (increase 5-HT and NE)

exception: Wellbutrin is a Da agonist

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Q

dangers of antidepressants…

A

-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

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Q

types of antidepressants

A

SSRIs/SNRIs
MAOIs
tricyclics (TCAs)

all equally effective but SSRIs best tolerated and have minimal lethality

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Q

antidepressants can also help with…

A

-bipolar
-anxiety, OCD, PTSD
-chronic pain
-eating disorders
-childhood sleep disorders

Q

benzodiazepines are…

A

-GABA agonists (increase GABA) –> leads to reduced anxiety and seizures, increased muscle relaxation and sedation
-anxiolytics and/or sedatives/hypnotics/sleep agents

Q

TCA side effects

A

-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

Q

agranulocytosis

A

sudden drop in white blood cell count associated w/ use of Clozaril (clozapine; 2nd gen antipsychotic), increased risk of serious infection

Q

Desyrel (trazodone)

A

an unusual antidepressant

Q

MAOI side effects

A

-orthostatis hypotension
-weight gain
-edema
-sexual dysfx.
-insomnia
-possible tyramine-induced hypertensive crisis

Q

side effects of benzos

A

mainly DROWSINESS and DIZZINESS

also: mild cognitive impairment (incl. memory), nightmares, headache, impaired coordination, upset stomach

Q

dangers of benzos…

A

-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

Q

benzo suffixes

A

“pam” and “lam”

Q

Buspar (buspirone)

A

non-BZ anxiolytic; takes 2-4 wks to work; low potential for abuse; does NOT cause sedation, cog imp, or withdrawal

Q

Inderal (propranalol)

A

beta-blocker (usually used for high BP, heart stuff) that can also be used as an anxiolytic (esp. for social anxiety disorder)

Q

beta-blockers (what is it, side effects)

A

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

Q

Xanax (alprazolam)

A

benzo - anxiolytic

Q

Klonopin (clonazepam)

A

benzo - anxiolytic

Q

Valium (diazepam)

A

benzo - anxiolytic

Q

Ativan (lorazepam)

A

benzo - anxiolytic

Q

Restoril (temazepam)

A

benzo - sedative/hypnotic

Q

Halcion (triazolam)

A

benzo - sedative/hypnotic

Q

Ambien (zolpidem)

A

non-BZ sedative

(also Lunesta, Sonata)

Q

withdrawal from benzos

A

can be fatal; must be tapered, monitored

Stage 1: tremors, sweating, agitated, anxious
Stage 2: hallucinations, panic
Stage 3: grand mal seizures

Q

benzo uses

A

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

Q

mood stablizers

A

1) lithium
2) anticonvulsants - originally for tx seizures, used when lithium doesn’t work or is contraindicated

mechanism of action unknown

Q

lithium side effects

A

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)

Q

anticonvulsant side effects

A

drowsiness
dizziness
headache
nausea, vomit, diarrhea
increase risk of SI/SBx

(used as mood stablizers)

Q

dangers of mood stabilizers

A

lithium contraindications: pregnancy, thyroid disease, heart disease

-no concern for dependence or withdrawal
-biggest concern w/ lithium is nonadherence

Q

Eskalith

A

mood stabilizer (lithium carbonate)

Q

Lithobid

A

mood stabilizer (lithium citrate)

Q

Tegretol (carbamazepine)

A

anticonvulsant mood stabilizer

Q

Neurontin (gabapentin)

A

anticonvulsant mood stabilizer

Q

Depakote (divalproex)

A

anticonvulsant mood stabilizer

Q

Depakene (valproic acid)

A

anticonvulsant mood stabilizer

Q

Lamictal (lamotrigine)

A

anticonvulsant mood stabilizer

Q

Trileptal (oxcarbazepine)

A

anticonvulsant mood stabilizer

Q

Ritalin/Concerta (methylphenidate)

A

stimulant

Q

Adderall (amphetamine)

A

stimulant

Q

Dexedrine (dextroamphetamine)

A

stimulant

Q

stimulants are generally…

A

dopamine and NE (catecholamine) agonists (increase them)

used to tx ADHD, response within first 2 days

Q

catecholamines

A

Da and NE

Q

lithium used for…

A

-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

Q

lithium used for…

A

-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

Q

anticonvulsants used for…

A

-bipolar - when lithium doesn’t work or is contraindicated

-depression
-impulse control disorders
-neurological chronic pain

Q

stimulants sometimes used for…

A

-tx-resistant depression
-tx-resistant obesity
-narcolepsy
-chronic, medically debilitating dxs (e.g., AIDS, cancer)

Q

side effects of stimulants

A

decreased appetite
insomnia
headaches
GI distress/nausea
anxiety, irritability, dysphoria
(temporary) growth suppression in kids
increased HR, BP

Q

dangers of stimulants (dependence, OD)

A

potential for abuse, dependence, and withdrawal

OD is rarely lethal

Q

stimulant withdrawal

A

increased appetite
weight gain
increased sleep
low energy

Q

tardive dyskinesia

A

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

Q

extrapyramidal sxs (EPS)

A

movement-related side effects of 1st gen antipsychotics

-dystonia (muscle spasms)
-parkinsonism (mask-like face, shuffling gait, drool, tremor, rigidity, bradykinesia)
-akathisia (restlessness)

Q

akathisia

A

-restlessness
-side effect of antipsychotics, antidepressants

Q

bradykinesia

A

slowness of movement or speed
hallmark sx of parkinson’s