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Nik essentials guidelines > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What is the algorithm for the diagnosis of Serotonin Syndrome?

A
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2
Q

What the clinical manifestations of Serotonin syndrome?

A
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3
Q

What are the main features of NMS?

A

FARM

  • Fever
  • Autonomic instability
  • Rigidity
  • Mental status change
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4
Q

What are two psychotropic drugs with Health Canada warning for liver disease?

A
  • Valproic acid
  • Duloxetine
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5
Q

What antipsychotics are not associated with QTc prolongation?

A
  • Lurasidone
  • Paliperidone
  • Aripiprazole
  • Asenapine

(Schizophrenia guidelines)

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6
Q

What are the drugs with significant QTc increase risk in decreasing order?

A

sertindole > amisulpiride > ziprasidone > iloperidone > risperidone > olanzapine > quetiapine > haloperidol

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7
Q

What are the recommended doses for psychosis for

  • Quetiapine
A

300 - 800 mg

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8
Q

What are the recommended doses for psychosis for

  • Clozapine
A

300-900 mg

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9
Q

What are the recommended doses for psychosis for

  • Risperidone
A

2-8 mg

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10
Q

What are the recommended doses for psychosis for

  • Olanzapine
A

10-20 mg

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11
Q

What are the recommended doses for psychosis for

  • Aripiprazole
A
  • 10-30 mg
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12
Q

What are the recommended doses for psychosis for

  • Ziprasidone
A

40-160 mg

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13
Q

What are the recommended doses for psychosis for

  • Paliperidone
A

3-9 mg

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14
Q

What are the recommended doses for psychosis for

  • Asenapine
A

10-20 mg

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15
Q

What are the recommended doses for psychosis for

  • Lurasidone
A

40-80 mg (up to 160 mg)

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16
Q

What is the algorithm for lithium treatment with renal impairment?

A
17
Q

What are the first-line treatments for ADHD in adults with BD + ADHD?

A
  • Bupropion
18
Q

What are the second-line treatments for ADHD in adults with BD + ADHD?

A
  • Mixed amphetamine salts
  • Methylphenidate
  • Modafinil
  • CBT
19
Q

What are the first-line treatments for ADHD in adults with MDD + ADHD?

A
  • Bupropion
  • Antidepressant + long-acting stimulant
  • Antidepressant + CBT
20
Q

What are the second-line treatments for ADHD in adults with MDD + ADHD?

A
  • Desipramine
  • Nortriptyline
  • Venlafaxine
21
Q

First-line pharmacological treatment for tics (in addition to psychoeducation and habit-reversal)

A
  • Guanfacine
  • Clonidine
22
Q

Second-line pharmacological treatment for tics (in addition to psychoeducation and habit-reversal)

A
  • Risperdal
  • Aripiprazole
23
Q

What TCA have the least anticholinergic activity?

A
  • Amoxapine
  • Nortryptiline
  • Maprotiline
  • Desipramine
24
Q

What antidepressant medication, others than Citalopram or Escitalopram has a Health-Canada warning for QTc?

A
  • Mirtazapine
25
Q

What is the starting dose for atomoxetine?

A
26
Q

What is the mechanism of action of Mirtazapine?

A

Presynaptic α2-adrenergic antagonist effects, which result in increased release of norepinephrine and serotonin.

It is also a potent antagonist of 5‑HT2A, 5‑HT2C, 5‑HT3, and H1 receptors and a moderate peripheral α1-adrenergic and muscarinic antagonist;

it does not inhibit the reuptake of norepinephrine or serotonin

27
Q

What serotonin receptor’s blockade is associated with reduced nausea?

A

5 HT-3

28
Q

What is the black-box warning for antidepressant-related suicidality?

A
29
Q

How might caffeine and clozapine interact?

A
  • Both of substrate of CYP 1A2 (and could compete)
30
Q

What do OCP do to Lamictal?

A
31
Q

What is the interaction between clozapine and carbamazepine?

A
  • Carbamazepine is contraindicated with clozapine because of the increased risk of agranulocytosis.
32
Q

What symptoms does α1 blockage typically cause?

A
  • Cardiovascular side effects such as orthostatic hypotension and drowsiness (especially if rapidly dosed).
  • Central α1 receptors have been linked to potential therapeutic effects such as improvement in nightmares by the α1 antagonist prazosin in PTSD and maybe even reduction of EPS
33
Q

What is the mechanism of action of trazodone?

A
  • Potent antagonist of the 5‑HT2A receptor as well as a dose-dependent blockade of serotonin transporter; also blocks 5‑HT2C, α1, and H1 receptors (CHPD)
34
Q

What is the mechanism of trazodone-induced priapism?

A
  • Priapism with trazodone and nefazodone due to prominent α1 blockade in the absence of anticholinergic activity
35
Q

What is cholinergic rebound syndrome?

A
36
Q

What EPS occurs more often as a result of intermittent antipsychotic use?

A
  • Tardive dyskinesia
37
Q

What is the link between anticholinergics and the occurrence of tardive dyskinesia?

A
  • Anticholinergics can unmask tardive dyskinesia
38
Q

What are the p.o. Risperidone doses to the following doses of Sustenna?

  • 150
  • 75-100
  • 50
A
  • 150 –> 12
  • 75-100 –> 6 mg
  • 50 –> 3 mg
39
Q

What serotonin receptors are involved in nausea / GI side effects?

A
  • 5HT-3

Nik essentials guidelines (6 decks)

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