Psychopharmacology Flashcards
Major classes of psychotropic medications (5)
Antipsychotics, antidepressants, antianxiety agents, mood stabilizers, stimulants
Most common Typical or Traditional Antipsychotics (Neuroleptics or Major Tranquilizers)
Thorazine (chlorpromazine)
Prolixin (fluphenazine)
Haldol (haloperidol)
Traditional Antipsychotics better at treating ___ sxs of psychosis
Positive- hallucinations, delusions, disorganized thinking
Atypical or Novel Antipsychotics
Clorazil (clozapine) Risperdal (risperidone) Zyprexa (olanzapine) Seroquel (quetipine) Geodon (ziprasidone) Abilify (ariprazole)
Atypical Antipsychotics are equally effective in treating __ and __ sx of schizophrenia. They are often preferred over traditional antipsyh meds because they does not cause ____ ______.
Positive; Negative
Extrapyramidal symptoms
Disorders treated with Antipsychotics
Schizophrenia Delirium Brief Psychotic Disorder Tourette's Disorder Autism/PDD PTSD Depression Delusional Disorder Some indications for dementia
Common side effects of lower potency antipsychotics
Sedation, anticholinergic effects, hypotension, lowers seizure threshold
Common side effects of high potency antipsychotics
Extrapyramidal sxs
___ ____ is a potential side effect of all traditional antipsychotics
Tardive dyskinesia
Anticholinergic Effects
*Hint: Dry everything out or hold it in
Dry mouth constipation urinary retention blurred vision nasal congestion confusion decreased memory
Orthostatic hypotension
lightheaded when stand up
Treatment of Extrapyramidal Sxs
Anticholinergic agents (Cogentin, Artane)
Extrapyramidal Symptoms
Mvmt related sxs
Parkinsonism-shuffling, tremor, mask face, rigidity
Akathisia: dysphoria, agitation, rocking, shifting wt
Dystonia-painful spasms in neck, back, tongue, larynx
Tardive dyskinesia
Abnormal movements of the lips, tongue, jaw, limbs, and trunk
generally arises 6 months after tx, plateaus after 3 to 6 yrs
Tx of Tardive dyskinesia
Monitoring pts to see if med needs to be changed or dosage reduced
Neuroleptics temporarily reduce sxs
The Atypical Antipsychotic with no side effect of tardive dyskinesia
Clozaril (clozapine)
What types of medications exacerbate tardive Dyskinesia?
anticholinergic agents
Agranulocytosis
Potentially lethal side effect, mostly assoc w/Clozaril (clozapine)
Sudden drop in granulocyte count leading to sore throat & high fever
___ is the atypical antipsychotic that is only prescribed when other antipsychotics have failed due to risk of lethal side effect, ___.
Clozaril; agranulocytosis
True of False: Antipsychotics can cause addiction and tolerance
False, but there can be withdrawal if a high dosage is stopped suddenly
Most Common Tricyclic Antidepressants (TCAs)
*Hint: end w/”amine” or “tyline”
Elavil (amitriptyline)
Anafranil (clomipramine)
Tofranil (imipramine)
SSRIs
Prozac (fluoxetine) Zoloft (sertraline) Paxil (paroxetine) Cymbalta (duloxetine) Strattera (atomoxetine) Serafem (fluoxetine) Luvox (fluvoxamine) Celexa (citalopram) Lexapro (escitalopram)
Monoamine Oxidase Inhibitors (MAOIs)
Inhibit activity of monoamine oxidase
Nardil (phenelzine)
Parnate (tranylcypromine)
Mechanism of Action of Antidepressants
Most block reuptake of norepinephrine and/or serotonin
Common meds for depression w/sleep problems
Desyrel (trazodone)
Sinequan (doxepin)
Due to hypnotic effects
Common tx for psychotic depression
TCAs combined w/antipsychotic
Common tx for inpt, melancholic, geriatric depression
TCAs
Common tx for atypical depressions
Treatment resistant depressions, depr w/panic disorder
MAOIs
SSRIs may eventually be effective too
Best tx for mild depression
psychotherapy; placebos equally effective as medication
Tricyclics can induce ___ in 10-15% of patients
Mania
Common tx for Panic Disorder
Tofranil (imipramine)
Paxil (paroxetine)
Prozac (fluoxetine)
Common tx of OCD
Anafranil (clomipramine)
Prozac & other SSRIs
Common tx of Chronic Pain
TCAs
Elavil (amitryptiline)
Norpramin (desipramine)
Sinequan (doxepin)
Common tx of bulimia
SSRIs
TCAs (Norpramin, Tofranil)
Common tx of premature ejaculation
TCA- Anafranil (clomipramine)
SSRI- Paxil (paroxetine)
Side effects of Tricyclics
TCAs can trigger mania in bipolar patients
Anticholinergic effects (dry mouth, memory issues, confusion)
Sedation
Orthostatic hypotension
Weight gain
Nausea
Sexual dysfunction
Side effects of SSRIs
Headaches Nervousness Restlessness Insomnia GI distress sexual dysfunction
Side effects of MAOIs
Orthostatic hypotension Weight gain Edema Sexual dysfunction Insomnia Tyramine Induced Hypertensive Crisis (must follow strict dietary guidelines to avoid excess tyramine)
2 Classes of Antidepr that are highly lethal by overdose
TCAs
MAOIs
Contraindicators for TCAs
heart conditions
High BP
seizures
what is the most common side effect of antipsychotic medications?
Akathisia
