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Psychiatry Rotation > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

HAM

A

anti- HISTAMINE
anti- ADRENERGIC
anti- MUSCARINIC

Dry mouth, blurred vision, urinary retention

Seen in TCA’s and low potency anti-psychotics

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2
Q

Serotonin Syndrome

A

Confusion, Flushing, diaphoresis, tremor, myoclonic jerks, hyperthemia, hypertonicity and rhabdo

Seen when mixing SSRI’s with MAOi’s

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3
Q

Hypertensive Crisis

A

MAOi’s + Foods with Tyramine (red wine, cheese etc)

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4
Q

Extrapyramidal Effects

A

Parkinsonism, Akathisia (restlessness and agitation.), Dystonia

High Potency Antipsychotics
Reversible

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5
Q

Hyperprolactinemia

A

due to low DA levels

Seen with high potency traditional antipsychotics and risperidone.

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6
Q

Tardive Dyskinesia

A

Chroeotheoid muscle movements

Occurse after years of anti-psychotic use

May be irreversible

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7
Q

Neuroleptic Malignant Syndrome

A

Fever, Tachycardia, HTN , tremor, elevated CPK, lead pipe rigidity

High Potency traditional anti-psychotics.

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8
Q

CYP450 Inducers

A

Carbamazepine

Barbituates

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9
Q

CYP450 Inhibitors

A 
Fluvoxamine
Fluoxetine
Paroxetine
Duloxetine
Sertraline
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10
Q

Classes of Anti-depressants

A

SSRI’s
TCA
MAOi

Most have a withdrawal phenomenon characterized by dizziness, headaches, nausea insomnia and malaise

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11
Q

Fluoxetine (Prozac)

A

Longest Half-Life SSRI.

Safe in pregnancy and approved for use in children

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12
Q

Sertraline (Zoloft)

A

Highest risk for GI disturbance

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13
Q

Paroxetine (Paxil)

A

sedation, constipation, WEIGHT GAIN

Withdrawal phenomenon

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14
Q

Fluvoxamine (Luvox)

A

Approved only for use in OCD

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15
Q

Citalopram (Celexa)

A

Fewest Drug interactions

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16
Q

Escitalopram ( Lexapro)

A

Possibly less side effects ?

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17
Q

Major Side Effects of SSRIs

A 
Sexual dysfunction
GI disturbance
Insomnia
Headache
Anorexia
Restlessness
Seizures

INCREASED SUICIDAL THOUGHTS AND BEHAVIORS (Black Box Warning)

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18
Q

SNRI’s

A

Venlafaxine

Duloxetine

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19
Q

Venlafaxine (Effexor)

A

Used for GAD and for use in ADHD with depression

Can lead to increased BP

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20
Q

Duloxetine (Cymbalta)

A

Often used for people with depression and neuropathic pain.

More dry mouth and GI disturbances than SSRI

21
Q

Buproprion (Wellbutrin)

A

Norepinephrine- Dopamine Reuptake Inhibitor

Lack of sexual side effects
INCREASED RISK OF SEIZURE (lowers threshold)

22
Q

Trazadone/Nefazadone

A

Good for refractory major depression and insomnia

PRIAPISM and sedation are side effects
Nefazadone carries a black box warning

23
Q

Mirtazapine (Remeron)

A

A2 Adrenergic Receptor Antagonist

Good for refractory MDD

SE: Weight Gain

24
Q

mode of action for TCA’s

A

Inhibit the reuptake of NE and Serotonin
Long Half Lives
Can be lethal in overdose

25
Q

Amitryptiline (Elavil)

A

Used in chronic pain migraine and insomnia

26
Q

Imipramine

A

Enuresis and Panic Disorder

27
Q

Doxepin

A

Useful in chronic pain

28
Q

Clomiprimine

A

Most serotonin specific, used in OCD

29
Q

Nortryptiline

A

2nd amine

30
Q

Desipramine

A

Least Anticholinergic

More Activating, Least Sedating

31
Q

Treatment of TCA overdose

A

Sodium Bicarbinate

32
Q

Mode of action for MAOi’s

A

block MAO and stop the breakdown of active amines like NE, serotonin and dopamine

MAO-A –> pref for serotonin
MAO-B –> Pref for NE/EPI

Phenelzine
Tranylcypromine
Isocarboxazid

33
Q

SE of MAOi

A

Serotonin Syndrome occurs with MAOi’s and SSRI’s

Hypertensive Crisis: MAOis taken with tyramine rich food

MOST COMMON IS ORTHOSTATIC HTN

34
Q

MoA fro Gen 1 Anti-psychotics

A

Block D2 Receptors

35
Q

MoA for atypical or Second Gen Anti-psychotics

A

Block both D2 and Serotonin (2A) receptors.

36
Q

Low Potency Typical Antipsychotics

A

Chlorpromazine (blue skin discoloration, cause photosensitivity)
Thioridizine (Retinitis pigmentosum)

37
Q

Midpotency Typical Antipsychotics

A

Loxapine
Thiothixene
Trifluperazine
Perphenazine

38
Q

High Potency Typical Antipsychotics

A

Haloperidol:
Fluphenazine
Pimozide: Heart SE’s

39
Q

Neuroleptic Malignant Syndrome

A 
Fever
Autonomic Instability 
Leukocytosis
Tremor
Elevated CPK
Rigidity
Excessive Sweating 
Delirium

Treatment: Bromocriptine, Dantrolene and amantadine.

40
Q

Advantage of Atypical ANtipsychotics

A

Less likely to cause EPS, Tardive Dyskinesia, or NMS

41
Q

CLozapine

A

Tachycardia and hypersalivation
Can cause neutropenia

Can reduce the risk of suicide !

42
Q

Risperidone

A

Has a long acting injectable form

43
Q

Quetiapine (Seroquel)

A

edndndndnd

44
Q

Olanzapine (Zyprexa)

A

Weight GAIN !

45
Q

Aripiprazole

A

don’t care … its abilift

46
Q

SE’s of Atypical AS’s

A

METABOLIC SYNDOME

Weight gain, hyperlipidemia

47
Q

Mood Stabilizers

A

Used to treat acute mania and prevent relapses

48
Q

Lithium

A

DOC in acute mania

Metabolized by the kidney (cannot give in renal dysfunction)

Can cause Diabetes Insipidus .

Low therapeutic window

Takes 5-7 days to take action

NOT SAFE IN PREGS ! Can cause Ebstein Anomaly

49
Q

Atinconvulsants

A

Carbamazepine

Valproic Acid

Psychiatry Rotation (15 decks)

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