Psychopharmacology

Question 1

Benzodiazepam (Librium and Valium)

Answer 1

-Kills from withdrawal
Side Effects: sedation, tolerance development, dizziness, ataxia
Implications: No alcohol, eliminated in liver, addiction, half-life

Question 2

Lithium carbonate (for antimania)

Answer 2

Side Effects: tremor, dull headaches, metallic taste, polydipsia
Implications: Narrow TI (.5-1.5 mEq/L), decrease Na, increase Li, excess sweating/diuretics
TOXICITY: disrupt muscle condistion, course tremor, GI, confusion, ataxia, dysarthria, seizure, coma, death

Question 3

Monoamine Oxidase Inhibitors (MAOIs) (for antidepressants)

phenelzine or Nardil

Answer 3

Side effects: hypotension, insomnia, sexual dysfunction, weight gain
Implication: low tyramine diet (aged food), no decongestants, hypertension, suicide assessment

Question 4

Tricylics (for antidepressants)

amitriptyline or Elavil

Answer 4

Side effects: sedation, anticholinergic effects, weight gain

Implication: stay on medication even if feeling better, suicide assessment

Question 5

Serotonin Selective Reuptake Inhibitors (SSRIs) (for antidepressants)
(fluozentine or Prozac)

Answer 5

-Safer than tricylics
Side effectsL insomnia, HA, N, sweating, drowsy, sexual dysfunction
Implication: goes through gut, if constipated=increased bowel movement
BLACK BOX WARNING: suicidal thoughts in children

Question 6

Dopamine ReUptake Inhibitors (for antidepressants)

NSRI, 5HT2 receptor agonist, noadrenergic agonist

Answer 6

NSRI: low does more norepinephrine, high dose more sedation
5HT2: primarily norepinephrine
Noradrenergic: primarily norepinephrine anticholinergic effect in low doses

Question 7

Phenothiazines

low potency: Thorazine, high potency: Haldol

Answer 7

Haldol: EPS
Therapeutic Effects: rapid sedation of agitation and aggression, lower psychotic symptoms
SE: EPS and anticholinergic SE, hypertension, lower seizure threshold, sun sensitivity
Implication: tardive dyskinesias

Question 8

Clorazil

agranulocytosis

Answer 8

agranulocytosis: wipes out immune system

Benefit over phenothiazines: works on neg sxs, fewer EPS, less tardive dyskinesias

Question 9

Benztropine or congentin (for psychotic SE)

Answer 9

dry mouth, urinary retention, constipation, dilated pupils

skin flushes, change in sensorium

Question 10

EPS- Acute Dystonic Reaction

Answer 10

First dose-3 days
Involuntary movement (torticollis, facial grimacing, abnormal eye movement, muscle movements, resp. distress)

Question 11

EPS- Akathisia

Answer 11

3-5 days

Looks like anxiety, restlessness, difficulty sitting still, strong urge to move use muscle relaxant

Question 12

EPS- Pseudo Parkinsonism

Answer 12

5-90 days

Motor retardation, mask-like face, tremor, pill-rolling, rigidity, cogwheeling, salivation, shuffling gait

Question 13

EPS- Tardive Dyskinesias

Answer 13

90-365 days

Protrusion of tongue, chewing movement, puffing of cheeks, movement of extremities, movement of trunks