PsychoPharmacology Flashcards
CLASSES OF PSYCHOACTIVE DRUGS
- antidepressants
- antipsychotics
- antiparkinsonian
- antianxiety
- antimanics (mood stabilizers)
- CNS stimulants
ANTIDEPRESSANTS ACTION
elevate serotonin and or norepinephrine levels
ANTIDEPRESSANTS INDICATIONS
- DEPRESSION
- ANXIETY DISORDERS
- OCD
- PTSD
- PANIC DISORDER
SELECTIVE SEROTOINI RE-UPTAKE INHIBITORS (SSRI) ANTIDEPRESSANTS
- fluoxetine (Prozac)
- paroxetine
- citalopram (celexa)
- sertraline(Zoloft)
- escitalopram (Lexapro)
SSRI SIDE EFFECTS
- may report GI symptoms
- change in appetitie /weight loss
- headache
- sexual dysfunction
may give person enough energy to act on thoughts of suicide
SERIOUS SIDE EFFECTS OF SSRI
-serotogenic syndrome caused by:
mixing MAOI’s and SSRI’s
overdose of SSRI’s
taking two antidepressants at once
SYMPTOMS OF SEROTONERGIC SYNDROME
agitation sweating fever rigidity tachycardia hypotension hyperreflexia in extreme conditions coma/death
SEROTONIN AND NOREPINEPHRINE RE-UPTAKE INHIBITORS SNRI’S
VENLAFAXINE (EFFEXOR) - WATCH BP
DESVENLAFAXINE
DULOXETINE (CYMBALTA)
TRICYCLIC ANTIDEPRESSANTS
-increase levels of serotonin and norepinephrine
NAMES OF TRICYCLIC ANTIDEPRESSANTS
amitriptyline imipramine doxepin desipramine nortriptyline
TRICYCLIC Antidepressants side effects
-blurred vision
-dry mouth
constipation
urinary retention
-ORTHOSTATIC HYPOTENSION
-EKG CHANGES DUE TO TOXICITY
SEDATION DUE TO HISTAMINE RECEPTOR
-MEMORY AND CONCENTRATION DISTURBANCES
- HEADACHES
-FATIGUE
- IMPOTENCE
MONOAMINE OXIDASE INHIBITORS MOAI’S
- inhibit the breakdown of monoamines specifically serotonin and norepinephrine by inhibiting the catabolic enzyme
- also inhibits the metabolism of tyramine (potent vasopressor)
- foods containing tyramine may stimulate hypertensive events ,possibly hypertensive crisis
MAO INHIBITORS
- tranylcypromine
- pheneizine
- isocarboxzid
RESTRICTED FOODS for MAOI
-aged cheeses aged and cured meats dried or pickled fish liver bananas broad bean pods sauerkraut soy sauce and other soy condiments draft beer vitamins with yeast
ANTIPSYCHOTICS INDICATION AND ACTION
indication - treatment of acute and chronic psychosis
action - dopamine antagonist , blocks dopamine
ATYPICAL ANTIPSYCHOTICS
now also known as second generation antipsychotics
most often prescribed currently due to side effect profile
COMMONLY USED ANTIPSYCHOTICS ATYPICALS (Second generation)
clozapine risperidone olanzapine quetiapine ziprasidone aripiprazole lurasidone
ATYPICAL/SGA
- aruguably the most effective for positive and negative symptoms
- first atypical very effective but some serious adverse reactions
- bone marrow suppression can cause leukopenia need weekly CBC with Diff every week for 1st 6months then every 2 weeks
- increased risk of seizures
ATYPICAL/SGA
- aruguably the most effective for positive and negative symptoms
- first atypical very effective but some serious adverse reactions
- bone marrow suppression can cause leukopenia need weekly CBC with Diff every week for 1st 6months then every 2 weeks
- increased risk of seizures
INTERDICIPLINARY COLLABORATION
- clozapine monitoring
- physician enrolls patient in registry, orders lab work
- nurse faxes lab work to pharmacy /physician as needed , monitors for symptoms of immunosuppression and delivers med
- pharmacist does not dispense medication until new lab values are received
COMMON SIDE EFFECTS ATYPICALS/SGA
clozaril and zyprexa- sedation, constipation, orthostatis ,low EPS
zyprexa- may cause appetite increase and is contraindicated with diabetes
Risperdal- sedation, orthostasis moderate EPS, ANTICHOLENERGIC -LOW CAN CAUSE ELEVATED PROLACTIN LEVELS
aeroquel- orthostais , somnolence, wt gain
Geodon- nausea, somnolence, increased QTC , EKG changes
Ability- nausea , H/A , somnolence/ insomnia
METABOLIC EFFECTS OF CLOZAPINE
WEIGHT GAIN
TYPE 2 DIABETES
DYSLIPIDEMIA
MYOCARDITIS , PERICARDITIS