Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 psych (JK) > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

What is important to establish before prescribing a medication for psychiatric problem?

A

Diagnosis

target symptoms - monitor therapy response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How to select the agent and dose

A

acceptable side effect profile
lowest effective dose
been on medication before which worked
PMH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indications for anti-depressants

A

unipolar and bipolar depression
organic mood disorders
schizoaffective disorder
anxiety disorders - OCD, panic, social phobia, PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How long is the delay after therapeutic dose is achieved and symptoms improving?

A

3-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If no improvement after 2 months of adequate dose what should be done?

A

switch to another antidepressant or augment with another agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Classifications of antidepressants

A 
TCAs
MAOIs
SSRIs
SNRIs
Novel antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 potentially unacceptable side effect profile of TCAs

A

anticholinergic
antihistaminic
antiandrenergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Caution with prescribing even a weeks dose of TCAs

A

lethal in overdose

can cause QT lengthening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why do TCAs have the 3 side effect profile?

A

tertiary side chains cross react with other types of receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

antihistaminic side effects

A

sedation and weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

anticholinergic side effects

A

dry mouth
dry eyes
constipation
memory deficits and delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anti adrenergic side effects

A

orthostatic hypotension
sedation
sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

tertiary TCAs receptors

A

predominantly serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of tertiary TCAs

A

imipramine
amitriptyline
clomipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do secondary TCAs arise from?

A

metabolites of tertiary TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

primary action of secondary TCAs

A

block noradrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of secondary TCAs

A

desipramine

nortriptyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do MAOIs work?

A

bind irreversibly, preventing inactivation of amines eg Norepinephrine, dopamine and serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are MAOI’s very effective for?

A

depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects of MAOIs

A 
orthostatic hypotension 
weight gain 
dry mouth 
sedation 
sexual dysfunction 
sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hypertensive crisis occurs with which meds and when?

A

MAOIs
taken with tyramine rich foods or sympathomimetics
cheese reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Serotonin syndrome occurs with which meds and when?

A

MAOI and meds that increase serotonin or sympathomimetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Serotonin syndrome symptoms

A 
abdominal pain 
diarrhoea
sweats 
tachycardia 
HTN 
myoclonus 
irritability 
delirium 
death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to avoid serotonin syndrome

A

wait 2 weeks before SSRI –> MAOI (fluoxetine is 5 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do SSRIs work?

A

block presynaptic serotonin reuptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Side effects of SSRIs

A 
GI upset
sexual dysfunction *
anxiety 
restlessness
nervousness
insomnia 
fatigue or sedation 
dizziness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do SSRIs treat?

A

anxiety and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Discontinuation syndrome of SSRIs

A

agitation
nausea
dysphoria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Name some SSRIs

A 
paroxetine
sertraline
fluoxetine
citalopram 
escitalopram
fluvoxamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How o SNRIs work?

A

block both serotonin and noradrenergic reuptake like TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Positives of SNRIs compared to TCAs

A

no anti cholinergic, histaminic or adrenergic side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

SNRIs uses

A

depression
anxiety
neuropathic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Examples of SNRIs

A

venlafaxine

duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Mirtazapine

A

5HT2 and 5HT3 receptor antagonist

35
Q

Buproprion

A

good as augmenting agent

36
Q

How to combat treatment resistance with antidepressants

A

combo eg SSRI/SNRI with mirtazapine
adjunctive with lithium
adjunctive with atypical antipsychotic eg olanzapine
ECT

37
Q

Indications for mood stabilisers

A

bipolar
cyclothymia
schizoaffective

38
Q

Classes of mood stabilisers

A

lithium
anticonvulsants
antipsychotics

39
Q

Only medication to reduce suicide rate

A

lithium

40
Q

Factors predicting positive response to lithium

A

prior long term response of family member good response
classic pure mania
mania followed by depression

41
Q

before starting lithium

A

U+E, TSH

pregnancy test - ebsteins

42
Q

monitoring lithium

A

TSH and creatinine

43
Q

Goal blood level for lithium

A

0.6-1.2

44
Q

Lithium side effects

A

GI distress - low appetite, vomiting, diarrhoea
thyroid abnormalities
polyuria/polydipsia
hair loss and acne

45
Q

Symptoms of lithium toxicity

A

vomit, diarrhoea, convulsions, renal failure, blurred vision, syncope

46
Q

Valproic acid compared to lithium

A

as effective in mania prophylaxis but not depression prophylaxis
better tolerated

47
Q

Factors predicting positive response to valproic acid

A

rapid cycling patient - F
co morbid substance issue
mixed patients
comorbid anxiety disorder

48
Q

Before starting valproic acid

A

LFT
pregnancy test
FBC
folic acid supplement in women

49
Q

monitoring valproic acid

A

LFT and CBC

50
Q

Goal blood level valproic acid

A

50-125

51
Q

Valproic acid side effects

A

thrombocytopenia
nausea, weight gain
sedation, tremor
NTD

52
Q

What is carbamazepine first line for?

A

acute mania and mania prophylaxis

53
Q

Who is carbamazepine indicated for?

A

rapid cyclers

mixed patients

54
Q

Before starting carbamazepine

A

LFT, FBC, ECG

55
Q

Monitoring carbamazepine

A

CBC and LFT

56
Q

Why must you check and adjust carbamazepine levels at a month?

A

induces own metabolism

57
Q

carbamazepine side effects

A

RASH

nausea, vomit, sedation, ataxia, water retention, drug-drug interactions

58
Q

Lamotrigine side effects

A

N&V, sedation, TEN, SJS - stop if any rash

blood dyscriasis

59
Q

What does valproic acid do to lamotrigine?

A

increases/doubles levels

60
Q

Indication for antipsychotics

A

schizophrenia
schizoaffective
bipolar - mood stabilisation/psychotic
psychotic depression

61
Q

4 dopamine pathways in brain

A

mesocortical
mesolimbic
nigrostriatal
tuberoinfindibular

62
Q

mesocortical

A

brain stem to cortex
negative symptoms
too little dopamine

63
Q

mesolimbic

A

dopaminergic cell bodies in brainstem to limbic system
positive symptoms
too much dopamine

64
Q

nigrostriatal

A

dopaminergic cell bodies in substantia nigra to basal ganglia
movement regulation

65
Q

Dopamine effect on Ach

A

suppression

66
Q

Dopamine hypoactivity

A

parkinsonian movements

67
Q

Tuberoinfindibular

A

hypothalamus to ant.pit.

68
Q

Dopamine effect on prolactin

A

inhibits release

69
Q

Blocking dopamine in tuberoinfindibular pathway

A

hyperprolactinaemia

gynaecomastia, galactorrhoea

70
Q

Typical antipsychotics class

A

D2 dopamine receptor antagonists

71
Q

High potency typical antipsychotics

A

bind with high affinity

extrapyramidal side effects

72
Q

Low potency typical antipsychotics

A

less affinity for 2
interact with non dopaminergic receptors
anticholinergic effects

73
Q

How atypical antipsychotics work

A

serotonin-dopamine 2 antagonists

74
Q

Why are atypical antipsychotics atypical?

A

affect dopamine and serotonin neurotransmission in 4 key brain dopamine pathways

75
Q

Examples of atypical antipsychotics

A 
risperidone
olanzapine
Seroquel
apiprazole
clozapine
76
Q

What is clozapine associated with?

A

agranulocytosis - weekly blood draws

77
Q

Antipsychotic adverse effects

A

tardive dyskinesia
neuroleptic malignant syndrome
EPS

78
Q

Agents for EPS

A

anticholinergics
dopamine facilitators
beta blockers

79
Q

Atypical antipsychotics before starting

A

fasting lipid profile
fasting blood sugar
LFT
CBC

80
Q

Anxiolytic use

A

panic disorder
GAD
substance related
insomnia

81
Q

Using anxiolytics to treat anxiety

A

used with SSRI or SNRI

82
Q

Anxiolytics

A

BZD

buspirone

83
Q

BZD side effects

A 
somnolence 
amnesia 
cognitive deficits 
disinhibition 
tolerance 
dependence

Year 3 psych (JK) (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions