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Psychiatry-Step 2 > Psychopharmacology > Flashcards

Psychopharmacology Flashcards

1
Q

What medications can cause Serotonin Syndrome? (6)

A
  1. Anti-depressants (SSRI’s, TCA, MAOIs)
  2. Ondansetron
  3. Triptans
  4. Tramadol
  5. Linezolid
  6. Meperidine (Opioid)
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2
Q

Symptoms of Serotonin Syndrome:

A
  • Hyperthermia
  • Autonomic Instability
  • Flushing (Rash)
  • Myoclonus/ Hyperreflexia
  • Encephalopathy
  • Diarrhea (GI Distress)
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3
Q

How do you treat Serotonin Syndrome?

A

Discontinue serotonergic medication –> Supportive care–> Benzodiazepines

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4
Q

How do you treat treatment resistant Serotonin Syndrome?

A

Cyproheptadine

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5
Q

When does Serotonin Syndrome occur?

A

Within the first 24 hrs of starting a medication

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6
Q

What can cause Neuroleptic Malignant Syndrome?

A
  • Antipsychotics (High Potency 1st gen.)
  • Antiemetics (metoclopramide, promethazine)
  • Antiparkinson medication withdrawal (bromocritptine)
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7
Q

Symptoms of Neuroleptic Malignant Syndrome:

A
  • Fever
  • Encephalopathy
  • Unstable Vitals
  • Elevated Creatine Kinase & WBCs
  • Rigidity of muscles/ Bradyreflexia ( lead pipe)
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8
Q

How do you treat Neuroleptic Malignant Syndrome?

A
  • Dantrolene
  • Bromocriptine
  • Amantadine
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9
Q

High Potency First generation Anti-Psychotics (4)

A
  • Haloperidol
  • Trifluoperazide
  • Fluphenazine
  • Pimozide
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10
Q

Treatment for acute delirium and agitation in the elderly?

A

IM High Potency 1st gen. Anti-Psychotics

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11
Q

Which class of medications are contraindicated in delirious elders?

A

Benzos

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12
Q

Low Potency 1st gen. Anti-psychotics?

A
  • Chlorpromazine

- Thioridazine

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13
Q

Adverse Effects of Chlorpromazine?

A
  • Corneal deposits
  • Cholestatic jaundice
  • Blue-gray discoloration
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14
Q

General adverse effects of Low potency 1st gen. psychotics?

A
  • Anti-cholenergic (dry mouth, tachycardia, urinary retention)
  • Anti- a1 adergenic (Orthostatic hypertension)
  • Anti- histamine (Sedation, Weight gain)
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15
Q

Adverse effect of Thioridazine?

A

Retinopathy

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16
Q

Extrapyramidal Symptoms of Antipsychotics:

A
  • Acute Dystonia: Occurs after hours to days, Treat w/ Benztropine or Diphenhydramine
  • Akathisia/Parkinsonism: Occurs days to months, Treat by reducing dose/ change medication
  • Tardive Dyskinesia: Occurs Months to Years, Treat by switching to 2nd gen. antipsychotic
17
Q

How do you treat severe Tardive Dyskinesia?

A

Valbenazine or Deep Brain Stimulation

18
Q

First line treatment for GAD?

A

SSRIs/SNRIs with Cognitive Behavioral Therapy

19
Q

An intense fear of dying is associated with which disorder?

A

Panic Disorder/ Panic Attack

20
Q

Panic attacks are associated with dysfunction with what nucleus in the brain?

A

Locus Ceruleus

21
Q

Neuroanatomical findings in panic disorder?

A

Deceased Amygdala volume

22
Q

Treatment for Panic Disorder?

A

CBT and SSRIs

23
Q

Immediate Treatment for Panic Attack?

A

Benzos

24
Q

Treatment for Jet lag?

A

Melatonin

25
Q

Treatment for Nacrolepsy?

A

Modinafil

26
Q

Ataxia, Confusion, GI upset, and tremor are associated with which medication toxicity?

A

Lithium Toxicity

27
Q

Lithium has a drug interaction with which classes of medication? (5)

A
  • NSAIDs
  • Tetracyclines
  • Metronidazole
  • Thiazide Diurectics
  • ACE inhibitors
28
Q

Lithium’s drug interactions have what effect?

A

Decrease Lithium renal clearance–> Increased Lithium levels–> Toxicity

29
Q

What is Antidepressant Discontinuation Syndrome?

A

The following symptoms occur after abrupt discontinuation of antidepressant medications:

  • Flu-like symptoms
  • Re-emergence of original symptoms (depressive)
  • GI upset
  • Neurosensory disturbances (shock-like sensations)
  • Tremor
30
Q

What can lead to a more severe presentation of Antidepressant Discontinuation Syndrome?

A
  • Serotonergics w/ short half lives (Venlafaxine, Paroxetine)
  • High Doses
  • Long Treatment Duration
31
Q

How do you treat Antidepressant Discontinuation Syndrome?

A

Restart antidepressant and then taper over 2-4 weeks

32
Q

The following symptoms are indicative of overdose from which substance?

  • Altered Mental Status
  • Ataxia
  • Slurred Speech
A

Benzodiazepine Overdose

33
Q

Which symptom indicates the combined use of both alcohol and benzodiazepine?

A

Respiratory Depression

34
Q

What are the side effects of opioids in the elderly?

A
  • Confusion
  • Risk of falls
  • Paradoxical Agitation (Disinhibition, Aggression)
35
Q

Clozapine severe side effects:

A
  • Risk of Seizures
  • Agranulocytosis
  • Myocarditis

Psychiatry-Step 2 (12 decks)

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