Brainscape's Knowledge GenomeTM

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


See full index

psych FA shelf > psychopharmacology > Flashcards

psychopharmacology Flashcards

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

the first line treatment for EPS caused by antipsychotics is

A

benztropine (cogentin)

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

characterized by grimacing and tongue protrusion

A

tardive dyskinesia

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

characterized by twisting and abnormal postures

A

acute dystonia

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

characterized by the inability to sit still

A

akathisia

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

characterized by decreased or slow body movement

A

bradykinesia

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

HAM side effects

** found in TCAs and low potency antipsychotics

A

H- antihistamine– sedation, weight gain

A- antiadrenergic–hypotension

M- antimmuscarinic– dry mouth, blurred vision, urinary retention, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment for serotonin syndrome

A

stop medications, supportive care

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

SE:

confusion, flushing, diaphoresis, tremor, myoclonic jerks, hyperhtermia, hypertonicity, rhabdomyolysis, renal failure and death

A

serotonin syndrome

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

caused by a buildup of stored catecholamines; caused by the combination of MAOIs with tyramine rich foods or with sympathomimetics

A

hypertensive crisis

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

EPS side effects reversible?

A

yep

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

When does EPS occurs?

A

within hours to days of starting medications or icnreasing doses

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

hyperprolactinemia occurs in which medication?

A

high potency, typical first generation antipsychotics and risperidone

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

mental status changes, fever, tachycardia, hypertension, tremor, elevated CPK “lead pipe” rigidity

A

neuroleptic malignant syndrome

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

CYP450 inducers (4)

A
  1. tobacci
  2. carbamazepine
  3. barbituates
  4. St. John’s wort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CYP450 inhibitors(5)

A
  1. fluvoxamine
  2. fluoxetine
  3. paroxetine
  4. Duloxetine
  5. sertraline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

common side effect of anticholinergic medications

A

consitpation

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

anticholinergic medications exaerbate

A

neurocognitive disorders–dementia

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

all antidepressants have similar response rates in treating major depression

A

yep

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

taper for antidepressants?

A

yep– depending on the dose and half-life

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

drugs that increase serotoning ma ybe found in ________________ that can possibly lead to serotonin syndrome

A

over-the-counter cold remedies such as dextromethorphan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what s the MOA thatmight explain the delay to onset of antidepressant effect

A

downstream effects that causes increased brain plasticity

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

SSRIs:

  1. longest half-life with active metabolites–no need to taper
  2. safe in pregnancy and approved in children and adolescense
  3. common se: insomnia, anxiety, sexual dysfunction
  4. can elevate levels of antipsychotics, leading to increased SE
A

Fluoxetine – PRozac

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

SSRIs:

  1. higher risk for GI disturbances
  2. very few drug interactions
  3. other common side effects: insomnia, anxiety, sexual dysfunction
A

sertraline– Zoloft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SSRIs:

  1. highly protein bound, leading to several drug interactions
  2. common SE: anticholinergi effects and sexual dysfunction
  3. short half-life leading to withdrawal phenomena if not taken consistently
A

Paroxetine– Paxil

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

SSRIs:

  1. currently approved only for use in obsessive-compulsive disorder (OCD)
  2. common-SE: nausea/vomiting
  3. multiple drug interactions due to CYP inhibition
A

fluvoxamine–luvox

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

SSRIs:

  1. fewest drug-drug interaction
  2. dose dependent QTc prolongation
A

Citalopram– Celexa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

SSRIs:

  1. levo-enantiomer of citalopram: similar efficacy, possibly fewer side effects
  2. dose dependent QTc prolongation
A

Escitalopram

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

Black box warning of SSRIs

A

potentially increasing “suicidal thinking and behavior” this warning applies sto children and young adults to age 25 but may be accurate for adults as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
  1. often used for depression, anxiety disorders like GAD and neuropathic pain
  2. low drug interaction potential
  3. extended release allows for once-daily dosing
  4. SE: increases BP in higher doses
A

venlafaxine–effexor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

is the active metabolite of venlafaxine; it is expensive do not use in patients with untreated or labile BP

A

desvenlafaxine–pristiq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q
  1. often used for people with depression, neuropathic pain and in fibromyalgia
  2. SE are similar to SSRIs but more dry mouth and constipation
  3. hepatoxicity in pts. with liver diseasr or alcohol diesease
  4. expensive
A

duloxetine– cymbalta

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

SSRIs can ______ levels of warfarin requiring monitoring when starting and stopping these medications

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q
  1. relative lack of sexual SE compared to SSRI
  2. some efficacy in treatment of adult ADHD
  3. effective for smoking cessation
  4. SE include increased anxiety as well as increased risk of seizures and psychosis at high doses
  5. CI in pt. with seizure or active eating disorders
A

Nupropion– wellbutrin

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

_________ for treating MDD in the elderly– helps with sleep and appetite

A

remeron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q
  1. useful in treating MDD, anxiety and insomnia
  2. do not have sexual SE and no REM effct
  3. SE: nausea, dizziness, orthostatic ypotension, cardiac arrhythmias, sedation and priapism
  4. not used as antidepressant due to orthostatic hypotension
A

Trazodone– Desyrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Black box warning of nefazodone (serzone)

A

liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q
  1. useful in treating MDD, especially in pt. who have significant weight loss and/or insomnia
  2. SE: sedation, weight gain, dizziness, tremor, dry mouth, contipation and agranulocytosis
  3. fewer SE comapred to SSRIs and few drug interactions
A

alpha-2 Adrenergic Receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

TCAs inhibits the

A

reuptake of NE and serotonin thus increases availibility of monoamines in the synapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

TCAs have long or short half lives?

A

long that is why most are dosed once daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

treatment for TCA overdose is

A

IV sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

TCAS:

useful in chronic pain, migraines and insomnia

A

amitriptyline–elavil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

TCAS:

  1. has intramuscular form
  2. useful in enuresis and panic disorder
A

imipramine– tofranil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

TCAS:

most serotonin specific, therefor useful in the treatment of OCD

A

clomipramine–anafranil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

TCAS:

  1. useful in treating chronic pain
  2. emergin use as a sleep aid in low doses
A

doxepin–sinequan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

TCAS:

  1. least likely to cause orthostatic hypotension
  2. useful therapuetic blood levels
  3. useful in treatig chronis pain
A

nortriptyline–pameliot/aventyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

TCAS:

  1. more activating/ lest sedating
  2. least anticholineergic
A

desipramine norpramin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

TCAS:

  1. metabolite of antipsychotic loxapine
  2. may cause EPS and has a similar side-effect profile to typical antipsychotics
A

amoxapine–asendin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

major complications of TCAS (3)

A

3 Cs

  • cardiotoxicity
  • convulsions
  • Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

MAOIS or TCAS are considered more effective in depression with atypical features, characterized dby hypersomnia, increased appetite, heavy feeling in extremities, and increased sensitivity to interpersonal rejection

A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

TCAS are __________ protein bound and lipid _______, and therefore can interact with other medications of the same characterisitcs

A

highly protein bound and lipid soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

the side effects of TCAS are mostly due to

A

lack of specificity and interaction with other receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

MAOIs:

is used to treatdepression that does not require following the dietary restrictions when used in low dosages

A

Selegiline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

why are MAOIs not used as first line treatment agents?

A

b/c of the increased safety and tolerability of newer agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

when are MAOIs are used? Name 3

A

used for certain types of recfractory depression and in refractory anxiety disorders:

  1. phenelzine–nardil
  2. tranylcypromine– parnate
  3. isocarboxazid– marplan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what do when you first suspect serotonin syndrome?

A

discontinue the medication, provide cupportive care and benzo.

56
Q

serotonin antagonist that can be used in serotonin syndrome

A

cyproheptadine

57
Q

hypertensive crisis when taking MAOIs occur when

A

you ea tyramine-rich foods or sympathomimetics

58
Q

what to use in OCD?

A

SSRIs (in high doses)

and TCAs (clomipramine)

59
Q

what to use in Panic disorder

A

SSRIs, TCAs and MAOIs

60
Q

what to use in eating disorder

A

SSRIs (in high doses) and TCAs

61
Q

what to use in persistent depressive disorder (dysthymia)

A

SSRIs, SNRIs

62
Q

what to use in social anxiety disorder (social phobia)

A

SSRIs, SNRIs and MAOIs

63
Q

what to use in GAD

A

SSRIs, SNRIs, TCAs

64
Q

what to use in posttraumatic stress disorder

A

SSRIs

65
Q

what to use iwhat to use in irritable bowel syndrome

A

SSRIs and TCAs

66
Q

what to use in enuresis

A

TCAs (imipramine)

67
Q

what to use in neuropathic pain

A

TCAs (amitriptyline and nortriptyline and SNRIs

68
Q

what to use in chronic pain

A

SNRIs and TCAs

69
Q

what to use in fibromyalgia

A

SNRIs

70
Q

what to use in migraine headaches

A

TCAs– amitriptyline

71
Q

what to use in smoking cessation

A

bupropion

72
Q

what to use in premenstrual dysphoric disorder

A

SSRIs

73
Q

what to use in insomnia

A

mirtazapine and trazodone and TCAs–doxepin

74
Q

low potency, typical antipsychotics

A
  1. chlorpromazinr (thorazine)

2. thioridazine

75
Q

midpotency, typical antipsychotics

A
  1. loxapine (loxitane)
  2. thiothixene (navane)
  3. molindone (moban)
  4. perphenazine (trilafon)
76
Q

High potency, typical antipsychotics

A
  1. haloperidol (haldol)
  2. fluphenazine (prolixin)
  3. trifluoperazine (stelazine)
  4. pimozide (orap)
77
Q

greater affinity for dopamine receptors; therefore a relatively low dose is needed to achieve effect– less sedation, orthostatic hypotension, and anticholinergic effects; greater risk for EPS

A

high potency, typical antipsychotics

78
Q

lower affinity for dopamine receptors and therefore higher does is required.–higher incidence of antiadrenergic, anticholinergic and antihistaminince effects’ lower incidence of EPS, increased lethality in overdose due to QTc prolongation

A

low potency, typical antipsychotics

79
Q

typical antipsychotics associated with retinitis pigmentosa

A

thioridazine

80
Q

typical antipsychotics associated with corneal deposition

A

chlorpromazine

81
Q

antidpoaminergic effects of typical antipsychotics

A
  1. EPS

2. hyperprolactinemia

82
Q

EPS (3)

A
  1. parkinsonism
  2. akathisia
  3. dystonia
83
Q

bradykinesia, maslike face, cogwheel rigidity, pill-rolling tremor

A

parkinsonism

84
Q

subjective anxiety and restlessness, objective fidgetiness. Patients may report a sensation of inability to sit still. Best treated with B-blockers or benzo

A

akathisia

85
Q

sustained painful contraction of musclecs of neck (torticollis), tongue, eyes (oculogyric crisis)– it may be life threatening if it involves the airway or diaphragm

A

dystonia

86
Q

antihistaminic effects

A

results in sedation and weight gain

87
Q

anti-a1-adrenergic effects

A

results in orthostatic hypotension, cardiac abnormalities and sexual dysfunction

88
Q

antimuscarinic effects

A

anticholinergic effects, resulting in dry mouth, tachycardia, urinary retention, blurry vision, cosntipation, and precipitation of narrow-angle glaucoma

89
Q

choreoathetoid (writhing) movements of mouth and tongue that may occur in patients who have used neuroleptics for >6 months

A

tardive dyskinesia

90
Q

treatment for tarduve dyskinesia

A

discontinuation

91
Q

which atypical antipsychotic is less likely to cause tardive dyskinesia

A

clozapine

92
Q

though rare it occurs more often in young males in early treatment with high potency of typical antipsyhoctics:
Fever, autonomic instability, leukocytosis, tremor, elevated CK, rigidity, excessive sweating, delirium

A

neuroleptic malignant syndrome

93
Q

onset of antipsychotic side effects:

  1. NMS
  2. Acute dystonia
  3. parkinsonism/akathisisa
  4. TD
A
  1. NMS– any time but usually early in treatment
  2. Acute dystonia– hours to days
  3. parkinsonism/akathisisa– days to weeks
  4. TD– months to years
94
Q

thirty percent of patients wiht treatment-resistant psychosis will respond to

A

clozapine

95
Q

onlyantipsychotic shown to decrease the risk of suicide

A

clozapine

96
Q

second generation antipsychotic:

  • unique mechanism of partial D2 agonism
  • can be more activating (akathisia) and less sedating
  • less potential for weight gain
A

aripiprazole (abilify)

97
Q

________ are often prescribed as monotherapy in the acute or maintenance treatment of bipolar disorder

A

atypical antipsychotics

98
Q

the only moos stabilizer shown to decrease suicidality

A

Lithium

99
Q

lithiums is metablozed by the ____

A

kidney

100
Q

blood levels are useful for (4)

A
  1. lithium
  2. valproic acid
  3. carbamazapine
  4. clozapine
101
Q

especially useful in treating mania with mixed features and rapid-cycling bipolar disorder; less effective for the depressed phase

A

carbamazepine–tegretol

102
Q

efficacy for bipolar depression, through little efficacy for aute mania or prevention of mania

A

lamotrigine–lamictal

103
Q

MOA of carbamezapine

A

acts by blocking sodium channels and inhibiting action potentials

104
Q

MOA of Valpric acid

A

blocks sodium channels and increases GABA concenrtation in the brain

105
Q

MOA of lamotrigine

A

sodium channels that modulate glutamate and aspartate

106
Q

as effective in mood disorders as carbamazepine but better tolerated

A

oxcarbazepine–trileptal

107
Q

often used adjunctively to help with anxiety, sleep, neuropathic pain but little efficacy in bipolar disorder

A

Gabapentin– neurontin

108
Q

used in GAD and fribormyalgia but little efficacy in bipolar disorder

A

pregabalin–Lyrica

109
Q

In chronic alcoholics or liver disease, use of benzo that are not metabolized by the liver are: (3)

A
  1. Lorazepam
  2. Oxazepam
  3. Tremazepam
110
Q

Benzo can be lethal when mized with _____– respiratory depression may cause death

A

alcohol

111
Q

for benzo overdose ______ is used to reverse the effects

A

flumazenil

112
Q

MOA of benzo

A

work by potentiating the effects of gamma-aminobutyric acid (GABA)

113
Q

long acting with half-life of >20 hr Benzo (2)

A
  1. diazepam–valium

2. clonazepam–klonopin

114
Q

Intermediate acting and half-life of 6-20 hr benzo (4)

A
  1. alprazolam–Xanaz
  2. Lorazepam–Ativan
  3. Oxazepam– Serax
  4. Temazepam–Restoril
115
Q

Short acting and half-life of <6 hrs Benzo (2)

A
  1. triazolam–Halcion

2. Midazolam–Versed

116
Q

selective melatonin MT agonist

A

ramelteon–rozerem

117
Q

MOA of Zolpidem (ambien)/ zaleplon (sonata)/ eszopiclone (Lunesta)

A

work by selctive receptor binding to the oemga-1 receptor on the GABA-A receptor, which is responsible for sedation

118
Q

Zolpidem (ambien)/ zaleplon (sonata)/ eszopiclone (Lunesta) used ofr?

A

short term treatmetn of insomnia

119
Q

buspirone used for

A

GAD

120
Q

useful for patients who want a quick-acting, short term medications, but who cannot take BDZs for various reasons

A

Hydroxyzzine–atarax

121
Q

Used in ADHD and in treatment of refractory depression

A

Dextroamphetamine and amphetamines (Dexedrine, adderall)

122
Q

Modafinil (provigil) is used in

A

narcolepsy

123
Q

inhibits presynaptic NE reuptake, resulting in increased synaptic NE and dopamine but is less effective than amphetamines for ADHD

A

atomoxetine—strattera

124
Q

acetylcholinesterae inhibitors used in dementia (3)

A
  1. Donepezil–aricept
  2. galantamine–razadyne
  3. rivastigmine–exelon
125
Q

used in moderate to severe neurocognitive disorders– dementia and has fewer side effects than cholinestrease inhibitors

A

Memantine– Namenda

126
Q

Effects of procainamide/quinidine

A

confusion and delirium

127
Q

effects of albuterol

A

anxiety and confusion

128
Q

effects on isoniazid

A

psychosis

129
Q

effects of tetracycline

A

depression

130
Q

effects of nifedipine and verapamil

A

depression

131
Q

effects of cimetidine

A

depression, confusion and psychosis

132
Q

effects of steroids

A

aggressiveness/agitation, mania, depression, anxiety, psychosis

133
Q

ECT is the most effective treatment for (3)

A

MDD with psyhcotic features, mania and catatonia

134
Q

surgical treatment involving the implantation of a medical device that sends electrical impulses to specific parts of the brain

A

Deep brain stimulation

135
Q

noninvasive method to excite neurons in the brain

A

repetitive transcranial magnetic stimulation

** less efficacy than ECT and more harmful SE

136
Q

exposure to daylight or to specific wavelengths of light using lasers, light emitting diodes for MDD w/ a seasonal pattern

A

light therapy

psych FA shelf (17 decks)

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