Psychopharmacotherapy Flashcards
NT found in nucleus basalis
Ach
NT found in VTA
DA; when it’s low»parkinson’s, when it’s high»psychosis
NT found in locus ceruleus
NE; when it’s low»ADHD/anxiety, when it’s high»anxiety
NT found in raphe
5HT/serotonin; when it’s low»depression
DA pathways dysregulation - mesocortical
Negative symptoms (isolation, poor hygeine)
DA pathways dysregulation - mesolimbic
Positive symptoms (delusions, AH/VH)
DA pathways dysregulation - nigrostriatal
EPS (dystonia, akathisia, TD, NMS)
DA pathways dysregulation - tuberoinfundibular
Prolactin Effects (gynecomastia, galactorrhea)
Antipsychotics Side Effects
“HAM” histamine: weight gain, sedation; adrenergic: orthostasis, arrhythmias (QTc prolongation); muscarinic: delirium, blurry vision, zerostomia, constipation, urinary retention; + (all) lower seizure threshold
Target of Anti-Psychotics
Typicals: DA receptor; Atypicals: DA and 5HT receptor
Which agent carriers a risk for agranulocytosis?
Clozapine (clozaril), an atypical antipsychotic
Side Effects of Lithium
Neurotoxicity, thyroid dysfunction, diabetes insipidus, leukocytosis, Ebstein’s anomaly; TW: 0.8-1.2mEq/L
Side Effects of Carbamazepine
Induces own metabolism, Steven Johnson rash, blood dyscrasia, craniofacial defects; TW: 8-12 mcg/mL
Side Effects of Valproic Acid
Hepatitis, blood dyscrasia, neural tube defects; 80-120 mcg/mL
Which benzodiazepenes only undergo glucuronidation?
Lorazepam (ativan), oxazepam and temazepam
Which serotinergic receptors are involved in the side effects of nausea, vomiting and diarrhea?
5HT3, 5HT4
Which serotinergic receptors are involved in the side effects of (early) headaches/jitters? (Late) decreased libido and insomnia?
5HT2a, 5HT2c
Which antidepressant is beneficial for patients with comorbid pain syndromes?
SNRIs
Which antidepressant is beneficial for patients who do not want sexual dysfunction side effects?
Bupropion (wellbutrin + zyban), an NDRI
Which antidepressant promotes sleep and appetite?
Mirtazapine (remeron)
Which benzodiazepine carries the highest risk of abuse?
Alprazolam (xanax)
What is a life-threatening risk associated with increased serotonin?
Serotonin Syndrome
What is perphenazine and what is it’s trade name?
Typical antipsychotic with mid-range efficacy and SE aka trialfon
What is chlorpromazine and what is it’s trade name?
Typical antipsychotic with low-range efficacy and SE aka thorazine
What is olanzapine and what is it’s trade name?
Atypical antipsychotic aka zyprexa with SE of metabolic syndrome
What is risperidone and what is it’s trade name?
Most like typical antipsychotics aka risperdal
What is fluphenazine and what is it’s trade name?
Typical antipsychotics aka prolixin
What is haloperidol and what is it’s trade name?
Typical antipsychotic aka haldol
What is quetiapine and what is it’s trade name?
Atypical antipsychotic aka seroquel with SE of sedation and orthostasis
What is apriprazole and what is it’s trade name?
Atypical antipsychotic aka abilify that is a partial DA agonist with least metabolic syndrome SE
What is ziprasidone and what is it’s trade name?
Atypical antipsychotic aka geodon with SE of QTc prolongation
What is clozapine and what is it’s trade name?
Atypical antipsychotic aka clozaril with SE of agranulocytosis, seizures, cardiomyopathy, hypotension and drooling but good for patients with TD and suicidality
What is lamotrigine?
An anti-convulsant used for prevention of depression aka lamictal
What is clonazepam?
A benzodiazepine with long onset and duration aka klonopin
