Psychopharmocology Flashcards
review
What are the FDA indications for Modafinil?
daytime sleepiness associated with narcolepsy, shift work sleep disorder, and obstructive sleep apnea/hypopnea syndrome
What are the side effects of Modafinil?
Headache, nervousness, diarrhea, insomnia, anxiety, dizziness
What are contraindications to Modafinil?
Severe hypertension or cardiac arrythmias
What are the FDA indications for Fluvoxamine?
OCD, also used off label for social anxiety/mdd/gad/ptsd
What are the side effects of Fluvoxamine
Nausea, Diarrhea, Xerostomia,Headache, Drowsiness, Dizziness, ejaculatory disorder, weakness
What is the MOA for Fluvoxamine
SSRI and sigma 1 antagonism
What is the CYP interactions for Fluvoxamine
Inhibits 1A2, 2C19, 2D6
What is the FDA approval for Atomoxetine?
ADHD (Non-stimulant)
What is the MoA of Atomoxetine
SNRI
What are the adverse effects of Atomoxetine
The serious medication adverse events that have been reported are psychosis, mania, aggressive behavior, suicidal ideation, depression, orthostatic hypotension, syncope, hypertension, tachycardia, QT prolongation, myocardial infarction, stroke, sudden death, seizures, hepatotoxicity, priapism, Raynaud phenomenon, hypersensitivity reaction, angioedema, anaphylaxis, and rhabdomyolysis.
What are adverse effects of desipramine
Common side effects are blurred vision, constipation, increased appetite, nausea, diarrhea, weakness, fatigue, sexual dysfunction and headache. Similar to other tricyclics, desipramine has life threatening side effects such as hyperthermia, lowered seizure threshold, orthostatic hypotension, arrhythmias, tachycardias, QTc prolongation, blood dyscrasias, rare activation of mania, suicidal ideation and it can be potentially lethal in overdose
What is the MOA of Desipramine
tricyclic antidepressant, impacts norepi more so than serotonin. It notably has the least amount of M1 and H1 receptor affinity compared to other TCA. Remember this is the metabolite of Imipramine
What is the MOA of Deutetrabenazine?
VMAT2 inhibitor
What are potential side effects of Deutetrabenazine
somnolence, diarrhea, xerostomia, fatigue, UTI, insomnia, anxiety, constipation, confusion, nasopharyngitis, akathisia, and dysthymic disorder and QT prolongation
What are the pharmacokinetics of Pramipexole?
The bioavailability following absorption exceeds 90%. The peak plasma time of the IR formulation is 2 hours and is 6 hours for ER. Pramipexole is 15% protein bound. Less than 10% of pramipexole is metabolized. The majority of the drug is excreted in the urine (90%), with a renal clearance of 400 mL/min. The elimination half-life is 8.5 hours. As most of pramipexole is not metabolized, 70% is not metabolized in the liver, and multiple cytochromes are not involved in its metabolism.
What is the MoA of Pyridiostigmine
Cholinesterase Inhibitor
What are the pharmacokinetics of pyridiostigmine
It reversibly binds to and inactivates acetylcholinesterase (cholinesterase inhibitor). Pyridostigmine metabolism is both via plasma and the liver. It is metabolized by the CYP450 pathway. It is excreted in the urine, primarily unchanged. The half-life of pyridostigmine is 3 hours. Pyridostigmine is dosed at 60–120 mg PO Q3–8 hours.
What are side effects of pyridiostigmine?
Sweating Diarrhea Nausea Vomiting Abdominal cramps Increased salivation Tearing Increased bronchial secretions Constricted pupils Facial flushing due to vasodilation Erectile dysfunction
What is the only medication to be FDA approved for Seasonal Affective Disorder?
Buproprion
What are some contraindications/potential side effects of Hydroxizine
have QT prolongation; a congenital long QT syndrome; a family history of QT prolongation; a history of torsades de pointes; electrolyte abnormalities; ventricular arrhythmias; bradycardia; history of a recent MI; history of congestive heart failure; or if the environmental temperature is hot; or if the patient has asthma.
What are the dose related side effects of Lithium?
Dose-related side effects include polyuria, polydipsia as (nephrogenic diabetes insipidus), weight gain, cognitive slowing, confusion, impaired memory, poor concentration, confusion, tremor, sedation, gastrointestinal distress, leukocytosis, acne, and edema.
What are mild symptoms of lithium toxicity?
mild symptoms of toxicity, such as increased tremor, slurred speech, and mild lethargy, generally occur when the serum lithium concentration falls between 1.5 to 2.5 mEq/L.
What are the moderate/severe symptoms of lithium toxicity?
worsening lethargy, coarse tremors, and clonus, can be seen when lithium levels are between 2.5 to 3.5 mEq/L.
What is the treatment for Lithium Toxicity?
The general approach lithium toxicity begins with assessment and stabilization of the airway, breathing, and circulation. The treatment for lithium toxicity includes intravenous fluids to maintain the glomerular filtration rate and replace losses, gastrointestinal decontamination in selected circumstances, and, hemodialysis in cases of severe toxicity. Hemodialysis criteria are not firmly established but generally when levels are below 2.5 mEq/L hemodialysis is not necessary. Hemodialysis is generally required with serum levels between 6 to 8 mEq/L however it may be necessary for those on long term lithium treatment at levels as low as 4 mEq/L. Regardless of level, hemodialysis is indicated in those with coma, convulsions, cardiovascular symptoms, or respiratory failure. Serum levels of lithium may rebound as intracellular stores of lithium enter the bloodstream and repeat dialysis may be needed.
