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Psychiatry > quick drug review > Flashcards

quick drug review Flashcards

1
Q

what are the SSRIs

A

fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, escitalopram.

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2
Q

what is the most drug interactions for SSRI

A

paroxetine because it is protein bound

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3
Q

what has the least drug interactions for the SSRIs

A

citalopram.

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4
Q

what are the SE in general for the SSRIs

A

very clean. usually cause insomnia, sexual dysfunction, GI disturbance. vivid dreams. headache.

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5
Q

which SSRIs can cause QT prolongation

A

citalopram and escitalopram

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6
Q

what are the SNRIs

A

venlafaxine, duloxetine

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7
Q

what does bupropion do

A

NE and SE reuptake inhibitor

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8
Q

why use bupropion

A

because it has less sexual SE than SSRIs and is effective in sexual dysfunction.

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9
Q

what is the mechanism of mirtazapine

A

alopha-2 antagonist

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10
Q

what is mirtazapine used for

A

treatment of depression in patients that have weight loss or insomnia. (causes weight gain!)

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11
Q

what is the mechanism of the TCAs

A

inhibit the reuptake of SE and NE.

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12
Q

what are the TCA

A

amitriptyline, imipramine, clomipramine, doxepin, nortriptyline, desipramine and amoxepine

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13
Q

what are the MAOIs

A

phenelzine, tranylcypromine, isocarboxazid

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14
Q

what disorders are SSRIs used for

A

OCD, panic, bulimia, persistent depressive disorder, social anxiety disorder, GAD, PTSD, IBS, premenstrual dysmorphic disorder

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15
Q

what are the SNRIs used for

A

persistent depressive, social anxiety, GAD, neuropathic pain, chronic pain, fibromyalgia,

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16
Q

what are mirtazapine and trazodone used for

A

insomnia

can be useful in major depression, major depression with anxiety.

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17
Q

what is bupropion used for

A

mainly smoking sensation. some efficacy in ADHD.

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18
Q

what are the low potency typical antipsychotics

A

thioridizine, Chlorpromazine

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19
Q

what are the medium potency typical

A

loxapine, thiothixene, molindone, perphenazine

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20
Q

what are the high potency typicals

A

haloperidol, trifluoprazine fluphenazine, pimozside

21
Q

what are the atypicals

A

clozapine, risperidone, quetiapine, ziprasidone, aripiprazole, olazapine, paliperidone, asenapine, iloperidone, lurasidone.

22
Q

what is buspirone used for

A

partial agonist of the HT1A. it is an anxiolytic. slower onset than the Benzos. it is not thought of as effective as others, so usually only used in combination. USED FOR ANXIETY.

23
Q

hydroxyzine

A

antihistamine. used for patients who want quick acting short term medication but who cannot take Benzodiazepines

24
Q

is modafinil used in ADHD

A

NO

25
Q

what is the difference in the low potency typicals

A

they have a lower affinity for the dopamine receptors

26
Q

what is the difference in side effect profiles between the high and low potency

A

the lower potency typicals have a higher incidence of antiadrenergic, anticholinergic, and antihistaminic SE.
The lower potency have a lower incidence of EPS and neuroleptic malignant syndrome.
there is more lethality in overdose due to QTc prolongation and for heart block and V tach.

27
Q

Can acute dystonia be life-threatening

A

Yes. diaphragmatic or airway spasms need to be considered

28
Q

In general what are the SE of the typicals vs atypicals

A

atypicals metabolic syndrome

typicals EPS, NMS, tardive

29
Q

what is methadone

A

a long-acting opioid receptor agonist. this is administered once daily and significantly reduces morbidity and mortality.

30
Q

what is the gold standard treatment for pregnant opioid dependent women

A

methadone.

31
Q

what must be done before treating with methadone

A

EKG. methadone can cause QTc prolongation.

32
Q

what is buprenorphine

A

partial opioid receptor agonist. it is a sublingual preparation that is safer than methadone as its effects plateau and make overdose less likely.

33
Q

what is suboxone

A

preparation of buprenorphine and naloxone. this prevents high from injection.

34
Q

what is naltrexone

A

competitive opioid antagonist that precipitates withdrawal if used within 7 days of heroin use. this is given monthly with a depot injection

35
Q

what is the biggest issue with naltrexone

A

compliance

36
Q

how do we treat moderate withdrawal from opioids

A

clonidine for the autonomic symptoms, NSAIDs for pain and dicyclomine for abdominal craps.

37
Q

what do we use for severe withdrawal

A

detox with buprenorphine or methadone.

38
Q

what BAL do you lose fine motor control

A

20-50

39
Q

what BAL do you have impaired judgement and coordination

A

50-100

40
Q

what BAL do you have ataxic gait and poor balance

A

100-150

41
Q

what BAL do you become lethargic, have difficulty sitting upright difficulty with memory and nausea and vomitting

A

150-200

42
Q

what BAL do you fall into a coma

A

300

43
Q

what BAL do you have respiratory depression and death

A

400

44
Q

what opioid drugs come up negative on a general tax screen

A

methadone and oxycodone

45
Q

when do alcohol withdrawal symptoms occur

A

begin within 6-24 hours and last 2-7 days

46
Q

what are the mild symptoms of alcohol withdrawal

A

irritability and tremor and insomnia

47
Q

what are the moderate symptoms of alcohol withdrawal

A

diaphoresis, hypertension, tachycardia, fever, disorientation

48
Q

what are the severe symptoms of alcohol withdrawal

A

tonic-clonic seizures, DTs, hallucinations

Psychiatry (11 decks)

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