Rotation Drugs

Question 1

Side effects of Chlorpromazine (Thorazine)

Answer 1

low potency typical antipsychotic:

• orthostatic hypotension
• blue gray skin discoloration
• photosensitivity

(Thioridazine) can cause retinitis pigmentosa

Question 2

General side effects of low potency typical antipsychotic

Answer 2

• antiadrenergic (orthostatic hypotension)
• anticholinergic (dry mouth, confusion)
• antihistaminic (sedation)
• low incidence of EPS
• increased QTC prolongation and changes of lethality
• slightly higher seizure risk than high potency

Question 3

Side effect of MAOI (used for refractory depression)

• Isocarboxazid
• Tranylcypromine
• Phenelzine

Answer 3

• orthostatic hypotension (most common)
• weight gain
• sexual dysfunction
• paresthesias (B6 defiicency)
• *serotonin syndrome (lethargy, restlessness, confusion, flushing, diaphoresis, tremor)
• hypertensive crisis (super elevated BP, headache, sweating, nausea, vomiting, chest pain, arrhythmias, and death)
• wait 2 week after SSRI
• wait 5 weeks for fluoxetine specifically

Question 4

Imipramine indication

Answer 4

useful in enuresis and panic disorder

Question 5

Amitriptyline indication

Answer 5

useful in chronic pain, migraines and insomnia

Question 6

Doxepin indication

Answer 6

tertiary amine (highly anticholinergic/antihistaminergic), antiadrenergic) 
-treats chronic pain, sleep aid at low doses

Question 7

Clomipramine indication

Answer 7

the most sertonin specific therefore useful in OCD

(actually starts with C), SSRI is fluvoxamine

Question 8

Nortriptyline (secondary amine)

Answer 8

less side effects compared to tertiary - useful for chronic pain, least likely of amines to cause orthostatic hypotension

Question 9

What is the specific side effect that can cause leukocytosis

Answer 9

NMS from antipsychotic

and

Lithium