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Behavioural > SJSM Block 4 quiz (BEHAVE MOOD DISORDER SCHIZOPHRENIA OTHER PSYCHOTIC DISORDERS NEUROPSYCHOPHARMACOLOGY) > Flashcards

SJSM Block 4 quiz (BEHAVE MOOD DISORDER SCHIZOPHRENIA OTHER PSYCHOTIC DISORDERS NEUROPSYCHOPHARMACOLOGY) Flashcards

1
Q

Pneumonic:

List the symptoms of MDD
“SIG-E-CAPS”

A

Sadness
Interest (low)
Guilt
Energy (Low)
Concentration (low)
Appetite change
Psychomotor (agitation/retardation)
Suicidality

“Two Blue weeks”

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2
Q

Pneumonic:

List the symptoms associated with SSRI’s “SSS”

A

Stomach (upset)
Sexual dysfunction
Serotonin syndrome

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3
Q

Pneumonic:

Describe the features of FLUoxetine

A

aka Prozac “Flu like in length” with the longest 1/2 life

SSRI

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4
Q

“Flu like in length” with the longest 1/2 life

SSRI

What is the drug??

A

Fluoxetine aka Prozac

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5
Q

Pneumonic:

Describe the features of Sertraline

A

aka Zoloft “think of it as Zertroline”

It has harsher GI side effects giving it the nickname Squirtyline

SSRI

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6
Q

It has harsher GI side effects giving it the nickname Squirtyline

SSRI

What’s the drug??

A

Sertraline aka Zoloft

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7
Q

Pneumonic:

Describe the features of Paroxetine

A

aka Paxil “avoid it to Prevent Pesky Pill-Popping in Preggos!”

SSRI

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8
Q

“avoid it to Prevent Pesky Pill-Popping in Preggos!”

SSRI

What’s the drug??

A

Paroxetine aka Paxil

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9
Q

Pneumonic:

Describe the features of Citalopram

A

aka Celexa “Instead to lexa think lexus with an abnormal eletro-CAR-diogram”
Wide QRS complexes

SSRI

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10
Q

“Instead to lexa think lexus with an abnormal eletro-CAR-diogram”
Wide QRS complexes

SSRI

What’s the drug??

A

Citalopram aka Celexa

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11
Q

Pneumonic:

Describe the features of Escitalopram

A

aka Lexapro “think of it as the overachieving younger sibling”

SSRI

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12
Q

“think of it as the overachieving younger sibling”

SSRI

What’s the drug??

A

Escitalopram aka Lexapro

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13
Q

Pneumonic:

Describe the features of Fluvoxamine

A

aka Luvox “think luvOCD an FDA approved treatment for OCD”

SSRI

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14
Q

“think luvOCD an FDA approved treatment for OCD”

SSRI

What’s the drug??

A

Fluvoxamine aka Luvox

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15
Q

Pneumonic:

Describe the features of Venlafaxine

A

aka Effexor “think vENlafaxine meaning it targets Norepi & Serotonin”

Side effect is short-lived hypertension

SSRI

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16
Q

it targets Norepi & Serotonin”

Side effect is short-lived hypertension

SSRI

What’s the drug??

A

Venlafaxine aka Effexor

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17
Q

Pneumonic:

Describe the features of Duloxetine

A

aka Cymbalta
“think Duo-loxetine both Norepi & SE”
&
“Duloxetine Dulls pain”

Rx Fibromyalgia & Diabetic neuropathy

SSRI

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18
Q

“think Duo-loxetine both Norepi & SE”
&
“Duloxetine Dulls pain”

Rx Fibromyalgia & Diabetic neuropathy

SSRI

What’s the drug??

A

Duloxetine aka Cymbalta

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19
Q

Pneumonic:

Describe the features of Mirtazapine

A

aka Remeron “think MEAL-tazapine because it increases hunger & reduces nausea”

A good Rx for cachexia

SSRI

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20
Q

“think MEAL-tazapine because it increases hunger & reduces nausea”

A good Rx for cachexia

SSRI

A

Mirtazapine aka Remeron

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21
Q

Pneumonic:

Describe the features of Bupropion

A

aka Wellbutrin “think BUtane as BU-DA-NE, because it antagonizes Dopamine & Norepi, & fire represents happiness, hot sex, and smoking cessation”

Causes seizures in Bulimic patients

SSRI

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22
Q

“think BUtane as BU-DA-NE, because it antagonizes Dopamine & Norepi, & fire represents happiness, hot sex, and smoking cessation”

Causes seizures in Bulimic patients

SSRI

What’s the drug??

A

Bupropion aka Wellbutrin

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23
Q

Pneumonic:

Describe the features of Trazedone

A

aka Desyrel
“think Trazzzzodone = treats insomnia & Trazo-BONE = can cause priapism”

SSRI

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24
Q

“think Trazzzzodone = treats insomnia & Trazo-BONE = can cause priapism”

SSRI

What’s the drug??

A

Trazodone aka Desyrel

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25
Q

Pneumonic:

Describe the features of Imipramine

A

aka Tofranil “I’m peeing-ramine via Ach inhibition”

used to treat bedwetting in children

TCA

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26
Q

“I’m peeing-ramine via Ach inhibition”

used to treat bedwetting in children

TCA

What’s the drug??

A

Imipramine aka Tofranil

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27
Q

Pneumonic:

Describe the features of Clomipramine

A

aka Anafranil “think people with OCD are ANAl”

Rx OCD

TCA’s

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28
Q

“think people with OCD are ANAl”

Rx OCD

TCA’s

What’s the drug??

A

Clomipramine aka Anafranil

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29
Q

Pneumonic:

Describe the features of Amitriptyline & Nortriptyline

A

Amitriptyline = Elavil
Nortriptyline = Pamelor

Both treat diabetic peripheral neuropathy

TCA’s

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30
Q

TCA’s to treat diabetic peripheral neuropathy

What’s the drug??

A

Amitriptyline (Elavil)
&
Nortriptyline (Pamelor)

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31
Q

What;s the treatment of a TCA overdose?

A

Bicarbonate

“a bi-CAR can always beat a TRICYCLE”

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32
Q

What three biological factors do TCAs target?

A

Transmitters (increase SE & NE)
Channels (decrease Na & Ca2+)
Antagonists (Ach & Histamine)

“Trans, Chans, & Ans”

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33
Q

What are the overall side effects of TCAs

A

Anticholinergic effects
- higher temperature
- Dry mouth
- Blurry vision
- Redness
- Memory impairment

Histamine
- Sedation
- Sleep

Channel blockage
- Wide QRS

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34
Q

Pneumonic:

Describe the features of Selegiline

A

A selective MAOI vs subtype B to increase Dopamine

Rx Parkinsons

High risk of a hypertensive crisis if exposed to tyramine-containing foods

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35
Q

A selective MAOI vs subtype B to increase Dopamine

Rx Parkinsons

High risk of a hypertensive crisis if exposed to tyramine-containing foods

What’s the drug??

A

Selegiline

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36
Q

Pneumonic:

Describe the features of Phenelzine

A

Non-selective inhibitor of both subtypes A & B (Increases SE, NE, & Dopamine)

Rx Depression

High risk of a hypertensive crisis if exposed to tyramine-containing foods

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37
Q

Non-selective inhibitor of both subtypes A & B (Increases SE, NE, & Dopamine)

Rx Depression

High risk of a hypertensive crisis if exposed to tyramine-containing foods

What’s the drug??

A

Phenelzine

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38
Q

If treated with an MAOI what should patients be informed to avoid what food?

A

Tyramine-rich foods (fermented i.e cheese, aged red wine)

“Maui (MAOI) on a date with miss Tyra banks, enjoying wine & cheese”

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39
Q

What’s the difference between first generation (typical) vs second generation (atypical) antipsychotics

A

First gen:
Neurological side effects & it’s mostly a dopamine antagonist

Second gen:
Metabolic side effects & it’s antagonistic effects are against dopamine & serotonin

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40
Q

Describe what extrapyramidal symptoms are? How do you treat it?

“Muscle, Rustle, & Hustle”

A
  1. Acute dystonia (muscle contraction)
    hrs after antipsychotic
  2. Akathisia (restlessness)
    days after antipsychotic
  3. Akinesia
    (Bradykinesia aka lacking movement
    with pin rolling hands)
    weeks after antipsychotic

Rx. Anticholinergics

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41
Q

Long-term use of antipsychotics can lead to a potentially irreversible condition?

A

Tardive Dyskinesia
“Chewing TAR”

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42
Q

Describe the features of Neuroleptic malignant syndrome

A

A potentially fatal condition,

Signs: Confusion/Agitation, Hyperthermia (severe), Rigidity, & Seizures

Rx Dantrolene

“Dan Never Missed a Step”

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43
Q

Pneumonic:

Describe the features of Chlorpromazine

A

1st Gen:
aka Thorazine “CHLOR-neal deposits long with long term use

Antipsychotic

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44
Q

1st Gen:
“CHLOR-neal deposits long with long term use

Antipsychotic

A

Chlorpromazine aka Thorazine

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45
Q

Pneumonic:

Describe the features of Thioridazine

A

1st Gen:
aka Mellaril “reTinal deposits”

Antipsychotics

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46
Q

1st Gen:
“reTinal deposits”
Antipsychotics

A

Thioridazine aka Mellaril

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47
Q

Pneumonic:

Describe the features of Haloperidol

A

1st Gen:
aka halodol “think HOLD-ol, it’s specific for D2R receptors and has extrapyramidal side-effects”

first give DECAnoate to make it last longer (DECAde)

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48
Q

1st Gen:

“think HOLD-ol, it’s specific for D2R receptors and has extrapyramidal side-effects”

first give DECAnoate to make it last longer (DECAde)

What’s the drug??

A

Haloperidol aka halodol

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49
Q

Pneumonic:

Describe the features of Clozapine

A

2nd Gen:
aka Clozaril “watch it CLOZEly for agranulocytosis”

Antipsychotic

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50
Q

2nd Gen:
“watch it CLOZEly for agranulocytosis”

Antipsychotic

A

Clozapine aka Clozaril

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51
Q

Pneumonic:

Describe the features of Olanzapine

A

2nd Gen:
aka zypnexa “think O for Obesity, it causes weight gain”

Antipsychotic

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52
Q

2nd Gen:
“think O for Obesity, it causes weight gain”

Antipsychotic

A

Olanzapine aka zypnexa

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53
Q

Pneumonic:

Describe the features of Risperidone

A

2nd Gen:
aka Risperdal
“RISE & shine = less sedation”
“RISEperidone gives rise to gynecomastia”

Antipsychotics

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54
Q

2nd Gen:
“RISE & shine = less sedation”
“RISEperidone gives rise to gynecomastia”

Antipsychotics

What’s the drug??

A

Risperidone aka Risperdal

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55
Q

Pneumonic:

Describe the features of Quetiapine

A

2nd Gen:
aka Seroquel “QUIETiapine time a strong sedative”

Antipsychotics

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56
Q

2nd Gen:
“QUIETiapine time a strong sedative”

Antipsychotics

What’s the drug??

A

Quetiapine aka Seroquel

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57
Q

Pneumonic:

Describe the features of Ziprasidone

A

2nd Gen:
aka Geodome
“think of geometros a zippy car, patients can have abnormal electro-CAR-diograms prolonged QT interval”

Antipsychotics

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58
Q

2nd Gen:
“think of geometros a zippy car, patients can have abnormal electro-CAR-diograms prolonged QT interval”

Antipsychotics

What’s the drug??

A

Ziprasidone aka Geodome

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59
Q

Pneumonic:

Describe the features of Ariprazole

A

2nd Gen:
aka Abilify “think AND-bilify because it’s a partial antagonist of Dopamine & SE”

Antipsychotics

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60
Q

2nd Gen:
“think AND-bilify because it’s a partial antagonist of Dopamine & SE”

Antipsychotics

What’s the drug??

A

Ariprazole aka Abilify

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61
Q

Pneumonic:

Describe the features of Lithium

A

“think lithi-ONE dosage should be between 1.0-to-1.2”

Side effects: “MNOP”
- Motor tremors
- Nephrotoxicity (Nephrogenic
Diabetes Insipidus)
- hyOthyroidism
- Preggos (Ebstein’s anomaly LIT, Lower
Implanted Tricuspid)

Mood Stabilizer

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62
Q

dosage should be between 1.0-to-1.2”

Side effects: “MNOP”
- Motor tremors
- Nephrotoxicity (Nephrogenic
Diabetes Insipidus)
- hyOthyroidism
- Preggos (Ebstein’s anomaly LIT, Lower
Implanted Tricuspid)

What’s the mood stabilizer??

A

Lithium

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63
Q

Pneumonic:

Describe the features of Valproic acid

A

aka Depakote “think valpro-ATE the folate = teratogenic NTD”

It inhibit Na+ channels & increase GABA (sedative)

Side effect: Hepatic necrosis

Mood stabilizer

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64
Q

“think valpro-ATE the folate = teratogenic NTD”

It inhibit Na+ channels & increase GABA (sedative)

Side effect: Hepatic necrosis

Mood stabilizer

What’s the drug??

A

Valproic acid aka Depakote

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65
Q

What are the 3 drugs that cause Hepatic necrosis as a side effect?

A

“HaVe A Seat”

Halothane
Valproic acid
Acetaminophen

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66
Q

Pneumonic:

Describe the features of Carbamazepine

A

aka Tegretol “CBZ”
C: Rx Trigeminal neuralgia
B: BPD
Z: Zeisures

It blocks Na+ channels & increases GABA

Side effects:
- Diplopia, Ataxia, Agranulocytosis, Steven Johnson Syndrome etc

Benzodiazepine

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67
Q

“CBZ”
C: Rx Trigeminal neuralgia
B: BPD
Z: Zeisures

It blocks Na+ channels & increases GABA

Side effects:
- Diplopia, Ataxia, Agranulocytosis, Steven Johnson Syndrome etc

Benzodiazepine

What’s the drug??

A

Carbamazepine aka Tegretol

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68
Q

Pneumonic:

Describe the features of Lamotrigine

A

aka Lamictal
“think lam-ITCH-tal because side effects are rash & Steven Johnson Syndrome”

It inhibits Na channels ONLY
Rx. BPD Depressive episodes

Mood stabilizers

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69
Q

“think lam-ITCH-tal because side effects are rash & Steven Johnson Syndrome”

It inhibits Na channels ONLY
Rx. BPD Depressive episodes

Mood stabilizers

What’s the drugs??

A

Lamotrigine aka Lamictal

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70
Q

What is a key difference between Barbiturates vs Benzodiazepines?

A

BarbituRATES: Increase DURATION of GABA channels being open

Benzodiazepines: Increase the FREQUENCY of GABA channels being open

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71
Q

Benzodiazepines:

List 3 Drugs with short half life

A

1/2 life 1-12hrs:

Triazolam (Halcyon)
Oxazepam (Serax)
Midazolam (Versed)

“short TOM”

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72
Q

Benzodiazepines:

List 4 Drugs with medium half life

A

1/2 life of 12-24hrs

Clonazepam (klonopin)
Alprazolam (xanax)
lorazepam (Ativan)
Temazepam

“medium CAAT”

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73
Q

Benzodiazepines:

List 2 Drugs with long half life

A

1/2 life of 40-250 hrs

Diazepam (valium)
Chlordiazepoxide (librium)

“long DivorCe”

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74
Q

Drugs with a longer half life are better for what conditions?

A

Chronic panic disorder
&
Alcohol withdrawal anxiety

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75
Q

Drugs with a medium half life are better for what conditions?

A

Anxiety, Insomnia, & Panic disorder

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76
Q

Drugs with a shorter half life are better for what conditions?

A

Panic attacks
&
Epileptic attacks

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77
Q

List the BPD symptoms (must have 3 out of 7)

A

Distractibility
Irresponsibility
Grandiosity

Flight of ideas
Agitation
Sleep deprivation
Talkativeness

“DIG FAST”

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78
Q

Distractibility
Irresponsibility
Grandiosity

Flight of ideas
Agitation
Sleep deprivation
Talkativeness

“DIG FAST”

Are all symptoms of what condition?

A

BPD

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79
Q

MOA:

Describe the MOA of Vortioxetine

A

Inhibits 5-HT reuptake & blocking 5-HT receptors

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80
Q

MOA:

Describe the MOA of Vilazodone

A

A partial agonist against 5-HT reuptake by stimulating 5-HT receptors
(Increases SEROTONIN)

Rx Depression

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81
Q

MOA:

Describe the MOA of Trazodone & Nefazodone

A

Decreases 5-HT reuptake & block 5-HT2A postsynaptic disorders (bad receptors!)

Rx. Depression & Sedation

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82
Q

MOA:

Describe the MOA of Mirtazapine

A

An Alpha-2 antagonist that increases Norepi & 5-HT neuronal transmission & blocks Histamine reuptake

Acts as a Sedative

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83
Q

MOA:

Describe the MOA of Bupropion

A

A weak Norepi & Dopamine reuptake inhibitor

Rx. Smoking cessation

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84
Q

List 3 non-selective MAOIs

A

Isocarboxazid
Phenelzine
Trancycloprine

Rx. Depression

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85
Q

List a selective MAOI

A

Selegiline

Rx Dopamine

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86
Q

MOA:

What is the primary MOA of TCA’s

A

They block SERT (5-HT transporters), NET (Norepi transporters), Histamine, & Muscarinic receptors

  • Decreases serotonin & norepi reuptake
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87
Q

TCA:

What TCA would you use for treating insomnia?

A

Doxepin

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88
Q

TCA:

What TCA would you use for treating migraines, depression, & neuropathic pain?

A

Nortriptyline & Amitriptyline

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89
Q

MOA:

Describe the general MOA of SNRI’s & what are they used to treat?

A

They block reuptake of 5-HT & Norepi (Blocking SERT & NET), it increases overall- synaptic Norepi & Serotonin

Rx. Fibromyalgia

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90
Q

SNRIs:

List 4 SNRIs

A

Venlafaxine
Desvenlafaxine
Duloxetine
Levomilnacipram

91
Q

SSRIs:

Describe the MOA of SSRIs & some side effects

A

They block SERT (5-HT transporter) to reduce serotonin reuptake

Side effects:
- Serotonin syndrome
- Stomach upset
- Sexual dysfunction

92
Q

SSRIs:

Give a list of 5 SSRIs & what conditions do they generally treat?

A

Citalopram
Escitalopram
Fluvoxamine
Paroxetine
Sertraline

Rx. General anxiety, PTSD, & OCD

93
Q

Citalopram
Escitalopram
Fluvoxamine
Paroxetine
Sertraline

Rx. General anxiety, PTSD, & OCD

What drug class?

A

SSRI’s

94
Q

Venlafaxine
Desvenlafaxine
Duloxetine
Levomilnacipram

What drug class?

A

SNRI’s

95
Q

What are the neurotransmitter levels in Depression?

A

Low Norepinephrine
Low Dopamine
Low Serotonin

96
Q

Low Norepinephrine
Low Dopamine
Low Serotonin

Levels represent what kind of condition?

A

Depression

97
Q

How long does it take to observe therapeutic effects of SNRI’s & SSRI’s

A

4-8 weeks

98
Q

What is the SNRI of choice for treating fibromyalgia?

A

Duloxetine

99
Q

What is the SNRI of choice for treating Nephropathy?

A

Venlafaxine

100
Q

What are 4 side effects of SNRI’s?

A

Depression
Chronic muscle/joint pain
Fibromyalgia
Urinary stress incontinence

101
Q

List 4 SNRI’s

A

Venlafaxine
Duloxetine
Nefazodone
Desvenlafaxine

102
Q

Venlafaxine
Duloxetine
Nefazodone
Desvenlafaxine

Are what type of drug class?

A

SNRI’s

103
Q

List 7 SSRI’s

A

Escitalopram
Fluoxetine
Fluvoxamine
Sertraline
Paroxetine
Citalopram
Dapoxetine

“Effective For Sadness, Panic, & Compulsion”

104
Q

Describe the side effects of SSRI

A

Stomach upset
Sexual dysfunction
Serotonin syndrome

“SSS”

105
Q

What 2 drugs would you use to treat Serotonin syndrome?

A

A Benzodiazepine
&
Cyproheptadine

106
Q

Which TCA would you use to treat panic disorder?

A

Imipramine

107
Q

Which TCA would you use to treat depression, insomnia, & chronic pain?

A

Amitriptyline

108
Q

List 6 TCAs that antagonize Norepinephrine & 5-HTRI

A

Imipramine
Amitriptyline
Trimipramine
Doxepin
Dothiepin
Clomipramine

109
Q

Which TCA is used to treat peptic ulcer disease?

A

Doxepin

110
Q

Which TCA would be used to treat OCD?

A

Clomipramine

111
Q

What 5 conditions do TCA’s generally treat?

A

Depression
Panic disorder
Bedwetting in kids
Migraine
Chronic pain syndrome

112
Q

What TCA would you use to treat depression in an elderly patient?

A

Nortriptyline

113
Q

List 4 TCAs that antagonize Norepinephrine

A

Desipramine
Nortriptyline
Amoxapine
Reboxetine

114
Q

TCA’s are antagonists against which neurotransmitters?

A

Norepinephrine
Serotonin
Histamine (Sedation)
GABA (Seizures)
Alpha-1 adrenergic antagonist
Na channel blockage

115
Q

What are the anticholinergic effects of TCAs?

A

Dilated pupils
Tachycardia
Dry mouth
Fever
Urinary retention

116
Q

List 4 MAO non-selective inhibitors

A

Moclobemide
Cordyline
Phenelzine
Tranylcypromine

117
Q

Which non-selective inhibitors would treat depression & Alzheimer’s?

A
  • Moclobemide (both)
  • Phenelzine & tranylcypromine (Depression)
118
Q

In general what are MAOI’s used to treat?

A

Atypical depression (A)
Anxiety (A)
Parkinsons (B)

119
Q

List 7 atypical antidepressants?

A

Trazodone
Mianserin
Mirtazapine
Bupropion
Tianeptine
Amineptine
Atomoxetine

120
Q

Trazodone
Mianserin
Mirtazapine
Bupropion
Tianeptine
Amineptine
Atomoxetine

Are examples of what drug class?

A

Atypical antidepressants

121
Q

What Atypical antidepressant would you use to treat smoking addiction, seasonal affective disorder, or SSRI-induced sexual dysfunction?

A

Bupropion

122
Q

Describe the side effects of Bupropion

A

Insomnia
Seizures
Sweating
Decrease sexual dysfunction

123
Q

Insomnia
Seizures
Sweating
Decrease sexual dysfunction

Are side effects of which Atypical Antidepressant?

A

Bupropion

124
Q

Describe the side effects of Trazodone

A

Excessive sedation
Priapism
Postural hypotension

125
Q

Excessive sedation
Priapism
Postural hypotension

Are side effects of which atypical antidepressants?

A

Trazodone

126
Q

List 3 serotonin modulators

A

Trazodone
Vilazodone
Vortioxene

127
Q

What 3 conditions is Trazodone used to treat?

A

Generalized Anxiety Disorder
Panic disorder
Eating disorder

128
Q

What condition is Lithium used to treat?

A

the manic episodes of BPD

129
Q

List 3 drugs that increase lithium reabsorption in PTC?

A

Thiazides
NSAIDS
ACEI

130
Q

Thiazides
NSAIDS
ACEI

Increase reabsorption of what in the PCT of the kidney?

A

Lithium

131
Q

Nausea
Diarrhea
Lethargy
Impaired cognition
Hand tremor
Hypothyroidism

Are all acute side effects of _______?

A

Lithium

132
Q

Are 6 acute side effects of Lithium

A

Nausea
Diarrhea
Lethargy
Impaired cognition
Hand tremor
Hypothyroidism

133
Q

Hypothyroidism
Weight gain
Leukocytosis
Acne + Psoriasis
Nephrogenic diabetes insipidus
Tubulointerstitial nephropathy
Ebsteins anomalies

Are all chronic side effects of _______?

A

Lithium

134
Q

Are 7 chronic side effects of lithium?

A

Hypothyroidism
Weight gain
Leukocytosis
Acne + Psoriasis
Nephrogenic diabetes insipidus
Tubulointerstitial nephropathy
Ebsteins anomalies

135
Q

What are 3 side effects of Carbamazepine?

A

Poor cognition
Agranulocytosis
Hepatic enzyme induction

136
Q

What benzodiazepine is best for alcohol withdrawal & anxiety?

A

Diazepam

137
Q

What benzodiazepines are good for anxiety?

A

Diazepam
Lorazepam
Clonazepam

138
Q

What benzodiazepine can be used to treat BPD & Refractory Depression? What are its side effects?

A

Lamotrigine, its side effects are skin rash & steven Johnson syndrome

139
Q

Which benzodiazepines are best for treating alcohol withdrawal?

A

Diazepam & Pregabalin

140
Q

What benzodiazepine can be used to treat Alcohol withdrawal & Binge eating?

A

Pregabalin

141
Q

What benzodiazepine can be used to treat Agitation, Alcohol withdrawal & Anxiety?

A

Lorazepam

142
Q

What benzodiazepine can be used to treat BPD?

A

Valproic acid

143
Q

What neurotransmitters do Anticonvulsants target?

A

Decrease Na+, Ca2+, & GABA

144
Q

Which 5 Anticonvulsants ONLY target Na channels?

A

Phenytoin
Carbamazepine
Lamotrigine

145
Q

Phenytoin
Carbamazepine
Lamotrigine

Are all anticonvulsants that target which channels?

A

Na+

146
Q

Which Anticonvulsant targets ONLY Ca2+ channels?

A

Ethosuximide

147
Q

Which anti convulsant targets Na+, Ca2+, & GABA channels?

A

Valproic acid

148
Q

Which anticonvulsants target Na+ & GABA?

A

Topiramate

149
Q

Which anticonvulsants target GABA?

A

Diazepam & Clonazepam (Benzos)

Phenobarbital
Gabapentin
Vigabatrin
Felbamate
(x4 Barbiturates)

150
Q

What’s a side effect of Topiramate?

A

Poor cognition

151
Q

What are 2 major side effects of Phenytoin?

A
  • Hypersensitivity syndrome
  • Steven Johnson Syndrome
152
Q

Describe the MOA for Barbiturates & Benzodiazepines

A

1) They bind to GABA receptors to increase (GABA release)

2) Barbiturates increase duration & Benzodiazepines increase frequency of Cl- channel opening

3) Increased Cl- causes membrane hyperpolarization and CNS depression

153
Q
  • Altered mental status or unresponsiveness
  • Confusion
  • Combativeness
  • Respiratory depression
  • Hypotension
  • Bradycardia
  • Ataxia
  • Slurred speech

Are all signs of _______Overdose

A

Benzodiazepine OD

154
Q

What do you use to treat Benzodiazepine OD?

A

Flumazenil (Benzo antagonist)

155
Q

Describe the uses of Zolpidem

A

A non-benzo hypnotic, GABA antagonist it has a rapid onset 4hrs
Rx. Insomnia

156
Q

What is an antagonist against Zolpidem?

A

Flumazenil

157
Q

What SSRI is used to Rx. Smoking & General anxiety?

A

Buspirone, a partial 5-HT1A agonist that has a 2 wk onset effectiveness

158
Q

Describe the features of a brief psychotic disorder

A

Short-term: more than 1 day but less than 1 month (self limiting)

Triggered by a stressful life event

Signs:
- Hallucinations
- Delusions
- Catatonic behaviour
- Peculiar speech
- Bizzare behaviour

159
Q

Short-term: more than 1 day but less than 1 month (self limiting)

Triggered by a stressful life event

Signs:
- Hallucinations
- Delusions
- Catatonic behaviour
- Peculiar speech
- Bizzare behaviour

A

features of a brief psychotic disorder

160
Q

Describe the features of a Schizophreniform disorder

A

Chronic: 2/+ Symptoms lasting between 1-6months

Signs (milder schizo symptoms)

  • Abnormal behavior (abusive, violent, negative etc)
  • Self neglect (hygiene)
  • +/- symptoms
  • Emotional outbursts
  • Abnormal posture (long-time)
  • Gesticulation/talking to oneself
161
Q

Chronic: 2/+ Symptoms lasting between 1-6months

Signs (milder schizo symptoms)

  • Abnormal behavior (abusive, violent, negative etc)
  • Self neglect (hygiene)
  • +/- symptoms
  • Emotional outbursts
  • Abnormal posture (long-time)
  • Gesticulation/talking to oneself
A

Schizophreniform disorder

162
Q

List the Positive symptoms of schizophrenia

A

Hallucinations
Delusions
Disorganized thoughts, speech, behavior, & catatonic behavior

163
Q

List the Negative symptoms of schizophrenia

A

Blunt/flat affect
Alogia
Avolition
Anhedonia
Attention deficit

164
Q

Describe the features of Schizoaffective disorder

A

Chronic: A mix of BPD, Schizophrenia, MDD, & Manic symptoms

Signs:
- Periods of uninterrupted illness
- More than 1 episode of mania &/or depression
- More than 2 periods of psychotic symptoms lasting 2 weeks with mania or depressive episodes-

165
Q

Chronic: A mix of BPD, Schizophrenia, MDD, & Manic symptoms

Signs:
- Periods of uninterrupted illness
- More than 1 episode of mania &/or depression
- More than 2 periods of psychotic symptoms lasting 2 weeks with mania or depressive episodes-

A

features of Schizoaffective disorder

166
Q

Time line for Schizophrenia

A

Experiencing symptoms (most of the time) once a month with decline in functioning for a min 6 months

167
Q

Experiencing symptoms (most of the time) once a month with decline in functioning for a min 6 months

A

Schizophrenia

168
Q

Time line for Schizophreniform

A

Similar to schizo but it’s for less than 6 months & doesn’t need a decline in functioning

169
Q

Similar to schizo but it’s for less than 6 months & doesn’t need a decline in functioning

A

Schizophreniform

170
Q

Time line for Schizoactive disorder

A

A major mood disorder with psychotic symptoms for 2/+ weeks

171
Q

A major mood disorder with psychotic symptoms for 2/+ weeks

A

Schizoactive disorder

172
Q

Time line of a Brief psychotic disorder

A

Psychotic symptoms for 1 or more days but less than 1 month (self limiting)

173
Q

Psychotic symptoms for 1 or more days but less than 1 month (self limiting)

A

Brief psychotic disorder

174
Q

Describe the features of Delusion disorder

A

Presence of persistent delusions which can be bizarre (not possible aliens!) or non-bizarre (possible news person on tv is talking to me)

175
Q

Presence of persistent delusions which can be bizarre (not possible aliens!) or non-bizarre (possible news person on tv is talking to me)

What is the condition?

A

Delusion disorder

176
Q

Describe shared delusion

A

When someone close to a person with DD develops their own delusion that the person with the disorder will believe unshakingly/firmly

The person with DD can recover when removed from the inducer

177
Q

Describe Schizophrenia

A

A chronic condition with
1) impaired perception & expression of reality
2) Persistent behavioral, social (withdrawal), & communicative disturbances

Symptoms are there at least once a month for at least 6 months

178
Q

What are some of the key risk factors of Schizophrenia

A
  • Parents have schizo
  • Markers on 5, 6, & 8 X
  • Being born in winter/spring
  • Viral infection during pregnacy
  • Rh incompatibility
  • Maternal starvation
  • Substance abuse
  • Poor SES
179
Q

Biochemical factors:

What are the 3 biochemical pathways involved with Schizophrenia

A

1) Dopamine (increase in dopamine Rx. with D2 antagonists)
2) Serotonin (increased serotonin Rx 5-HT antagonists)
3) GABA (Decreased GABAergic neurons in the Hippocampus)

180
Q

Which two drugs increase dopamine and exacerbate symptoms of schizophrenia

A

Cocaine & amphetamines

181
Q

What psychological factors are involved in Schizophrenia

A

Freud (EGO disintegration)
&
Learning theories (mimic poor emotional role models)

182
Q

Clinical course of Schizophrenia:

Describe the Prodromal phase

A

1st phase:
Signs & symptoms happen before the 1st episode, it presents with:
- Social withdrawal
- New interest in religion/philosophy
- Physical complaints

183
Q

1st phase:
Signs & symptoms happen before the 1st episode, it presents with:
- Social withdrawal
- New interest in religion/philosophy
- Physical complaints

Is what phase in schizophrenia

A

Prodromal phase

184
Q

Clinical course of Schizophrenia:

Describe the Psychotic phase

A

Phase 2:
They lose touch with reality, presents with:
- Hallucinations & Delusions

185
Q

Phase 2:
They lose touch with reality, presents with:
- Hallucinations & Delusions

A

Schizophrenia of Psychotic phase

186
Q

Clinical course of Schizophrenia:

Describe the Residual phase

A

3rd phase:
It happens in between the psychotic episodes, it presents with:
- Negative symptoms

187
Q

3rd phase:
It happens in between the psychotic episodes, it presents with:
- Negative symptoms

A

Residual phase of Schizophrenia

188
Q

Schizo types:

Describe Schizo-paranoid type

A

No thought, behavior, or blunt affect, but it presents with:
- Delusions
- Hallucinations

189
Q

No thought, behavior, or blunt affect, but it presents with:
- Delusions
- Hallucinations

A

Describe Schizo-paranoid type

190
Q

Schizo types:

Describe Schizo-disorganized type

A

Aka Hebephrenic type:
Disorganized speech, behavior, & blunted affect all present together

191
Q

Aka Hebephrenic type:
Disorganized speech, behavior, & blunted affect all present together

A

Schizo-disorganized type

192
Q

Schizo types:

Describe Schizo-catatonic type

A

Presents with:
- prominent psychomotor disturbances (catatonic stupor, waxy flexibility, inappropriate or bizarre postures)
- Extreme negativity
- Purposeless movement

193
Q

Presents with:
- prominent psychomotor disturbances (catatonic stupor, waxy flexibility, inappropriate or bizarre postures)
- Extreme negativity
- Purposeless movement

A

Schizo-catatonic type

194
Q

Schizo types:

Describe Schizo-undifferentiated type

A

Has characteristics of other subtypes and it presents with:
- Psychotic symptoms

195
Q

Has characteristics of other subtypes and it presents with:
- Psychotic symptoms

A

Schizo-undifferentiated type

196
Q

Schizo types:

Describe Schizo-residual type

A

It presents with:
- Low intensity positive symptoms
- Negative symptoms

197
Q

It presents with:
- Low intensity positive symptoms
- Negative symptoms

A

Schizo-residual type

198
Q

What typical neuroleptics/antipsychotics are used to treat schizophrenia

A

Chlorpromazine
Trifluoperazine
Thioridazine
Haloperidol

199
Q

What atypical neuroleptics/antipsychotics are used to treat schizophrenia

A

Risperidone (1st)
Clozapine
Olanzapine

200
Q

When is ECT used in schizophrenia?

A

-Acute psychotic episodes
- Catatonic symptoms
- Suicidal/homicidal intent
- Refractory or intolerant to other antipsychotics

201
Q

What are the neurotransmitters levels in mania

A

High Dopamine
Low GABA

202
Q

List 7 typical 1st generation antipsychotics

A

Chlorpromazine
Fluphenazine
Thioridazine
Chlorprothixene
Thiothixene

203
Q

Chlorpromazine
Fluphenazine
Thioridazine
Chlorprothixene
Thiothixene

Are all examples of what generation of antipsychotics?

A

typical 1st gen

204
Q

List 7 typical 2st generation antipsychotics

A

Clozapine
Risperidone
Olanzapine
Quetiapine
Sulpiride
Sertindol
Seroquel

205
Q

Clozapine
Risperidone
Olanzapine
Quetiapine
Sulpiride
Sertindol
Seroquel

Are all examples of what gen of antipsychotics?

A

atypical 2nd gen

206
Q

Which 3 drugs present with extrapyramidal symptoms?

A

High potency 1st generation
- Fluphenazine
- Haloperidol
- Trifluoperazine

207
Q

Which 1st gen antipsychotics are low potency?

A

Chlorpromazine
Thioridazine

They have anticholinergic & histamine effects

208
Q

Antipsychotics:

Dopamine pathways involved with antipsychotics

A

1) Mesolimbic & Mesocortical (Rx. decrease psychotic symps)
2) Nigrostriatal (Rx. Movement disorders)
3) Tuberoinfundibular (Rx. Reduce prolactin)

209
Q

Describe Mesolimbic overactivation involves which areas of the brain & what symptoms

A

Ventral tegmental area which innervates the nucleus acumens

  • Controls motivation, emotions, & rewards

Associated with positive of schizophrenia

Rx D2 Antagonists

210
Q

Describe the features of mesocortical overactivation

A

Signs:
- Cognitive hypofunction
- Negative schizo symptoms

Involves:
- Midbrain, Ventral tegmental area, & dorsolateral prefrontal cortex

211
Q

Nigrostriatal with D2 antagonist

A

has neurological effects

involves:
- Pars compacta of the substantia nigra, caudate, & putamen
- Motor planning & purposeful movement

212
Q

Describe Extrapyramidal effects

A
  1. acute dystonia
  2. Akathisia
  3. Bradykinesia (+pill rolling)
  4. Tardive dyskinesia
213
Q

Risks of Clozapine

A

Myocarditis
Agranulocytosis
Seizures
Sialorrhea

Gain weight

“MASS Gained”

214
Q

Risk of Risperidone

A

Hyperprolactinemia
Weight gain
Extrapyramidal eff
Tachycardia
Orthostatic hypotension

215
Q

Risk of Quentapine

A

Cataracts

216
Q

Describe Neuroleptic Malignant Syndrome (NMS)

A

A rare reaction to antipsychotics causing:
-fever
- AMS
- Leukocytosis
- Tremor
-Elevated CPK
- Rigidity
“FALTER”

217
Q

Describe the features MDD

A

2 Blue weeks with 5/9 symptoms everyday:
- Sleep disturbances
- Interest lost
- Guilt
- Energy loss
- Concentration issues
- Psychomotor agitation/retardation
- Suicide
“SIG-E-CAPS”

Rx. Mood stabilizers (lithium) or Benzos/antipsychotics

218
Q

2 Blue weeks with 5/9 symptoms everyday:
- Sleep disturbances
- Interest lost
- Guilt
- Energy loss
- Concentration issues
- Psychomotor agitation/retardation
- Suicide
“SIG-E-CAPS”

Rx. Mood stabilizers (lithium) or Benzos/antipsychotics

A

MDD

219
Q

Describe the features of Cyclothymic disorder

A

Less severe than BPD:
Mild hypomania & mild depressive episodes lasting 2yrs (never absent for 2 consecutive months)

Rx 1st SSRI, 2nd TCA, MAO

220
Q

Describe Dysthymic disorder

A

Less severe, non-episodic, & chronic form of depression lasting 2yrs

NO psychosis

Signs:
- Sleep disturbances
- Guilt/hopelessness
- Depressed mood
- Energy loss
- Concentration issues

221
Q

Less severe, non-episodic, & chronic form of depression lasting 2yrs

NO psychosis

Signs:
- Sleep disturbances
- Guilt/hopelessness
- Depressed mood
- Energy loss
- Concentration issues

A

Dysthymic disorder

222
Q

Neurotransmitter abnormalities in schizophrenia include

A

dopamine hypothesis:
- Excessive dopamine activity in the limbic system leads to positive symptoms in schizophrenia.

Dopamine-related evidence:
- Drugs that increase dopamine levels can cause psychotic symptoms.
- Elevated levels of homovanillic acid (HVA) may be present in body fluids of schizophrenia patients.

Reduced dopamine activity:
- Negative symptoms in schizophrenia are thought to be caused by reduced dopamine activity in the frontal cortex.

223
Q
A

Behavioural (6 decks)

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