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Psychiatry pro +1700 > Somatic Therapies II > Flashcards

Somatic Therapies II Flashcards

1
Q

What are the four major general classes of anxiolytics?

A
  • Antidepressants
  • benzos
  • Buspirone
  • Antihistamine
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2
Q

What are the antidepressants that are used to treat anxiety disorders? (3)

A

SSRIs
SNRIs
Mirtazapine

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3
Q

For treating OCD using SSRIs or clomipramine, what are the changes compared to treating depression?

A
  • SSRIs need higher doses

- Need longer response time

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4
Q

What is the drug of choice for an acute panic attack? What is the major issue with this?

A

Alprazolam (xanax)

Fast onset, but short acting, and highly addictive because of that.

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5
Q

What is the only benzo that is absorbed IM?

A

Lorazepam

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6
Q

What are the side effects of benzos?

A
  • Drowsiness
  • Reduced motor coordination
  • potential for tolerance
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7
Q

What are the withdrawal s/sx of benzos?

A

Like alcohol withdrawal

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8
Q

True or false: benzos have major adverse effects in pregnancy

A

False–generally safe PRN

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9
Q

True or false: benzos have adverse effects with breastfeeding

A

True

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10
Q

What is the MOA of buspirone? Use?

A
  • 5HT1a agonism
  • Anxiolytic w/o sedation
  • No risk of tolerance
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11
Q

True or false: buspirone is effective for treating OCD, but not panic attacks or phobias

A

False–not effective for any of them. Only GAD.

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12
Q

What is buspirone used for now?

A

Augment antidepressants for anxiety disorders

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13
Q

What is the general treatment regimen for anxiety?

A
  • SSRIs
  • SNRIs if SSRIs fail
  • Mirtazapine
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14
Q

What is the role of benzos in the treatment of anxiety disorders?

A

Short term, acute episodes PRN

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15
Q

Is buspirone used PRN or long term?

A

Long term

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16
Q

What are the four major typical antipsychotics? Which is a weak one?

A
  • Haloperidol
  • Chlorpromazine**
  • Thioridazine**
  • Fluphenazine
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17
Q

What are the atypical antipsychotics? (6)

A
  • Olanzapine
  • Clozapine
  • Quetiapine
  • Risperidone
  • Aripiprazole
  • Ziprasidone
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18
Q

What is the general MOA of antipsychotics?

A

Postsynaptic D2 receptor blockade in the mesolimbic and mesocortical pathway

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19
Q

What are the uses of FGAs?

A
  • Schizophrenia
  • Psychosis
  • Agitation
  • Tourette’s syndrome
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20
Q

What is the only antipsychotic that is not approved for use with schizophrenia? What is it used for?

A

Clozapine

Refractory schizophrenia

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21
Q

What is the use for risperidone that is unlike the other FGAs?

A

ASD

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22
Q

How fast are antipsychotics in treating agitation?

A

30-60 minutes

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23
Q

What organ metabolizes antipsychotics?

A

Liver

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24
Q

What is the duration of an adequate trial of antipsychotics?

A

4-6 weeks

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25
Q

What percent of pts taken off of antipsychotics for schizophrenia will relapse?

A

75%

26
Q

True or false: prevention of relapse with schizophrenia is more important than side effects

A

True

27
Q

What is the psychotic drug that causes agranulocytosis?

A

Clozapine

28
Q

What is the psychotic drug that causes hyperprolactinemia? How?

A

Risperidone

Dopamine antagonism

29
Q

What is neuroleptic malignant syndrome? S/sx?

A

Reaction to antipsychotics

  • Fever
  • Elevated CPK
  • Vital sign instability
  • Encephalopathy
  • Rigidity
30
Q

What is the treatment for NMS? (3)

A
  • IVFs
  • Dantrolene
  • Bromocriptine or other dopamine agonist
31
Q

Why do SGAs have a lower risk of movement disorders?

A

Blockade of 5HT2a receptors

32
Q

What is acute dystonic reaction? Treatment?

A
  • Reaction to FGAs or SGAs that causes painful muscle contractions
  • Treat with antihistamine or benztropine
33
Q

What are the s/sx of pseudoparkinsonism?

A
  • Rigidity
  • Coarse tremor
  • Hypokinesia/ bradykinesia
34
Q

What is the treatment for pseudoparkinsonism?

A

Anticholinergics

35
Q

When does akathisia usually occur with antipsychotic use?

A

within the 1st few weeks of treatment

36
Q

What are the subjective symptoms of akathisia

A

anxiety and tension

37
Q

How do you differentiate between akathisia and anxiety?

A

Akathisia will point to extremities as source of symptoms, as opposed to chest

38
Q

What is the treatment for tardive dyskinesia?

A
  • Beta blockers such as propranolol

- Switch drugs

39
Q

What is the early sign of tardive dyskinesia?

A

See tongue fasciculations

40
Q

Which gender is at greater risk of tardive dyskinesia?

A

Women

41
Q

What happens initially with decreasing dose of antipsychotic with TD?

A

Gets worse, but you should not increase

42
Q

What is the most sedating antipsychotic?

A

Quetiapine

43
Q

What is the antipsychotic with the most EPS?

A

Risperidone

44
Q

What are the two antipsychotics that have weight gain as a major side effect?

A

Clozapine

Olanzapine

45
Q

What are the two antipsychotics that do NOT have weight gain as a major side effect?

A

Aripiprazole

Ziprasidone

46
Q

What atypical has the least EPS?

A

Clozapine

47
Q

What are the disadvantages of SGAs?

A

-Metabolic syndrome and DM

48
Q

Which generally is more effective for the positive symptoms of schizophrenia: FGAs or SGAs?

A

FGAs

49
Q

What is the major advantage of SGAs?

A

Lower movement disorders

50
Q

What is the major side effect of risperidone?

A

CVAs

51
Q

What is paliperidone?

A

Risperidone active metabolite

52
Q

What is the role of clozapine in the treatment of schizophrenia?

A

Second or third line treatment

53
Q

Drooling is caused by what SGA?

A

Clozapine

54
Q

What is the major side effect of clozapine?

A

Agranulocytosis

55
Q

What must be followed with clozapine?

A

Weekly absolute neutrophil count for 6 months, then every other week for 6 months

56
Q

What is the major side effect with ziprasidone?

A

-QT prolongation

57
Q

What is asenapine?

A

SGA

58
Q

True or false: SGAs are first line for psychosis

A

True

59
Q

What should be done if there are significant side effects with SGAs or FGAs?

A

switch or lower dose

60
Q

What are depot formulations?

A

IM injections q 2-4 weeks

61
Q

Which type of antipsychotic has a risk of metabolic symptoms?

A

SGAs

Psychiatry pro +1700 (28 decks)

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