First Aid Psychiatry Drugs – Flashcards

question
how to treat: Alcohol withdrawal
answer
Benzodiazepines
question
how to tx Anxiety
answer
SSRIs, SNRIs, Busprione
question
ADHD
answer
methyphenidate, amphetamines
question
Bipolar Disorder
answer
Mood stabilizers: lithium, valproic acid, carbamazepine, atypical antipsychotics
question
Bulimia
answer
SSRIs
question
Depression
answer
SSRIs, SNRIs, TCAs, busprione, mirtazapine (especially with insomnia)
question
Obsessive compulsive disorder
answer
SSRIs, clomipramine
question
Panic Disorder
answer
SSRIs, venlafaxine, benzodiazepines
question
PTSD
answer
SSRIs
question
Schizophrenia
answer
Antipsychotics
question
Social Phobias
answer
SSRIs
question
Tourette's syndrome
answer
antipsychotics haloperidol, risperidone
question
what are the CNS stimulants?
answer
Methylphenidate, dextroamphetamine, methamphetamine
question
what is the CNS stim method of action
answer
increase catecholamines at the synaptic cleft, especially NE and dopamine
question
What is the clinical use of CNS stimulants:
answer
ADHD, narcolepsy, appetite control
question
haloperidol
answer
antipsychotics
question
trifluoperazine
answer
antipsychotics
question
fluphenazine
answer
antipsychotics
question
thioridazine
answer
antipsychotics
question
chloropromazine
answer
antipsychotics
question
so what's the name thing for antipsychotics?
answer
haloperidol + "azines"
question
mechanism of Antipsychotics
answer
all typical antipsychotics block dopamine D2 receptors, increasing cAMP
question
what are the high potency antipsychotics? and what are the side effects?
answer
Trifluperazine, fluphenazine, Haloperidol...try to fly high? neurolgoic side effects (extrapyrimidal)
question
clinical use of antipsychotics
answer
schizo (primarily positive symptoms) psychosis, acute mania, Tourette's syndrome
question
what are the low potency antipsychotics? side effects?
answer
chloropromazine, thioridazine -cheating thieves are low.....non neurologic side effects (anticholinergic, antihistamine and alpha 1 blockade effects)
question
what is the toxicity of antipsychotics?
answer
highly lipid soluble, and stored in body fat; thus very slow to be removed from the body, extrapyramidal system side effects: dyskinesias, endocrine side effects: dopamine receptor antagonism---hyperprolactinemia: galactorrhea, side effects from blocking muscarinic receptors; hypotension, and dry mouth, and sedation.
question
Chloropromazine causes:
answer
corneal deposits
question
thioridazine causes
answer
retinal deposits
question
haloperidol:
answer
NMS, tardive dyskinesia
question
evolution of EPS side effects:
answer
4 hr of acute dystonia (muscle spasm, stiffness, oculogyric crisis) 4 day akathisia (restlessness) 4 wk bradykinesia (parkinsonism) 4 mo tardive dyskinesia
question
what is neuroleptic malignant syndrome-and what drug is this associated with? Treatment:
answer
rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Tx=dantrolene, D2 agonists (bromocriptine)
question
Tardive dyskinesia:
answer
stereotypic oral facial movements as a result of long term antipsychotic use...often irreversible
question
for neuoleptic malignant syndrome: (NMS) think
answer
think fever: fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles
question
atypical antipsychotics mmneom..
answer
it's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z
question
olanzapine
answer
atypical antipsychotic
question
clozapine
answer
atypical antipsychotic
question
quetiapine
answer
atypical antipsychotic
question
risperidone
answer
atypical antipsychotic
question
aripiprazole
answer
atypical antipsychotic
question
ziprasidone
answer
atypical antipsychotic
question
mechanism of atypical antipsychotics...
answer
not understood...varied effects on 5ht2, dopamine and alpha and H1 receptors
question
clinical use of atypical antipsychotics
answer
schizophrenia-both positive and negative symptoms: also used for bipolar disorder, ocd, anxiety disorder, depression, mania, tourette's syndrome
question
what are the toxicities for atypical antipsychotics?
answer
fewer extrapyramidal and anticholinergic side effects than traditional antipsychotics.....olazapine, clozapoine may cause significant eight gain...clozapine may cause agranulocytosis...requires weekly wbc monitoring and sezure ziprasidone may prolong the QT interval
question
olanzapine/clozapine may cause significant:
answer
weight gain
question
clozapine may cause
answer
agranulocytosis -rqrs weekly wbc monitoring and seizure
question
ziprasidone
answer
may prolong the QT interval
question
Lithium Mechanism:
answer
not established, possibly related to inhibition of phosphoinositol cascade
question
clinical use of lithium
answer
mood stabilizer for bipolar disorder-blocks relapse and acute manic events...also for SIADH
question
Toxicity of Lithium-what do teratogenic effects include:and mnemonic:
answer
tremor, sedation, edema, heart block, polyuria...ADH antagonist-causing nephrogenic diabetes insipidus, TERATOGENIC...cardiac defects-ebstein anomaly and malformaltion of the great vessels... LMNOP-lithium side effects: movement (tremor), nephrogenic diabetes insipid us, hypothyroidism, pregnancy problems.
question
what rqrs close monitoring of serum levels of lithium...
answer
narrow therapeutic window.
question
lithium is almost exclusively excreted by:___ where?
answer
the kidneys-most is reabsorbed at the proximal convoluted tubule following Na reabsorption
question
buspirone: used in:
answer
used in generalized anxiety disorder....
question
buspirone MOA: mnemonic
answer
stimulates 5HT1a receptors: I'm always anxious if the BUS will be ON time, so I take BUSpirONe
question
how long does it take for buspirone to take effect? doesn't cause what? takes ____ weeks to take effeect? does it interact w/alcohol compared to __
answer
1-2 weeks for it to take effect...does not cause sedation, addiction, or tolerance. does not interact with alcohol-vs barbiturates and benzodiazepines
question
SSRIs...names and mnemonic:
answer
FLashbacks PARalyze Senior CITizens Fluoxetine, paroxetine, sertraline, Citalopram
question
fluoxetine
answer
SSRI
question
Paroxetine
answer
SSRI
question
Sertraline
answer
SSRI
question
Citalopram
answer
SSRI
question
MOA of SSRI-how many weeks does it usually take for antidepressants to have an effect?
answer
serotonin specific reuptake INHIBITORS. 4-8 weeks to take effect?
question
Clinical use of SSRIs
answer
depression, genralized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
question
Toxicity of SSRIs
answer
Fewer than TCAs-Gi distress, SEXUAL DYSFUNCTION-anorgasmia and decreased libido. Serotonin synddrome: with any drug that increases serotonin (MAOIs, SNRIs, TCAs): hyperthermia, confusion, myoclonus, cardiovascular collapse..flushing, diarrhea, seizures....tx of it: 5HT2 receptor antagonist: (octreotide)
question
So generalized anxiety disorder can be tx w/
answer
Busiprone and SSRIs, SNRIs
question
Venlafaxine, duloxetine
answer
SNRIs
question
SNRI MOA
answer
inhibit serotoinin and NE uptake
question
Clinical use of SNRIs...duloxetine is also indicated for. which SNRI has a greater effect on NE
answer
Depression....Venlafax-also used in generalized anxiety disorder and panic disorders....Duloxetine=also indicated for diabetic peripheral neuropathy...Duloxetine=greater effect on NE
question
Tricyclic antidepressants:
answer
all end in -iptyline and -ipramine except doxepin and amoxapine
question
MOA TCAs
answer
Block reuptake of NE and serotonin
question
clinical use of tCAs...bedwetting, OCD drugs
answer
Major depression, bedwetting (imipramine), OCD (clomipramine) fibromyalgia
question
Toxicity of TCAs...which ones to use in elderly, which one for ppl with seizures...how to tx some of the tox?
answer
alpha 1 blocking effects like hypotension, and dry mouth, urinary retention...amitryp(3rd degree) have more anticholin effects than 2ndary-nortriptyline...despiramine=less sedating-and higher sezure threshold...TRI-C's=convulsions, coma, cardiotoxicity....also resp depression and hyperpyrexia...confusion and hallucinations in elderly due to tricyclic effecs-use nortryptyline in elderly. use NaHCO3 for cardio tx
question
MAO Inhibitors (MAOIs)
answer
MAO Takes Pride In Shanghai Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline(selective MAO B inhibitor)
question
Tranylcypromine
answer
MAOI
question
Phenelzine
answer
MAOI
question
Isocarboxazid
answer
MAOI
question
Selegiline
answer
MAOI-selective MAOB inhibitor
question
MOA of MAOIs
answer
nonselective MAO inhibition increases levelsof amine neurotransmitters-NE, serotonin, dopoamine
question
Clicical use of MAOIs
answer
atypical depression, anxiety, hypochondriasis..
question
Toxicity of MAOIs--a lot due to ingestion of:
answer
Hyperensive crisis-MOST NOTABLY WITH ingestion of TYRAMINE-which is found in many foods such as wine and cheese....CNS stimulation, contraindicated with SSRIs, TCAs, St. John's Wort, Meperidine, and dextromethophan-(to prevent serotonin syndrome)
question
Atypical Antidepressants:
answer
buproprion, Mirtazapine, Maprotilline, Trazadone
question
Buproprion: MOA, type of drug, side effects...be careful w/giving to which type of ppl
answer
Used for smoking cessation...increases Norepinephrine and dopamine via unknown mechanism..atypical antidepressant...tox=stimulant effects=tachycardia, insomnia) also headache, seizure in Bulimic pts...no sexual side effects.
question
Mirtazapine. Type of drug, moa, toxicity
answer
alpha 2 antagonist (increases the release of NE and serotonin), and potent 5Ht2 and 5HT3 receptor antagonist. this drug is an atypical antidepressant, and it's toxic effects: sedation (may be desired in depressed pts w/insomnia), increased appetite and weight gain-may be good in elderly or anorexic, and dry mouth
question
Maprotilline: type of drug and MOA, tox
answer
Blocks NE reuptake. Toxicity : sedation, orthostatic hypotension. This drug is an atypical antidepressant
question
Trazodone-type of drug, Moa, used mostly for___ toxicity....male side effects:
answer
atypical antidepressant. Primarily inhibits serotonin reuptake. used primarily for insomnia, as high doses are nedded for antidepressant effects...toxicity: sedation, nausea, priapism, postural hypotension...called trazoBONE to ue to male specific side effects :)
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question
how to treat: Alcohol withdrawal
answer
Benzodiazepines
question
how to tx Anxiety
answer
SSRIs, SNRIs, Busprione
question
ADHD
answer
methyphenidate, amphetamines
question
Bipolar Disorder
answer
Mood stabilizers: lithium, valproic acid, carbamazepine, atypical antipsychotics
question
Bulimia
answer
SSRIs
question
Depression
answer
SSRIs, SNRIs, TCAs, busprione, mirtazapine (especially with insomnia)
question
Obsessive compulsive disorder
answer
SSRIs, clomipramine
question
Panic Disorder
answer
SSRIs, venlafaxine, benzodiazepines
question
PTSD
answer
SSRIs
question
Schizophrenia
answer
Antipsychotics
question
Social Phobias
answer
SSRIs
question
Tourette's syndrome
answer
antipsychotics haloperidol, risperidone
question
what are the CNS stimulants?
answer
Methylphenidate, dextroamphetamine, methamphetamine
question
what is the CNS stim method of action
answer
increase catecholamines at the synaptic cleft, especially NE and dopamine
question
What is the clinical use of CNS stimulants:
answer
ADHD, narcolepsy, appetite control
question
haloperidol
answer
antipsychotics
question
trifluoperazine
answer
antipsychotics
question
fluphenazine
answer
antipsychotics
question
thioridazine
answer
antipsychotics
question
chloropromazine
answer
antipsychotics
question
so what's the name thing for antipsychotics?
answer
haloperidol + "azines"
question
mechanism of Antipsychotics
answer
all typical antipsychotics block dopamine D2 receptors, increasing cAMP
question
what are the high potency antipsychotics? and what are the side effects?
answer
Trifluperazine, fluphenazine, Haloperidol...try to fly high? neurolgoic side effects (extrapyrimidal)
question
clinical use of antipsychotics
answer
schizo (primarily positive symptoms) psychosis, acute mania, Tourette's syndrome
question
what are the low potency antipsychotics? side effects?
answer
chloropromazine, thioridazine -cheating thieves are low.....non neurologic side effects (anticholinergic, antihistamine and alpha 1 blockade effects)
question
what is the toxicity of antipsychotics?
answer
highly lipid soluble, and stored in body fat; thus very slow to be removed from the body, extrapyramidal system side effects: dyskinesias, endocrine side effects: dopamine receptor antagonism---hyperprolactinemia: galactorrhea, side effects from blocking muscarinic receptors; hypotension, and dry mouth, and sedation.
question
Chloropromazine causes:
answer
corneal deposits
question
thioridazine causes
answer
retinal deposits
question
haloperidol:
answer
NMS, tardive dyskinesia
question
evolution of EPS side effects:
answer
4 hr of acute dystonia (muscle spasm, stiffness, oculogyric crisis) 4 day akathisia (restlessness) 4 wk bradykinesia (parkinsonism) 4 mo tardive dyskinesia
question
what is neuroleptic malignant syndrome-and what drug is this associated with? Treatment:
answer
rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Tx=dantrolene, D2 agonists (bromocriptine)
question
Tardive dyskinesia:
answer
stereotypic oral facial movements as a result of long term antipsychotic use...often irreversible
question
for neuoleptic malignant syndrome: (NMS) think
answer
think fever: fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles
question
atypical antipsychotics mmneom..
answer
it's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z
question
olanzapine
answer
atypical antipsychotic
question
clozapine
answer
atypical antipsychotic
question
quetiapine
answer
atypical antipsychotic
question
risperidone
answer
atypical antipsychotic
question
aripiprazole
answer
atypical antipsychotic
question
ziprasidone
answer
atypical antipsychotic
question
mechanism of atypical antipsychotics...
answer
not understood...varied effects on 5ht2, dopamine and alpha and H1 receptors
question
clinical use of atypical antipsychotics
answer
schizophrenia-both positive and negative symptoms: also used for bipolar disorder, ocd, anxiety disorder, depression, mania, tourette's syndrome
question
what are the toxicities for atypical antipsychotics?
answer
fewer extrapyramidal and anticholinergic side effects than traditional antipsychotics.....olazapine, clozapoine may cause significant eight gain...clozapine may cause agranulocytosis...requires weekly wbc monitoring and sezure ziprasidone may prolong the QT interval
question
olanzapine/clozapine may cause significant:
answer
weight gain
question
clozapine may cause
answer
agranulocytosis -rqrs weekly wbc monitoring and seizure
question
ziprasidone
answer
may prolong the QT interval
question
Lithium Mechanism:
answer
not established, possibly related to inhibition of phosphoinositol cascade
question
clinical use of lithium
answer
mood stabilizer for bipolar disorder-blocks relapse and acute manic events...also for SIADH
question
Toxicity of Lithium-what do teratogenic effects include:and mnemonic:
answer
tremor, sedation, edema, heart block, polyuria...ADH antagonist-causing nephrogenic diabetes insipidus, TERATOGENIC...cardiac defects-ebstein anomaly and malformaltion of the great vessels... LMNOP-lithium side effects: movement (tremor), nephrogenic diabetes insipid us, hypothyroidism, pregnancy problems.
question
what rqrs close monitoring of serum levels of lithium...
answer
narrow therapeutic window.
question
lithium is almost exclusively excreted by:___ where?
answer
the kidneys-most is reabsorbed at the proximal convoluted tubule following Na reabsorption
question
buspirone: used in:
answer
used in generalized anxiety disorder....
question
buspirone MOA: mnemonic
answer
stimulates 5HT1a receptors: I'm always anxious if the BUS will be ON time, so I take BUSpirONe
question
how long does it take for buspirone to take effect? doesn't cause what? takes ____ weeks to take effeect? does it interact w/alcohol compared to __
answer
1-2 weeks for it to take effect...does not cause sedation, addiction, or tolerance. does not interact with alcohol-vs barbiturates and benzodiazepines
question
SSRIs...names and mnemonic:
answer
FLashbacks PARalyze Senior CITizens Fluoxetine, paroxetine, sertraline, Citalopram
question
fluoxetine
answer
SSRI
question
Paroxetine
answer
SSRI
question
Sertraline
answer
SSRI
question
Citalopram
answer
SSRI
question
MOA of SSRI-how many weeks does it usually take for antidepressants to have an effect?
answer
serotonin specific reuptake INHIBITORS. 4-8 weeks to take effect?
question
Clinical use of SSRIs
answer
depression, genralized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
question
Toxicity of SSRIs
answer
Fewer than TCAs-Gi distress, SEXUAL DYSFUNCTION-anorgasmia and decreased libido. Serotonin synddrome: with any drug that increases serotonin (MAOIs, SNRIs, TCAs): hyperthermia, confusion, myoclonus, cardiovascular collapse..flushing, diarrhea, seizures....tx of it: 5HT2 receptor antagonist: (octreotide)
question
So generalized anxiety disorder can be tx w/
answer
Busiprone and SSRIs, SNRIs
question
Venlafaxine, duloxetine
answer
SNRIs
question
SNRI MOA
answer
inhibit serotoinin and NE uptake
question
Clinical use of SNRIs...duloxetine is also indicated for. which SNRI has a greater effect on NE
answer
Depression....Venlafax-also used in generalized anxiety disorder and panic disorders....Duloxetine=also indicated for diabetic peripheral neuropathy...Duloxetine=greater effect on NE
question
Tricyclic antidepressants:
answer
all end in -iptyline and -ipramine except doxepin and amoxapine
question
MOA TCAs
answer
Block reuptake of NE and serotonin
question
clinical use of tCAs...bedwetting, OCD drugs
answer
Major depression, bedwetting (imipramine), OCD (clomipramine) fibromyalgia
question
Toxicity of TCAs...which ones to use in elderly, which one for ppl with seizures...how to tx some of the tox?
answer
alpha 1 blocking effects like hypotension, and dry mouth, urinary retention...amitryp(3rd degree) have more anticholin effects than 2ndary-nortriptyline...despiramine=less sedating-and higher sezure threshold...TRI-C's=convulsions, coma, cardiotoxicity....also resp depression and hyperpyrexia...confusion and hallucinations in elderly due to tricyclic effecs-use nortryptyline in elderly. use NaHCO3 for cardio tx
question
MAO Inhibitors (MAOIs)
answer
MAO Takes Pride In Shanghai Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline(selective MAO B inhibitor)
question
Tranylcypromine
answer
MAOI
question
Phenelzine
answer
MAOI
question
Isocarboxazid
answer
MAOI
question
Selegiline
answer
MAOI-selective MAOB inhibitor
question
MOA of MAOIs
answer
nonselective MAO inhibition increases levelsof amine neurotransmitters-NE, serotonin, dopoamine
question
Clicical use of MAOIs
answer
atypical depression, anxiety, hypochondriasis..
question
Toxicity of MAOIs--a lot due to ingestion of:
answer
Hyperensive crisis-MOST NOTABLY WITH ingestion of TYRAMINE-which is found in many foods such as wine and cheese....CNS stimulation, contraindicated with SSRIs, TCAs, St. John's Wort, Meperidine, and dextromethophan-(to prevent serotonin syndrome)
question
Atypical Antidepressants:
answer
buproprion, Mirtazapine, Maprotilline, Trazadone
question
Buproprion: MOA, type of drug, side effects...be careful w/giving to which type of ppl
answer
Used for smoking cessation...increases Norepinephrine and dopamine via unknown mechanism..atypical antidepressant...tox=stimulant effects=tachycardia, insomnia) also headache, seizure in Bulimic pts...no sexual side effects.
question
Mirtazapine. Type of drug, moa, toxicity
answer
alpha 2 antagonist (increases the release of NE and serotonin), and potent 5Ht2 and 5HT3 receptor antagonist. this drug is an atypical antidepressant, and it's toxic effects: sedation (may be desired in depressed pts w/insomnia), increased appetite and weight gain-may be good in elderly or anorexic, and dry mouth
question
Maprotilline: type of drug and MOA, tox
answer
Blocks NE reuptake. Toxicity : sedation, orthostatic hypotension. This drug is an atypical antidepressant
question
Trazodone-type of drug, Moa, used mostly for___ toxicity....male side effects:
answer
atypical antidepressant. Primarily inhibits serotonin reuptake. used primarily for insomnia, as high doses are nedded for antidepressant effects...toxicity: sedation, nausea, priapism, postural hypotension...called trazoBONE to ue to male specific side effects :)