Psych Drugs- GOOD Flashcards

1
Q

Gold standard ADHD tx?

A

-stimulants

methylphenidate, amphetamines

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2
Q

DOC for alcoholic withdraw?

A

Benzos

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3
Q

Bipolar:

What are your three treatment options?

A
  • lithium
  • valproic acid
  • atypical antipsychotics

…NOT SSRIs (one of the few psych things you cannot use this for.)

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4
Q

DOC for schizophrenia

A

atypical antipsychotics

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5
Q

Two treatment options for tourettes:

A
  • atypical antipsychotics (fluphenazine, pimozide)

- tetrabenazine and clonidine

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6
Q

Bulimia, Depression, GAD, OCD, panic disorder, social anxiety disorder & PTSD can all be treated with?

A

-SSRIs

may also us sNri’s except in bulimia and depression= SSRI only

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7
Q

Performance Social Anxiety Disorder may be treated with? (2)

A
  • BBers

- Benzos

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8
Q

CNS stimulants (i.e. methylphenidate):
MOA
3 conditions for which these may be useful

A

^^ Dopa/ NE at synaptic cleft

-ADHD, narcolepsy, appetite control

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9
Q

Haloperidol + psych drugs that end in –azine are of what class?

A

-CLASSIC antipsychotics (neuroleptics)

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10
Q

Neuroleptics:

  • MOA
  • lipophilic or hydrophilic?
  • aside from desired MOA, what other receptors in body may be targeted?
A
  • block D2 receptors, ^^ cAMP
  • lipophilic, long t1/2
  • muscarinic, H1, a1 all blocked.
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11
Q

What are three high potency neuroleptics?

What neuroleptic ADR is highly likely when taking these drugs?

A
  • Try to Fly High
  • Trifluoperazine, fluphenazine, haloperidol = HIGH potency
  • assc with extrapyramidal ADRs (i.e. parkinsonism, tardice dyskinesia)
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12
Q

Endocrine effects assc with neuroleptics?
Cardio?
Neuro?

A
  • endo = gynecomastia due to ^^ PRL
  • cardio= orthostatic hypoTN (a1 block), QT prolongation
  • neuro= tardive dyskinesia, parkinsonism, NMS, sedation (H1 antagonism)
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13
Q

Chlopromazine: strange ADR
Thioridazine: strange ADR

A

Chlorpromazine: “C”orneal deposits
Thioridazine: re”T”inal deposits

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14
Q

Signs of NMS (neuroleptic malignant syndrome)?
WHAT DRUG REVERSES?
(If you don’t know this by now, you’re doomed.)

A
  • fever, encephalopathy, rigid muscle contractures

- give them some DANTROLENE. Inhibits Ca release from SARCOPLASMIC RETICULUM.

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15
Q

Describe tardive kinesia assc with haloperidol and the –azine drugs (neurolpetics)

A

orofacial chorea

looks like bunny twitching nose

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16
Q

What receptors are effected by ATYPICAL antipsychotics?

A

-D2, 5HT2, a, H1

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17
Q

Which symptoms of schizo can atypical antipsychotics treat? Which can typical psychotics treat?

A
  • atypical: positive + neg sx

- typical: positive symptoms only

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18
Q

What effect can all antipsychotics have on the heart? (both typical and atypical?)

A

QT prolongation

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19
Q

What do atypical anti-psychotics ending in –pine cause?

A

-metabolic syndrome

20
Q

Special ADR assc with clozapine? olanzapine?

What kind of drugs are these and how do we know?

A
  • end in –pine, do NOT end in –azine= atypical antipsych
  • clozapine= agranulocytosis, must watch marrow CLOZEly
  • all –pines can cause metabolic syndrome, but “O”lanzapine is esp known for causing “O”besity
21
Q

Risperidone:
What ADR is it most known for?
What kind of psych drug is this?
How do you know?

A
  • known for hyperprolactinemia
  • you know its ATYPICAL antipsych because it sounds like one of those crazy drugs you learned in psych and it isn’t haloperidol/ doesnt end in –azine.
  • also, they probably gave it to someone with psych issues in the question stem!
22
Q

Lithium:

  • mechanism unkown
  • classically used to treat what disorder?
  • Key ADRs (4)
A

-bipolar
-LMNOP
Lithium = Movement (tremor), Nephrogenic di, hypOthyroid, Preg problems.

**Please note: lithium +thiazide combo will ^^^ risk nephrogenic DI

23
Q

Where is lithium reabsorbed in the kidney?

A

-PCT with Na

24
Q

What birth defect is lithium assc with?

A

-Ebstein anomaly (tricuspid anomaly)

25
Q
Buspirone:
MOA 
Use 
Benefit over other treatments?
Downfall?
A
  • stimulates 5HT1a receptors
  • treats GAD
  • no sedation/ addiction/ tolerance/ alcohol/benzo interaction (= good choice for addicts)
  • will take 1-2 weeks to begin working
26
Q

List the four SSRIs

A
  • Flashbacks Paralyze Senior Citizens
  • Fluoxetine
  • Paroxetine
  • Sertraline
  • Citalopram
27
Q

How long does it take for SSRIs to begin working?

What are three ADRs worth mentioning?

A
  • 4-8 weeks

- 3 S’s: SIADH (tx with demeclocycline), sex prob (decreased libido), & serotonin storm (MAOi, SNRI, TCA)

28
Q

Desvenlafaxine, levomilnacipran, milnacipran are what kind of drugs?
What are two BETTER KNOWN drugs in this class, whose names are worth being able to regurgitate?

A
  • SNRIs

- venlafazine, duloxetine

29
Q

Of the SNRIs, which has the most DIVERSE use?

A

-venlafaxine

choose THIS to treat most psych conditions– other SNRIs may be limited to depression/ pain/ diabetic neuropathy.

30
Q

Most common ADR assc with SNRIs?

A

HTN

31
Q

Serotonin storm:

What does this look like?

A
  1. Hyperthermia, flushing
  2. Myoclonus/ Seizures
  3. Cardiovascular instability
  4. Diarrhea
32
Q

Treatment for serotonin storm?

A

-cyproheptadine (5HT2 antagonist)

33
Q

Amitryptyline, nortryptyline are what kind of psych drugs?

A

-TCAs

*others worth reading:
imipramine, desipramine, clomipramine (notice the pramine trend), doxepine, amoxapine

34
Q

MOA for TCAs

A

-block NE/5HT reuptake

35
Q

TCA commonly used in OCD?

A

-clomipramine

36
Q

What are three non-psych indications for TCA use?

A
  • migraine px
  • chronic pain
  • peripheral neuropathy
37
Q

ADRs for TCA are very similar to what other psych drug class?

A
  • typical antipsychtoics (without the parkinsonism)

- blocks a1/ has atropine like ADRs, prolongs QT

38
Q

What are the “three C’s” of TCA overdose?

Whats the most common cause of death in TCA overdose? How do you prevent it?

A
  • cardiotox, coma, convulsions

- #1 COD is fast Na channel block –> arrhythmia, give NaHCO3

39
Q

Anticholinergic symptoms assc with TCAs may cause confusion or hallucination in the elderly.

Which of the TCAs is LEAST likely to have this effect?

A

-nortyptilline

40
Q

What are the four MAOis?

Which is MAO-B specific?

A
  • MAO Takes Pride In Shanghai
  • trancyclopromine
  • phenelzine
  • isocarboxazaid
  • selegiline (MAO-B only, parkinsons)
41
Q

What are two most noteworthy ADRs assc with MAOis?

A
  • serotonin storm with any drug that also causes ^^^ 5HT
  • stop this drug TWO WEEKS before starting another that will ^^5HT
  • hypertensive crisis w/ tyramine (wine, cheese)
42
Q

What three NTs are ^^^ in response to MAOis?

A

-^^ NE,Dopa, 5HT

43
Q

Buproprion:
MOA
Special benefit
Use

A
  • ^^NE, Dopa only– not 5HT
  • no sexual ADRs
  • used for depression and also smoking cessation
44
Q

Varenicline: MOA

Use, ADR

A
  • nicotinic Ach receptor partial agonist
  • used for smoking cessation
  • causes sleep changes
45
Q

Mirtazapine, a weird antidepressant, has several MOAs. List them. Sorry, Just try.

A
  • a1 antagonist –> ^^ NE, 5HT
  • 5HT2/3 antagonist
  • H1 antagonist
46
Q

Trazadone MOA + use

A
  • blocks 5HT2, a1, H1 receptors + weakly blocks 5HT reuptake
  • treats insomnia + ED (traZZZZaBONE)