psychdrugs.txt

Card Set Information

Author:
vaneshka
ID:
7128
Filename:
psychdrugs.txt
Updated:
2010-03-21 11:52:24
Tags:
psych drugs
Folders:

Description:
Psychiatry 200 medications
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user vaneshka on FreezingBlue Flashcards. What would you like to do?


  1. All Antipsychotics
    • block D2 receptor (typicals only D2, atypicals 5HT2A also)
    • lower seizure threshold (only clozapine known to induce seizures)
    • potentially prolong QTc
    • atypicals augment partial responders to SSRI's
  2. Side Effect Receptors (HAM)

    Anti- Histamine
    ...symptoms?
    weight gain, sedation
  3. Side Effect Receptors (HAM)

    Anti- Alpha 1
    ...symptoms?
    orthostasis, cardiac arrhythmias
  4. Side Effect Receptors (HAM)

    Anti- Muscarinic (Anti-ACh)
    ...symptoms?
    delirium, blurred vision, xerostomia (dry mouth), constipation, urinary retention

    (remember: mad as a hatter, blind as a bat, dry as a bone, red as a beet, hot as a hare)
  5. Extrapyramidal Symptoms (EPS)
    nigrostriatal pathway, too little DA

    • acute dystonia
    • akathisias (subjective sense of restlessness)
    • parkinsonism
    • tardive dyskinesia
    • neuroleptic malignant syndrome (NMS- altered MS, rigidity, hyperthermia, autonomic dysfunction)
  6. 5HT1A

    increased 5HT -->
    relief of depression and anxiety
  7. 5HT2A/C
    increased 5HT -->
    decrease libido (long-term), insomnia (long-term), headache and jitteriness (temporary)
  8. 5HT3/4
    increased 5HT -->
    GI upset (N/V/D) - temporary
  9. Acute Dystonia
    Definition?
    Treatment?
    sustained muscle contractions causing twisting and repetitive movements or abnormal postures (1 week)

    • Benztropine (Cogentin) -anti-cholinergic
    • Diphenhydramine (Benadryl)- anticholinergic
  10. Akathisia

    Definition?
    Treatment?
    Subjective sense of restlessness, need to move

    • beta blockers (propranolol)
    • Benzos (calming effect)
    • anti-cholinergic
  11. Parkinsonism

    Definition?
    Treatment?
    bradykinesia, rigidity, tremor, postural instability (couple weeks)

    change offending medication
  12. Tardive Dyskinesia

    definition?
    treatment?
    involuntary movements usually the mouth (3-6 months)

    none (might be permanent), switch meds
  13. Neuroleptic Malignant Syndrome

    Definition?
    Treatment?
    altered MS, rigidity, hperthermia, autonomic dysfunction, increased CK

    IV fluids (supportive), dantrolene (muscle relaxant), bromocriptine (DA agonist)
  14. Haloperidol
    • Haldol
    • Typical, first generation
    • High potency, low HAM action
    • high incidence of EPS
    • available in decanoate shots
  15. Fluphenazine
    • Prolixin
    • Typical, 1st gen
    • High potency, low HAM
    • high incidence of EPS
    • available in decanoate shots
  16. Perphenazine
    • Trilafon
    • Typical, 1st gen
    • Mid potency, mix of SE's
    • (not really important to know details)
  17. Chlorpromazine
    • Thorazine
    • Typical, 1st gen
    • Low potency, high HAM (orthostasis, sedating)
    • avoid in elderly (falls)
  18. Olanzapine
    • Zyprexa
    • Atypical, 2nd gen
    • worst for metobolic SE, sedating
  19. Risperidone
    • Risperdal
    • Atypical, 2nd gen
    • binds tightly (most "typical" of atypicals)- EPS
    • 2nd worst for metabolic syndrome (of our list)
    • available in decanoate (Risperdal Consta)
  20. Quetiapine
    • Seroquel
    • Atypical, 2nd gen
    • extremely sedating, causes orthostasis
    • middle of the pack as far as metabolic SE's
    • used for sleep also
  21. Ziprasidone
    • Geodon
    • Atypical, 2nd gen
    • specifically worry about QT prolongation
    • least metabolic SE's
  22. Aripiprazole
    • Abilify
    • Atypical, 2nd gen
    • partial D2 agonist (novel MOA)
    • least metabolic SE's
  23. Clozapine
    • Clozaril
    • Atypical, 2nd gen
    • most effective and most dangerous
    • risks: aplastic anemia, seizures, cardiomyopathy, hypotension (also drooling)
    • good for TD
    • (this and lithium are the only two drugs known to decrease suicide)
  24. Phenelzine
    Tranylcypromine
    • MAOI A&B
    • very powerful
    • drug-drug interactions
    • too much NE--> malignant HTN (drug-food interactions, avoid tyramine)
    • too much 5HT--> serotonin syndrome (2 wk wash out from other anti-depressants)
    • (don't use with demerol)
  25. Selegiline
    • MAOI B
    • very powerful
    • drug-drug interactions
    • available as a patch
    • too much NE--> malignant HTN (drug-food interactions, avoid tyramine)
    • too much 5HT--> serotonin syndrome (2 wk wash out from other anti-depressants)
    • (don't use with demerol)
  26. Serotonin Syndrome
    • Clinical presentation (Usually present with 6 hours of administration or change of drug):
    • Mental status changes: anxiety, delirium, restlessness, and disorientation.
    • Autonomic changes: diaphoresis, tachycardia, hyperthermia, hypertension, vomiting,
    • diarrhea.
    • Neuromuscular hyperactivity: tremor, muscle rigidity, myoclonus, hyperreflexia,
    • bilateral babinski.
    • Lab features: Elevated WBCs, elevated CPK, decreased serum bicarb. Rarely may
    • progress to DIC, rhabdomyolysis, metabolic acidosis, renal failure, ARDS.

    Treatment:Discontinue all serotonergic agents, stabilize vitals, Sedate with benzos, Give serotonin antagonist (cyproheptadine)
  27. Amitriptyline
    • Elavil
    • TCA
    • 5HT and NE
    • most lethal in overdose (TdP, cardiotoxicity)
    • high SE profile (*anti-cholinergic*, anti-histamine)
    • pain syndromes
  28. Clomipramine
    • TCA
    • mostly 5HT
    • lethal in overdose (TdP, cardiotoxicity)
    • high SE profile (*anti-cholinergic*, anti-histamine)
    • OCD
  29. imipramine
    • TCA
    • Mostly 5HT
    • lethal in overdose (TdP, cardiotoxicity)
    • high SE profile (*anti-cholinergic*, anti-histamine)
    • enuresis
  30. nortriptyline
    • TCA
    • mostly NE
    • lethal in overdose (TdP, cardiotoxicity)
    • high SE profile (*anti-cholinergic*, anti-histamine)
    • elderly depression
  31. Venlafaxine
    • Effexor
    • SNRI
    • Pro-5HT at doses up to 150mg; Pro-NE btwn 150-300mg
    • SE's of 5HT (GI, etc) and NE (HTN)
    • lowest protein binding
    • good for comorbid pain syndromes
  32. Duloxetine
    • Cybalta
    • SNRI
    • (equal increase in 5HT and NE with increasing dose, unlike venlafaxine)
    • SE's of 5HT (GI, etc) and NE (HTN)
    • good for comorbid pain syndromes
  33. Citalopram
    • Celexa
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
  34. Escitalopram
    • Lexapro
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
  35. Fluoxetine
    • Prozac
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
    • Longest 1/2 life (least risk of discontinuation syndrome)
  36. Fluvoxamine
    • Luvox
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
    • Hepatic Failure
  37. Paroxetine
    • Paxil
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
    • shortest 1/2 life (high risk of discontinuation)
  38. Sertraline
    • Zoloft
    • SSRI
    • 5HT SE's (2A/C (Sexual dysfunction, insomnia), 3/4(GI))
  39. Buspirone
    • BuSpar
    • partial 5HT1A agonist
    • primarily for GAD, also as adjunctive to primary antidepressant
  40. Buproprion
    • Wellbutrin, Zyban
    • NDRI
    • lowers seizure threshold
    • potentially makes anxious/jittery
    • good for craving, bad for psychosis, no sexual SE's
  41. Mirtazapine
    • Remeron
    • alpha2 antagonist
    • acts by modulating 5HT and NE via autoreceptors
    • only med that increases secretion of monoamines
    • very H1 at low doses (good for sleep)
    • no sexual SE's, significant weight gain (good for low appetite)
  42. Nefazodone
    • Serzone
    • SARI (5HT antagonist and reuptake inhibitor)
    • 5HT2 antagonist , partial 5HT1A agonist
    • fatal hepatitis
  43. Trazodone
    • SARI (5HT antagonist and reuptake inhibitor)
    • 5HT2 antagonist , partial 5HT1A agonist
    • dose too high for antidepressant effects so used as a sleeping agent
    • priapism
  44. Lithium
    • Mood Stabilizer
    • therapeutic range= .8-1.2
    • SEs: neurotoxicity, hypothyroid, DI, leukocytosis, GI, tremor
    • Teratogenicity: Ebsteins Anomaly
    • Metabolism: Renal
  45. Carbamazepine
    • Mood Stabilizer
    • therapeutic range= 8-12
    • SEs: Autoinducer at liver (increase cyp3A4), S/J rash, CBC abnl, acute hepatitis
    • Teratogenicity: Craniofacial Defects
    • Metabolism: Hepatic
  46. Valproic Acid
    • Mood Stabilizer
    • therapeutic range= 80-120
    • SEs: hepatitis, CBC abnl (decr platelets), sedation, wt gain, acute pancreatitis, acne, alopecia
    • Teratogenicity: Ebsteins Anomaly
    • Metabolism: Neural Tube Defects
  47. Lamotrigine
    • Lamictal
    • good for prevention of depression in Bipolar
    • no level needed
    • S/J rash
  48. Alprozolam
    • Xanax
    • Benzo (short t1/2 6-12hrs)
    • another short acting- midazolam (versed)
  49. Lorazepam
    • Ativan
    • Benzo, intermediate t1/2
    • liver safe
  50. Oxazepam
    • Serax
    • Benzo, short t1/2
    • liver safe
  51. Temazepam
    • Restoril
    • Benzo, short t1/2
    • liver safe
  52. Clonazepam
    • Klonopin
    • Benzo, long t1/2
  53. Diazepam
    • Valium
    • Benzo, long t1/2
    • active metabolites
  54. Flumazenil
    • Benzo receptor antagonist
    • good for benzo OD

What would you like to do?

Home > Flashcards > Print Preview