Psych Drugs

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Psych Drugs
2011-04-10 11:38:20
PA Psych Drugs

EOR Flashcards
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  1. This anti-depressant has a very long half-life, so it can be taken once a week.
    Fluoxetine (Prozac)
  2. 30-40% of pts taking this anti-depressant group complain of sexual SEs that don't usually go away (decreased libido, delayed orgasm or diminished arousal).
  3. This syndrome can occur when combining SSRIs, MAOIs, bupropion (Wellbutrin), ranitidine (Zantac), erythromycin, ciprofloxacin, or verapamil.

    The symptoms include muscle rigidity, autonomic hyperactivity (fever, shivering, diarrhea, tachycardia, HTN), agitation, and coma. Can be mild to life-threatening.
    Serotonin Syndrome
  4. These 2 groups are the best anti-depressants to use prophylactically in anxiety.
    SSRIs and SNRIs
  5. This SNRI is very toxic if overdosed.
    Venlafaxine (Effexor)
  6. This group of anti-depressants can help with chronic pain but these other anti-depressants are much better (at lower doses than for depression).
    • SNRIs
    • TCADs
  7. There is additive sedation with this drug group, so pts should take care with EtOH.
  8. Avoid these anti-depressants in the elderly due to sensitivity to antimuscarinic effects.
  9. These anti-depressants are lethal in an overdose, so they are 2nd line and most often prescribed by a psychiatrist.
  10. This 5-HT2 antagonist is not used for depression due to hepatotoxicity.
  11. This 5-HT2 antagonist is used primarily for sleep rather than for depression.
    Trazodone (Desyrel)
  12. This group of anti-depressants has the least amount of sexual SEs.
    Tetracyclic & Unicyclic group (bupropion, mirtazapine, amoxapine, maprotiline)
  13. This anti-depressant is not used for anxiety, but can be used for smoking cessation due to decreaseing the urge to smoke with decreased modd sx's and maybe decreased weight gain while withdrawing from nicotine.
    Bupropion (Wellbutrin)
  14. This group of anti-depressants is 3rd line due to its many side effects including hypertensive crisis when taken with food high in tyramine (red wine and cheese).
  15. This is just as effective as anti-depressants, but usually takes longer and is more expensive.
    Cognitive Behavioral Therapy (CBT)
  16. If __ or more serious major depression episodes in __ years or __ or more in a lifetime, then place on maintenance therapy to prevent recurrence.
    • 2
    • 5
    • 3
  17. Withdrawal happens with these groups of anti-depressants.
  18. This black box warning is placed on ALL anti-depressants.
    Increased risk of suicidal ideation and gestures in 1st 1-2 months in those <25 yo BUT absence of tx is a risk of completed suicide!
  19. This is the best guide to choosing which anti-depressant your patient needs.
    History of response on previous agents
  20. __% of depressed patients don't get better at all
    __% don't get full remission
    • 33
    • 66
  21. These anti-psychotics have a black box warning for QT prolongation.
    Thioridazine and Atypicals
  22. These anti-psychotics have a black box warning for use in elderly with dementia for increased risk of death (mostly CVS and infection).
    ALL Anti-psychotics
  23. This anti-psychotic is only used for acute nausea and vomiting, not psychosis.
    Prochlorperazine (Compazine)
  24. This is when a patient is awake, but not responding to external stimuli, and it responds to this medication.
    • Catatonia
    • Benzos
  25. Extrapyramidal Symptoms (early SEs of anti-psychotic drugs): spasms in neck so it bends backwards. Treat with what?
    • Spastic Retrocollis
    • Treat with diphenhydramine (Benadryl) or antiparkinson drugs
  26. Extrapyramidal Symptoms (early SEs of anti-psychotic drugs): neck pulled to one side or the other. Treat with what?
    • Spastic Torticollis
    • Treat with diphenhydramine (Benadryl) or antiparkinson drugs
  27. This is the inability to sit still or uncontrollable restlessness that is an early SE that can happen with anti-psychotics.
  28. This is the most important unwanted SE to anti-psychotics and occurs late. It is not always reversible. Involves repetitive, involuntary, purposeless movements (mostly in face). Tx is to decrease dose, change to newer atypical agenet, stop other anticholinergic drugs (TCAD or antiparkinsonism drugs) and/or give diazepam.
    Tardive Dyskinesia
  29. Monitor weight gain every visit and fasting blood sugar and lipid panel every 3-6 months with all but especially these anti-psychotics.
    • Clozapine (Clozaril)
    • Olanzapine (Zyprexa)
  30. This anti-psychotic drug causes agranulocytosis so need weekly blood counts for 1st 6 months and every 3 weeks after.
    Clozapine (Clozaril)
  31. This is a life-threatening syndrome that can happen with neuroleptic anti-psychotics (and a little with atypicals). Sx's include muscle rigidity, fever, autonomic instability (change in BP and HR), and increased serum CK. What's the treatment?
    • Neuroleptic Malignant Syndrome
    • Cooling and Diazepam (Valium)
  32. This is the target blood level for Lithium.
    0.9 mEq/L (0.6-1.4 mEq/L)
  33. This SE occurs at therapeutic doses of Lithium, but can be decreased with beta blockers.
  34. This is the mainstay of treatment for bipolar disorder.
  35. This is irregular, spasmodic, involuntary movemnts of limbs or facial muscles as well as slow, writhing, involuntary movements of fingers and hands and can happen when taking Lithium.
  36. At therapeutic levels of Lithium, patients may experience these symptoms similar to that of DM.
    Polyuria and polydipsia
  37. Lithium causes this change in the WBCs.
    Leukocytosis which may make you think there's an infection when there's not
  38. Lithium can get toxic easily. Anything above __ mEq/L is toxic, but can be toxic even below this level.
  39. This medication is for depression in those with bipolar.
    Lamotrigine (Lamictal)
  40. Avoid these 3 drug groups when taking benzos due to impairment of mentation or motor function when combined.
    • EtOH
    • Antihistamines
    • Anticholinergics
  41. Use (long/short)-acting benzos for DTs or withdrawal from other CNS depressants.
    • Long-acting
    • Takes advantage of cross-tolerance, and the long half-life lets it be excreted slowly enough so no withdrawal.
  42. This sedative-hypnotic is indicated to relieve anxiety without sedation, hypnosis or euphoria and is not controlled due to lack of addiction potential.
    Buspirone (Buspar)
  43. This sedative-hypnotic is indicated for those having trouble falling asleep, not staying asleep and is not a controlled substance since it is not addictive.
    Ramelteon (Rozerem)
  44. Patients with pulmonary disease should not take sedative-hypnotics due to this side effect at therapeutic doses.
    Respiratory distress
  45. Patients with hypovolemia, heart failure or other cardiac disease should not take sedative-hypnotics due to this side effect at therapeutic doses.
    Decrease in heart function
  46. At toxic doses, sedative-hypnotics cause these cardiovascular symptoms.
    • Decreased muscle tone in the heart (heart failure)
    • Decreased vascular tone (decreased blood pressure)
  47. This is the benzodiazepine antagonist used for overdoses or for more rapid recovery from anesthesia.
    Flumazenil (Romazicon)
  48. This disease is related to EtOH abuse and causes paralysis of eye muscles, ataxia, confusion and is due to a deficiency in this vitamin.
    • Wernicke’s Encephalopathy
    • Thiamine
  49. This disease is related to EtOH abuse and is a
    form of permanent dementia w/ impaired memory & confabulation.
    Korsakoff’s Psychosis
  50. This drug causes flushing, HA, N/V, sweating, hypotension, confusion when a patient drinks alcohol. It is not used a lot due to noncompliance and drug interactions.
    Disulfiram (Antabuse)
  51. These 3 drugs can cause a similar reaction to drinking alcohol and taking Disulfiram (Antabuse).
    • Metronidazole (Flagyl)
    • Cefotetan (Cefotan)
    • Trimethoprim
  52. This drug decreases cravings for EtOH and decreases rate of relapse, but only works short term.
    Naltrexone (Revia)