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69 Cards in this Set
- Front
- Back
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Drug for Alcohol Withdrawal?
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Benzodiazepines
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Drug for Anorexia/Bulimia?
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SSRI's
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Drugs for Anxiety?
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Benzo's
Buspirone SSRI's |
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Drugs for ADHD?
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Methylphenidate (ritalin)
Amphetamines (dexedrine) |
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Drugs for Atypical Depression?
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MAO Inhibitors
SSRI's |
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Drugs for Bipolar Disorder?
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Mood Stabilizers: Lithium, Valproic Acid, Carbamazepine
Atypical Antipsychotics |
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Drugs for Depression?
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SSRI's
NSRI's TCA's |
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Rx for Depression w/ Insomnia?
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Mirtazapine
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Rx for OCD?
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SSRI's
Clomipramine |
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Rx for Panic Disorder?
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SSRI's
TCA's Benzo's |
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Rx for PTSD?
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SSRI's
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Rx for Schizophrenia?
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Antipsychotics
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Rx for Tourette's Syndrome?
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Antipsychotics (haloperidol)
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MOA for Methylphenidate?
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Inc Presynaptic NE vesicular release (like amphetamines)
However, mech for relieveing ADHD is unknown |
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Who are the high yield "typical" antipsychotics?
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Haloperidol
Thioridazine Fluphenazine Chlorpromazine Halo + the "azine"s |
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MOA for Typical Antipsychotics? reason?
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They all block Dopamine D2 receptors
Reasoning is that excessive dopamine activity in mesolimbic system--->psychotic sx's |
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Clinical Uses for Typical Antipsychotics?
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Schizophrenia (mostly positive sx's)
Pyschosis Acute Manie Tourette's |
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What are the 4 areas of possible efficacy of the Typical Antipsychotics?
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EPS
M Block Sedation Alpha Block |
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How does Haloperidol affect the 4 areas?
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Mostly just messes w/ the EPS system
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Main SE's of Haloperidol?
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NMS = Neuroleptic Malignant Syndrome
Tardive Dyskinesia these can be seen w/ other antipsychotics, but halo has the highest chance. |
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SE's of Thioridazine?
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Cardiotoxic-->Torsades (quinidine-like)
Retinal Deposits (permanent, dose-dependent) |
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When do we use Atypical Antipsychotics?
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For Persistent Negative Sx's
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Other benefit of Atypicals when it comes to SE?
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Dec risk of EPS issues (tardive)
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General Common MOA for all Atypical Antipsychotics?
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All block 5HT-2 (serotonin) receptors
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Other possible SE's of Typical Antipsychotics?
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Endocrine SE's
M block and Alpha Block SE's |
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What is Neuroleptic Malignant Syndrome? mnemonic?
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Rigidity
Myoglobinuria Autonomic Instability Hyperpyrexia FEVER fever encephalopathy vitals unstable elevated enzymes rigidity |
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Rx for NMS?
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Dantrolene
Agonists (like bromocriptine) |
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How do EPS SE's evolve?
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4 hours: acute dystonia (muscle spasm, stiffness, oculogyric crisis)
4 Days: akinesia (parkinson like) 4 Weeks: Akathasia (restlessness) 4 Months: Tardive |
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Rx for acute EPS SE's?
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Antimuscarinic Drugs:
benztropine diphenhydramine |
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Rx for chronic EPS SE's (like tardive)?
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switch to atypical
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Endocrine SE's w/ Typical Antipsychotics?
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Temperature Regulation Problems in NMS (from rigidity)
Inc eating |
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Who are the high yield Atypical Antipsychotics?
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Clozapine**
Olanzapine Risperidone Aripiprazole |
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SE's of Clozapine?
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Agranulocytosis requiring weekly WBC counts
Inc salivation (wet pillow) Seizures |
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Clinical uses of Olanzapine?
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OCD
Anxiety Depression mania Tourette's |
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MOA for Lithium?
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Not Established
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Clinical uses for Lithium?
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Mood stabilizer for bipolar pts
Blocks relapse and acute manic events (also SIADH) |
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SE's of Lithium?
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Tremor
Hypothyroidism Polyuria--->nephrogenic DI Teratogenesis |
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MOA for Buspirone?
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Stimulates 5-HT-1a receptors
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Clinical uses for Buspirone?
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Generalized Anxiety Disorder
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Why is Buspirone good?
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No sedation or addiction
Doesn't interact w/ booze |
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Possible MOA for Lithium?
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Prevents recycling of inositol (dec PIP2)
Dec cAMP by uncoupling Gs receptors |
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Rx of Lithium induced nephrogenic DI?
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Amiloride
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Type of Teratogenicity associated w/ Lithium?
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Ebstein's Anomaly
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What is ebstein's anomaly?
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Tricuspid valve is pushed into RV--->need for valve replacement
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Who are the TCA's?
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Amitriptyline
Imipramine Clomipramine |
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MOA of TCA"s?
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Block reuptake of NE and Serotonin
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TCA uses?
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Major Depression
Phobic and Panic attack states OCD (clomipramine) Bedwetting (Imipramine, 2nd line) Neuropathic Pain (chronic pain syndromes) |
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SE's of TCA's?
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Sx's of M and Alpha Blockade
3 C's Coma Convulsions Cardiotoxic (quinidine like--->torsades) |
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Rx for TCA-induced cardiotoxicity?
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NAHCO3
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DDI's for TCA's?
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HTN crisis w/ MAO inhibitors
Serotonin Syndrome w/ SSRI's and MAO inhibitors |
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Who are the SSRI's?
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Fluoxetine
Paroxetine Sertraline Citalopram |
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MOA for SSRI's?
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Serotonin-Specific Reuptake Inhibitors
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SE's of SSRI's?
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Less than TCA's
GI distress Sexual dysfxn Serotonin Syndrome (w/ any other drug that inc serotonin) |
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Sx's of Serotonin Syndrome?
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Hyperthermia
Muslce Rigidity CV collapse Flushing Diarrhea |
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uses for SSRI's?
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depression
OCD bulimia Anxiety disorders PMDD=premenstrual dysphoric disorder |
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"Other" high yield antidepressants?
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**Bupropion (wellbutrin)
**Mirtazapine Venlafaxine Trazodone |
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Kicker for Bupropion?
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Only one who is a DA reuptake blocker
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Uses of Bupropion?
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Smoking Cessation
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Kicker for Mirtazapine?
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Alpha-2 Antagonist
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SE' of Mirtazapine?
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Wt Gain...enough to make this clinically important
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Who are the MAO Inhibitors?
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Phenelzine
Tranylcypromine |
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MOA of Phenelzine, Tranylcypromine?
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Nonselective blocking of MAO-1 and MAO-2
---> Inc levels of amine Neurotransmitters |
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Uses for MAO inhibitors?
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Atypical Depression
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DDI's of MAO inhibitors?
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Inc NE--->hypertensive crisis
Inc 5HT---> Serotonin syndrome |
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ways to get a hypertensive crisis w/ MAO-I's?*************
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Drugs:
Releasers like tyramine TCA's Alpha-1 agonists Levodopa |
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Sx's of Serotonin Syndrome?
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Sweating
Rigidity Myoclonus Hyperthermia ANS instability Seizures |
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Drugs that interact w/ MAO-I's to cause Serotonin syndrome?******
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SSRI's
TCA's Meperidine Dextromethorphan |
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Why can meperidine cause serotonin syndrome?
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It is an opioid w/ an SSRI-like metabolite
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How do you distinguish NMS from Serotonin Syndrome?
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Both have Rigidity and Hyperthermia, but ONLY Serotonin syndrome has Myoclonus
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