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48 Cards in this Set

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drug class used to treat alcohol withdrawl?
benzos
drug class used to treat anorexia and bulimia?
SSRIs
drug classes used to treat anxiety?
-benzos
-barbituates
-buspirone
-MAO inhibitors
drug class used to treat atypical depression?
MAO inhibitors
drugs used to treat bipolar disorder?
mood stabilizers:
-lithium
-valproic acid
-carbamazepines
drug classes used for depression?
SSRIs
TCAs
drugs used for depression with insomnia?
-mirtazapine
-trazodone
drug classes used for obsessive-compulsive disorder?
SSRIs
drug classes used for panic disorder?
TCAs
Buspirone
drugs used for schizophrenia?
antipsychotics
what drugs are antipsychotics (neuroleptics)? (4)
Thioridazine
Haloperidol
Fluphenazine
Chlorpromazine
MOA of antipsychotics?
Most antipsychotics block dopamine D2 receptors (excess dopamine effects connected with schizophrenia).
clinical use of antipsychotics? (4)
Schizophrenia
psychosis
acute mania
Tourette syndrome
toxicities associated with antipsychotics?
-what problems arise from blocking the different receptors classes?

-what is neuroleptic malignant syndrome?

-what is tardive dyskinesia?
Extrapyramidal system (EPS) side effects, endocrineside effects (e.g., dopamine receptor antagonism →
hyperprolactinemia → gynecomastia), and side effects arising from blocking muscarinic (dry mouth, constipation), α (hypotension), and histamine (sedation) receptors.

Neuroleptic malignant syndrome––rigidity,
myoglobinuria, autonomic instability, hyperpyrexia
(treat with dantrolene and dopamine agonists).

Tardive dyskinesia––stereotypic oral-facial movements probably due to dopamine receptor sensitization; results of long-term antipsychotic use.
explain the evolution of EPS side effects?
4hrs - acute dystonia
4d - akinesia
4wks - akathisia
4mo - tardive dyskinesia (often irreversible)
what drugs are atypical antipsychotics? (3)
Clozapine
olanzapine
risperidone.
moa of atypical antipsychotics?
Block 5-HT2 and dopamine receptors.
clinical use of atypical antipsychotics? (1)

what else can olanzapine be used for? (5)
Treatment of schizophrenia; useful for positive and negative symptoms.

Olanzapine is also used for OCD, anxiety disorder, depression, mania, Tourette syndrome.
toxicity of atypical antipsychotics?

what additional problem can clozapine cause?
Fewer extrapyramidal and anticholinergic side effects
than other antipsychotics.

Clozapine may cause agranulocytosis (requires weekly WBC monitoring).
mnemonic to remember the atypical antipsychotics?
"It's not atypical for OLd CLOsets to RISPER."
MOA of lithium?
Not established; possibly related to inhibition of phosphoinositol cascade.
clinical use of lithium? (2)
Mood stabilizer for bipolar affective disorder

Blocks relapse and acute manic events.
toxicity of Lithium? (4)
Tremor, hypothyroidism, polyuria (ADH antagonist causing nephrogenic diabetes insipidus), teratogenesis. Narrow therapeutic window requiring close monitoring of serum levels.
mnemonic for lithium side effects?
"LMNOP"
-Lithium side effects -
-Movement (tremor)
-Nephrogenic diabetes insipidus
-HypOthyroidism
-Pregnancy problems
MOA of Buspirone?
stimulates 5-HT-1A receptors
clinical use of Buspirone?
-anxiolysis for generalized anxiety disorder
-does not cause sedation or addiction
-does not interact with alcohol
what 4 classes of drugs are antidepressants?

(see picture on p.386)
1. SSRIs
2. tricyclic antidepressants
3. heterocyclic antidepressants
4. MAOIs
what 4 drugs are SSRIs?
Fluoxetine
Sertraline
Paroxetine
Citalopram.
MOA of SSRIs?
Serotonin-specific reuptake inhibitors.
clinical use of SSRIs? (2)
Endogenous depression
OCD.
toxicity of SSRIs?

when do you get serotonin syndrome and what is it?
Fewer than TCAs.

GI distress, sexual dysfunction(anorgasmia).

“Serotonin syndrome” with MAO inhibitors––hyperthermia, muscle
rigidity, cardiovascular collapse.
how long does it take for antidepressants to have an effect?
2-3 weeks
what 6 drugs are tricyclic antidepressants?
Imipramine
Amitriptyline
Desipramine
Nortriptyline
Clomipramine
Doxepin
MOA of TCAs?
Block reuptake of NE and serotonin.
Clinical use of all TCAs?

Other use for Imipramine?

Other use for clomipramine?
major depression

Imipramine --> bed-wetting

Clomipramine --> OCD
side effects of TCAs?

which TCAs have more anticholinergic effects?

which TCA is the least sedating?
Sedation, α-blocking effects, atropine-like (anticholinergic) side effects (tachycardia, urinary retention).

3° TCAs (amitriptyline) have more anticholinergic effects than do 2° TCAs (nortriptyline).

Desipramine is the least sedating.
toxicity of TCAs? (mnemonic?)

what can happen in the elderly?
Tri-C’s: Convulsions, Coma, Cardiotoxicity (arrhythmias)

also respiratory depression,
hyperpyrexia

Confusion and hallucinations in elderly due to anticholinergic side effects (use nortriptyline).
What drugs are Heterocyclic antidepressants? (5)
Bupropion
Venlafaxine
Mirtazapine
Maprotiline
Trazodone
What are Heterolytic antidepressants?

What can they all be used for?
2nd- and 3rd-generation antidepressants with varied and mixed mechanisms of action.

Treat major depression.
Burpropion:
-also used for?
-mechanism?
-toxicity?
-sexual side effects?
Also used for smoking cessation. Mechanism not well known. Toxicity: stimulant effects (tachycardia, insomnia), headache, seizure in bulimic patients.

Does not cause sexual side effects.
Venlafaxine:
-also used for?
-MOA?
-toxicity?
Also used in generalized anxiety disorder.

Inhibits serotonin, NE, and dopamine reuptake.

Toxicity: stimulant effects, sedation, nausea, constipation, BP.
Mirtazapine:
-MOA?
-toxicity?
α2 antagonist (↑ release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist.

Toxicity: sedation, ↑ appetite, weight gain, dry mouth.
Maprotiline:
-MOA?
-toxicity?
Blocks NE reuptake. Toxicity: sedation, orthostatic hypotension.
Trazodone:
-MOA?
-toxicity?
Primarily inhibit serotonin reuptake.

Toxicity: sedation, nausea, priapism, postural hypotension.
what drugs are MOAIs? (2)
Phenelzine
Tranylcypromine
MOA of MAOIs?
Nonselective MAO inhibition → ↑ levels of amine neurotransmitters
clinical use of MAOIs? (3)
-Atypical depression (i.e., with psychotic or phobic features)
-Anxiety
-Hypochondriasis
toxicity of MAOIs occur when combined with what?

C/I with what drug classes?
Hypertensive crisis with tyramine ingestion (in many foods) and meperidine; CNS stimulation.

Contraindication with SSRIs or β-agonists (to prevent serotonin syndrome).