Pharma- Psych

Front 1

Rx for anorexia/ bulimia

Back 1

SSRIs

Front 2

Rx for anxiety (4)

Back 2

Benzos
Buspirone
SSRIs
Venlafazine (SNRI)

Front 3

Rx for ADHD (2)

Back 3

Amphetamines
Methylphenidate (Ritalin)

Front 4

Rx for atypical depression (2)

Back 4

MAOIs
SSRIs

Front 5

Rx for depression with insomnia

Back 5

Mirtazapine

Front 6

Rx for OCD (2)

Back 6

SSRIs
Comipramine

Front 7

Rx for panic disorder (3)

Back 7

SSRIs
TCAs
Benzos

Front 8

Rx for Tourette's syndrome

Back 8

Antipsychotics (haloperidol)

Front 9

Rx for social phobias

Back 9

SSRIs

Front 10

5 antipsychotics (typical)

Back 10

Haloperidol + azines (trifluoperazine, fluphenazine, thioridazine, chlorpromazine)

Front 11

Mechanism of typical antipsychotics

Back 11

Block dopamine D2 receptors, increasing cAMP

Front 12

4 clinical uses of antipsychotics (neuroleptics)

Back 12

Schizophrenia (primarily positive symptoms, as they may exacerbate negative symptoms)
Psychosis
Acute mania
Tourette's syndrome

Front 13

Which antipsychotics are high potency, and which are low potency?

Back 13

High: haloperidol, trifluoperazine, fluphenazine

Low: thioridazine, chlorpromazine

Front 14

High potency antipsychotics have ___ side effects, while low potency antipsychotics have _____

Back 14

Neurologic side effects (extrapyramidal symptoms)

Non-neurologic (anticholinergic, antihistamien, and alpha blockade)

Front 15

Evolution of extrapyramidal side effects

Back 15

Dystonia (spasm, stiffness)--> akinesia (parkinsonism)--> akathisia (restlessness)-->
tardive dyskinesia
(4 hrs, days, weeks, months)

Front 16

Treat EPS with?

Back 16

Bentropine or trihexyphenidyl
(other drugs for Parkinsonism can exacerbate psychosis)

Front 17

What is tardive dyskinesia?

Back 17

Sterotypic oral-facial movements
Often irreversible

Front 18

Endocrine side effects of antipsychotics

Back 18

Dopamine receptor antagonist --> hyperprolactinemia --> galactorrhea (worst with risperidone, an atypical antipsychotic)

Front 19

Side effects of antipsychotics from block muscarinic, alpha, and histamine receptors

Back 19

Dry mouth/ constipation
Hypotension
Sedation

Front 20

Clinical sequelae of neuroleptic malignant syndrome (NMS)

Back 20

FEVER

Fever
Encephalopathy
Vitals unstable (autonomic instability)
Elevated enzymes
Rigidity of muscles (and myoglobinuria)

Front 21

Treatment of neuroleptic malignant syndrome

Back 21

Dantrolene
Agonists (e.g. bromocriptine)

Front 22

6 atypical antipsychotics

Back 22

Olanzapine
Clozapine
Quetiapine
Risperidone
Aripiprazole
Ziprasidone

Front 23

Atypical antipsychotics block these 4 receptor types

Back 23

5-HT2
Dopamine
Alpha
H1

Front 24

Drug of choice for both positive and negative symptoms of schizophrenia?

Back 24

Atypical antipsychotics (better side effect profile)

Front 25

Olanzapine used for (besides schizophrenia) (5)

Back 25

OCD
Anxiety
Depression
Mania
Tourette's

Front 26

Two atypical antipsychotics that may cause significant weight gain

Back 26

Olanzapine
Clozapine

Front 27

Clozapine has these 2 serious side effects

Back 27

Agranulocytosis (monitor WBC weekly)
Seizures

Front 28

Best treatment for bipolar disorder

Back 28

Mood stabilizers (lithium, and antiepileptics, e.g. valproic acid, carbamazepine, and lamotrigine)

Front 29

Other than bipolar, lithium is also used to treat

Back 29

SIADH

Front 30

Side effects of Lithium

Back 30

LMNOP

Movement (tremor)
Nephrogenic diabetes insipidus (polyuria and polydipsia, b/c is an ADH antagonist)
hypOthyroidism
Pregnancy problems (causes Ebstein anomaly and malformation of great vessels)

Also sedation, edema, and heart block

Front 31

Buspirone is used for

Back 31

Generalized anxiety disorder

Front 32

Buspirone stimulates ____ receptors

Back 32

5-HT-1A

Front 33

Advantage of buspirone over barbiturates/ benzos

Back 33

Doesn't interact w/ alcohol
No sedation/ addiction/ tolerance

Front 34

Buspirone is also used for

Back 34

Smoking cessation

Front 35

7 tricyclic antidepressants (TCAs)

Back 35

Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin, amoxapine

Front 36

Mechanism of TCAs

Back 36

Block reuptake of NE and serotonin

Front 37

3 uses of all TCAs

Back 37

Major depression
Fibromyalgia
Diabetic neuropathy

Front 38

Additional clinical use of imipramine

Back 38

Bedwetting

Front 39

Additional clinical use of clomipramine

Back 39

OCD

Front 40

3 main side effects

Back 40

Sedation (from histamine blockade)
Orthostatic hypotension (from alpha blockade)
Anticholinergic (tachycardia, urinary retention)

Front 41

More anticholinergic effects with ____ TCAs than ____

Back 41

3rd generation (amitriptyline) than 2nd generation (nortriptyline)

Front 42

Least sedating and lowest seizure threshold of the TCAs?

Back 42

Desipramine

Front 43

5 main toxicities of TCAs

Back 43

Convulsions
Coma
Cardiotoxicity (arrhythmias)
Respiratory depression
Hyperpyrexia

Front 44

Toxicity of TCAs in elderly

Back 44

Confusion and hallucinations from anticholinergic side effects (so use 2nd generation, like nortriptyline, which has fewer anticholinergic side effects)

Front 45

Treatment of CV toxicity for TCAs?

Back 45

NaHCO3

Front 46

4 SSRIs

Back 46

Fluoxetine
Paroxetine
Sertraline
Citalopram

Front 47

4 uses of SSRIs

Back 47

Depression
OCD
Bulimia
Social phobias

Front 48

3 toxicities of SSRIs

Back 48

GI distress
Sexual dysfunction (anorgasmia)
Serotonin syndrome

Front 49

Symptoms of serotonin syndrome

Back 49

Hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures

Front 50

Rx for serotonin syndrome

Back 50

Cyproheptadine (5-HT2 receptor antagonist)

Front 51

2 SNRIs

Back 51

Venlafaxine
Duloxetine

Front 52

Other than depression, venlafaxine is indicated for ? and duloxetine is indicated for?

Back 52

Generalized anxiety disorder

Diabetic peripheral neuropathy

Front 53

Most common toxicity of SNRIs

Back 53

HTN (monitor)

Front 54

Other toxicities of SNRIs

Back 54

Stimulant effects, sedation, nausea

Front 55

4 MAOIs

Back 55

Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline (selective for MAO-B)

Front 56

Mechanism of MAO inhibitors

Back 56

Increase levels of amine neurotransmitters (NE, serotonin, dopamin)

Front 57

3 uses of MAOIs

Back 57

Atypical depression
Anxiety
Hypochondriasis

Front 58

MAOIs can cause a _____ crisis

Back 58

Hypertensive (with ingestion of tyramine, e.g. from wine and cheese, or with beta agonists)

Front 59

MAOIs are contraindicated with

Back 59

SSRIs or meperidine (to prevent serotonin syndrome)

Front 60

4 atypical depressants

Back 60

Bupropion, mirtazapine, maprotiline, and trazodone

Front 61

Bupropion is a ?

Back 61

NDRI (increases NE and dopamine)

Front 62

Bupropion is also used for

Back 62

Smoking cessation

Front 63

Side effects of bupropion (3)

Back 63

Stimulant effects (tachycardia, insomnia)
Headache
Seizure (in bulimic pts)

Front 64

Advantage of the side effect profiles of bupropion and mirtazapine?

Back 64

No sexual side effects

Front 65

2 mechanisms of mirtazapine

Back 65

Alpha-2 antagonist (increasing release of NE and serotonin)
5HT2 and 3 receptor antagonist

Front 66

Toxicity of mirtazapine

Back 66

Sedation, increased appetite, weight gain

Front 67

Mechanism of maprotiline

Back 67

Blocks NE reuptake

Front 68

Toxicity of maprotiline (2)

Back 68

Sedation
Orthostatic hypotension

Front 69

Trazodone: mechanism and use

Back 69

Primarily inhibits serotonin reuptake

Used for insomnia (high doses needed for antidepressant effects)

Front 70

4 toxicities of trazodone

Back 70

Priapism (painful prolonged erection)
Postural hypotension
Sedation
Nausea