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39 Cards in this Set

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4 Typical antipsychotics (neuroleptics)
Thioridazine
Haloperidol
Fluphenazine
Chlorpromazine
Mechanism of typical antipsychotics
Block D2 receptors
4 Clinical uses of typical antipsychotics
1. Schizophrenia
2. Psychosis
3. Acute mania
4. Tourette Syndrome
3 categories of side effects of typical antipsychotics.
1. Extrapyramidal system/endocrine (hyperprolactinemia, dry mouth, constipation, hypotension, sedation.
2. Neuroleptic malignant syndrome (rigidity, myoglobinuria, autonomic instability, hyperpyrexia.
3. Tardive dyskinesia (stereotypic oral-facial movements; assoc c long-term use)
3 atypical antipsychotics
1. Clozapine
2. Olanzapine
3. Risperidone
(It's not atypical for OLd CLOsets to RISPER
Mechanism of atypical antipsychotics
Block 5-HT2 and DA receptors.
Clinical use of atypical antipsychotics.
+/- symptoms of schizophrenia.
Olanzapine also used for OCD, anxiety, depression, mania, Tourette's.
Advantage of atypical antipsychotics over typical.
Fewer extrapyrimidal and anti-cholinergic side effects.
Toxicity associated with Clozapine.
Agranulocytosis.
Side effects of Lithium
(LMNOP)
Movement (tremor)
Nephrogenic DI (ADH antagonist)
HypOthyroidism
Pregnancy problems.
Clinical use of Buspirone
Anxiolysis. Does not cause sedation or addiction, nor does it interact with alcohol.
Mechanism of buspirone.
Stimulates 5-HT1A receptors.
4 classes of antidepressants.
1. SSRIs
2. Tricyclic
3. Heterocyclic
4. MAOIs
4 SSRIs.
1. Fluoxetine
2. Sertraline
3. Paroxetine
4. Citalopram
Clinical use of SSRIs.
Depression, OCD.
Side effects of SSRIs.
GI distress, anorgasmia.
What is Serotonin syndrome?
If SSRIs administered with MAOIs, hyperthermia, muscle rigidity, cardiovascular collapse.
6 Tricylic antidepressants.
1. Imipramine
2. Desipramine
3. Clomipramine.
4. Amitriptyline
5. Nortriptyline
6. Doxepin
Mechanism of antidepressants.
Block reuptake of NE and serotonin.
Tricylic used for bedwetting.
Imipramine
"I'm about to wet the bed"
Trycyclic used for OCD.
Clomipramine.
3 Side effects of tricyclics.
1. Sedation
2. alpha-blocking effects
3. Anticholinergic side effects (tachycardia, urinary retention)
Which tricyclics have more anticholinergic side effects?
Tertiary (amitripyline) > Secondary (nortriptyline)
Which TCA is the least sedating?
Despiramine
Toxicity of TCAs/
Tri-C's:
1. Convulsions
2. Coma
3. Cardiotoxicity
Also respiratory depression and hyperpyrexia.
In elderly, confusion/hallucinations d/t anticholinergic side effects.
Which TCA is best to use in the elderly?
Nortripyline. Less anticholinerigc side effects.
5 Heterocylic antidepressants.
1. Buproprion
2. Venlafaxine
3. Mirtazapine
4. Maprotiline
5. Trazodone
(You need BUtane in your VEINs to MURder for a MAP of alcaTRAZ.)
Toxicity of bupropion.
Tachycardia, insomnia, headache, seizure in bulemic pts.No sexual side effects.
Mechanism and uses of Venlafaxine.
Also toxicities.
GAD, depression.
Inhibits 5-HT, NE, DA reuptake.
Stimulant effects, sedation, nausea, constipation, increased BP.
Mechanism of Mirtazapine.
alpha2 antagonist (increases NE and serotonin release) + potent 5-HT2 and 5-HT3 antagonist.
4 Toxicities of Mirtazapine.
1. sedation
2. increased appetite.
3. weight gain.
4. dry mouth.
Mechanism of Maprotiline.
Blocks NE reuptake.
2 toxicities of Maprotiline.
1. Sedation
2. Orthostatic hypotension.
Mechanism of Trazodone.
Inhibits 5-HT reuptake.
4 toxicities of Trazodone.
1.sedation
2. nausea
3. priapism
4. postural hypotension
Name 2 MAOIs.
1. Phenelzine.
2. Tranylcypromine.
Clinical use of MAOIs.
Atypical depression (with psychotic or phobic features), anxiety, hypochondriasis.
Toxicity of MAOIs.
Hypertensive crisis with tyramine ingestion and meperidine.
CNS stimulation.
Contraindications of MAOIs.
Don't admin with SSRIs or beta-agonists (to prevent serotonin syndrome).