Pharmacology - Psychiatry

Front 1

Antipsychotics (neuroleptics) - typical

name them (4)

Back 1

Thioridazine
Haloperidol
Fluphenazine
Chlorpromaine

Front 2

Typical antipsychotics (THFC)
-mechanism

Back 2

Most block D2 receptors (since XS DA effects is connected with schizophrenia)

Front 3

Typical antipsychotics (THFC)
-clin use

Back 3

schizophrenia, psychosis, acute mania, Tourette syndrome

Front 4

typical antipsychotics
-toxicity

Back 4

Extrapyramidal system (dystonia, akinesia, akathis, TD)
Endocrine (gynecomastia)
Antimuscarinic (dry mouth, constp)
Alpha adren block (hypotension)
Histamine block (sedation)
*Neuroleptic malignant syndrome
*Tardive Dyskinesia

Front 5

Extrapyramidal system (EPS) side effects of Typical Antipsychotics
- EVOLUTION

Back 5

4 hours - Acute dystonia
4 days - Akinesia
4 weeks - Akathisia (motor restlessness)
4 months - Tardive dyskinesia (often irreversible)

Front 6

Neuroleptic
Malignant syndrome
- side effect of Typical Antipsychotics

Back 6

Rigidity
Myoglobinuria
Autonomic instability
HyperPYREXIA (rx: Dantrolene and DA agonist)

Front 7

Tardive Dyskinesia

Back 7

-stereotypic oral-facial movements
-probably d/t DA receptor sensitization
-results of long0term antipsychotic use

Front 8

Atypical antipsychotics
-name them (3)
-Mechanism

Back 8

Clozapine
Olanzapine
Risperidone
*block 5-HT2 and DA receptors

Front 9

Atypical antipsychotics
-clin use

-extra uses for olanzapine

Back 9

schizophrenia - useful for positive and neg sxs

Olanzapine - also used for OCD, anxiety d/o, depression, mania, Tourrette syndrome

Front 10

Atypical antipsychotics
-toxicity

-toxicity of Clozapine

Back 10

fewer EPS and anticholinergic side effects than other antipsychotics

Clozapine may case AGRANULOCYTOSIS (need weekly WBC monitoring)

Front 11

Lithium
-mechanism

Back 11

-not established
-possibly related to inhibition of PHOSPHOINOSITOL CASCADE

Front 12

Lithium
-clin use

Back 12

mood stabilizer for bipolar affective disorder
-blocks relapse and acute manic events

Front 13

Lithium
-toxicity

*narrow therapeutic level -> requires close monitoring of serum levels

Back 13

-tremor
-HYPOTHYROIDISM
-polyuria (ADH antagonis -> NEPHROGENIC DIABETES INSIPIDUS)
-teratogenesis

Front 14

Lithium Side effects Mnemonic:

LMNOP

Back 14

Lithium side effects -
Movement (tremor)
Nephrogenic diabetes insipidus)
HypOthyrodism
Pregnancy problems

Front 15

Buspirone
-mech
-clin use
-toxicity? does not...

Back 15

-stimulates 5HT-1A receptors

-anxiolysis for generalized anxiety disorder

- does not cause sedation or addiction
-dose not interact with alcohol

Front 16

SSRIs
-name them (4)

Back 16

fluoxetine
sertraline
paroxetine
citalopram

Front 17

SSRIs
-mech *time to effect

Back 17

Serotonin-specific reuptake inhibitors
*2-3 weeks for effect

Front 18

SSRIs
-clin use

Back 18

endogenous depression
OCD

Front 19

SSRIs
-tox

Back 19

GI distress
Anorgasmia
"Serotonin syndrome" with MAO inhibotors

Front 20

Serotonin syndrome
-which drug combo?
-sxs?

Back 20

-SSRIs with MAO inhibitors
-sxs: hyperthermia, muscle rigidity, CV collapse

Front 21

Tricyclic antidepressants
-name them(6)

Back 21

Imipramine
Amitriptyline
Despiramine
Nortriptyline
Clomipramine
DOXEPIN

Front 22

TCA mechanism

-clin use
-special use for imipramine? clomipramine?

Back 22

block reuptake of NE and serotonin

-major depression
-bedwetting (IMIPRAMINE)
-OCD (clomipramine)

Front 23

TCA Side effects

Back 23

-sedation
-alpha-adrenergic blocking effects
-atropine-like (anticholinergic) side effects (tachycardia, urinary retnetion)

Front 24

compare TCA side effects:
-tertiary (amitriptyline) vs. secondary (nortriptyline) TCAs
-desipramine is the ____ sedating

Back 24

-tertiary TCAs have more anticholinergic effects than do secondary TCAs

-desipramine is the LEAST sedating

Front 25

TCA Toxicity

"Tri-C's"
-other
-in elderly - use what and why?

Back 25

Convulsions
Coma
Cardiotoxicity (arrhythmias)

Also, resp depression, hyperpyrexia
*Confusion and hallucinations in elderly d/t anticholinergic side effects (USE NORTRIPTYLINE)

Front 26

Heterocyclic Antidepressants
-name them

"you need BUtane in your VEINs to MURder for a MAP of alcaTRAZ"

Back 26

BUpropion
VENlafaxine
MIRtazapine
MAProtiline
TRAZodone

Front 27

BUpropion
-clin use
-toxicity

Back 27

Heterocyclic Antidepressant
-also for SMOKING CESSATION
-mech not well known
Tox: stimulate (tachycardai, insomnia), HA, *SZ in bulemia. No sexual side effects

Front 28

Venlafaxine
-clin use
-mech
-tox

Back 28

Heterocyclic Antidepressant
-also for generalized anxiety d/o
-mech:inhibits serotonin, NE, and DA reuptake
-tox: stimulant effects, sedation, nausea, constip, increased BP

Front 29

Mirtazapine
-clin use
-mech
-tox

Back 29

Heterocyclic Antidepressant
-alpha-2 antagonis (increases release of NE and serotonin)
-potent 5-HT2 and 5-HT3 receptor antagonist
Toxicity: sedation, orthostatis hypotension

Front 30

Trazodone
-mech
-tox

Back 30

Heterocyclic Antidepressant
-primarily inhibit serotonin reuptake
-tox: sedation, nausea, priapism, postural hypotension

Front 31

Monoamine Oxidase inhibitors
-name them (2)

Back 31

Phenelzine
Tranylcypromine

Front 32

MAO-Is
-mechanism
-clin use

Back 32

-nonselective MAO-inhibition -> increase levels of amine neurotransmitters

-for ATYPICAL depression (with psychotic or phobic features)
-for ANXIETY, HYPOCHONDRIASIS

Front 33

MAO-Is
-toxicity
-contraindication

Back 33

-Hypertensive Crisis with TYRAMINE INGESTION and MEPERIDINE
-CNS stim
*contraindicated with SSRIs or beta-agonists (to prevent serotonin syndrome)