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90 Cards in this Set
- Front
- Back
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Typical Antipsychotics
(11) |
Thioridazine (Mellaril)
Chlorpromazine (Thorazine) Mesoridazine (Serentil) Molindone (Moban) Perphenazine (Trilafon) Loxapine (Loxitane, Daxolin) Trifluoperazine (Stelazine) Thiothixene (Navane) Haloperidol (Haldol) Fluphenazine (Prolixin) Pimozide (Orap) |
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Which antipsychotics act to block the D2 receptors?
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Typical antipsychotics
Risperidone (Risperdal) |
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Thioridazine
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(Mellaril)
typical antipsychotic high anticholinergic and only used for refractory schizophrenia |
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Chlorpromazine
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(Thorazine)
typical antipsychotic |
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Mesoridazine
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(Serentil)
Typical antipsychotic only used for refractory schizophrenia |
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Molindone
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(Moban)
Typical Antipsychotic |
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Perphenazine
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(Trilafon)
typical AP |
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Loxapine
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(Loxitane, Daxolin)
typical AP |
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Trifluoperazine
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(Stelazine)
typical AP |
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Thiothixene
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(Navane)
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Haloperidol
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(Haldol)
Typical AP |
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Fluphenazine
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(Prolixin)
Typical AP |
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Pimozide
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(Orap)
Typical AP |
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When is a n antipsychotic considered atypical?
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when they produce fewer side effects
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That is the mechanism of atypicals?
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-block dopamine and serotonin (5-HT) receptors
-by blocking the serotonin receptors you can have some protection against extrapyramidal SE's. |
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Aripiprazole
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(Abilify)
Atypical |
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Clozapine
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(Clozaril)
atypical |
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Risperidone
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(Risperdal)
atypical |
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Olanzapine
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(Zyprexa)
atypical |
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Paliperidone
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(Invega)
atypical |
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Quetiapine
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(Seroquel)
atypical |
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Ziprasidone
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(Geodon)
atypical |
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Which atypical has less serotonin and more D2 receptor blocker?
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risperidone (Risperdal)
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Which drug is the only medication that is superior in patients for whom other antipsychotics have failed?
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Clozapine
-agranulocytosis (has to be regulated) -non specific electrocardiographic changes -myocarditis -obesity and diabetes |
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first line choice for acute psychosis?
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oral preps of atypicals
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antipsychotic choice for manic phase of BP?
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aripiprazole, chlorpromazine, olanzapine, quetiapine, riperidone, ziprasidone
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SE of typicals?
SE of atypicals? |
-movement disorders
-sedation or metabolic |
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common SE of both typical and atypicals that should be monitored?
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seizures, they lower the threshold
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SE of the low potency typical antipsychotics?
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anticholinergic SE
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Which antipsychotics cause hypotension?
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low potency typicals and risperidone by blocking the alpha receptor
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Which antipsychotic causes pigmentary reinopathy?
causes cataracts? |
thioridazine (Mellaril)
quetiapine (Seroquel) |
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Fluoxetine
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(Prozac)
SSRI |
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Sertraline
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(Zoloft)
SSRI |
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Paroxetine
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(Paxil)
SSRI |
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Fluvoxamine
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(Luvox)
SSRI |
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Citalopram
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(Celexa)
SSRI |
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Escitalopram
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(Lexapro)
SSRI |
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Venlafaxine
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(Effexor)
SNRI |
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Duloxetine
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(Cymbalta)
SNRI |
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Trazodone
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(Desyrel)
serotonin receptor agonist and antagonist |
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Nefazodone
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serotonin receptor agonist and antagonist
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Bupropion
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(Wellbutrin or Zyban)
NDRI |
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Nortriptyline
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(Pamelor)
TCAD |
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Imipramine
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(Tofranil)
TCAD |
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Despiramine
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(Norpramin)
TCAD |
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Clomipramine
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(Anafranil)
TCAD |
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Selegiline
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(EMSAM patch)
MAOI |
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Tranylcypromine
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(Parnate)
MAOI |
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Phenelzine
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(Nardil)
MAOI |
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Isocarboxazid
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(Marplan)
MAOI |
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Mirtazapine
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(Remeron)
-modulator of NE and S -quite sedating but low incidence of sexual dysfunction |
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Indications for antidepressants?
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depressed phase of bipolar
psychotic depression atypical depression seasonal depression seasonal depression panic disorder (or benzo's) OCD binging and purging |
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How do MAOI's work?
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inhibit monoamine oxidase; this normally breaks down NE, D, and S
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How do TCA's work?
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block S and NE reuptake
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3 SE of TCA's and MAOI's?
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sedation
anticholinergic orthostatic hypotension |
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Rx of choice for OCD?
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high dose SSRI's or clomipramine
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general SE of all SSRI's?
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-nausea, headhache
-neuromuscular reslessness -insomnia -sexual dysfunction -fatal serotonin syndrome w/ MAOI's |
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SE of TCA's?
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orthostatic hypotension
anticholinergic effects cardiac toxicity (quinidine like effect) sexual dysfunction |
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SE of MAOI's
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-hyperadrenergic crisis from sympathomimetic amines (tyramine) that in ibit GI MOA.
-found in cured meats, fish, beer, cheese, red win, ripe fruit |
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Trazodone is also used for.....
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-adjunct to an SSRI for sleep at low doses
-on rare occasions can cause priapism |
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indications for mood stabalizers?
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-with antipsychotics acutely for mania
-prophalaxis against mania in BP -anticonvulsant -impulse behaviors seen in BP |
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Lithium
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-mood stabalizer
-thought to modify two intracellular second messanger systems: (1) adenyl cyclase and (2) GPC phosphoinositide -and as an ion alter ion channels -NE and S use GPCR's -lithium also alters GAMA metabolism |
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first line Rx for cycling bipolar disorder?
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lithium
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Which drug has been shown to reduce the incidence of completed suicide?
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Lithium
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What do you have to worry about when taking Lithium?
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-it can easily reach toxic levels with impaired renal function
-it also causes hypothyroidism in 5% |
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Valproate
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mood stabalizer
increases GABA synthesis, decreases GABA breakdown, and enhances its postsynaptic activity |
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indications for Valporate?
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-acute mania
-maintenance phase of bipolar I -rapid cycling and mixed variants BP -off label impulse control -seizure disorder -is NOT used as prophylaxis against depression or augment depression |
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Depakoe loading
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valporate can be initiated with a larger that usual dose for the acute manic episode
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Serious SE of valporate?
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-fatal hepatotoxicity
-fulminant pancreatitis -agranulocytosis |
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Lamotrigine
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mood stabilizer
-unkonwn mech, maybe stabalizes neuronal membranes -used in maintenance and depressed phases of bipolar I disorder |
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What happens if you increase Lamotrigine dosing too fast?
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increased risk of SJS
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Carbamazepine
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mood stabilizer
-unknown mech, maybe block Na channels after the action potential |
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Carbamazepine indications and SE?
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-acute mania, prophylaxis for mania in BP, rapid cycling and mixed mania, impulse
-AV block, agranulocytosis, pancytopenia, aplastic anemia |
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Benzodiazepine indications
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panic diorder
GAD anxiety associated with stress anxiety that complicates depression insomnia alochol withdrawal catatonia |
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MOA of benzo's?
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-augment of GABA function in the limbic system, virtually instantaneous
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theory of anxiety
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decreased number of GABA receptors
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Alprazolam
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(Xanax)
Benzo |
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Chlordiazepoxide
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(Librium)
Benzo |
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Clonazepam
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(Klonopin)
Benzo |
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Diazepam
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(Valium)
Benzo |
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Flurazepam
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(Dalmane)
Benzo |
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Lorazepam
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(Ativan)
Benzo |
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Oxazepam
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(Serax)
Benzo |
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Temazepam
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(Restoril)
Benzo |
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Triazolam
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(Halcion)
Benzo |
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Which benzo's are used for the tx of panic disorder?
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high potency benzo's
alprazolam and clonazepam |
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Which benzo's might you use in liver damage?
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lorazepam, oxazepam, temazepam
(require conjugation, not oxidation) |
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Buspirone
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(Buspar)
Anxiolytic |
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Mech of Buspirone?
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-agonist at the 5HT receptor and it has some D2 antagonist effects, but takes a long time to work (weeks).
-No GABA affinity, not sedative, no withdrawal. -only used for GAD |
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SE of Benzo's?
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-cognitive impairment
-respiratory depression |
