Psych Drugs

Front 1

Cause and symptoms of serotonin syndrome

Back 1

Caused by combination of SSRI and MAOIs

Early: Lethargy, restlessness, confusion, flushing, diaphoresis, tremor, myoclonic jerks

Late: hyperthermia, hypertonicity, rhabdomyolysis, renal failure, convulsions, coma, death

Front 2

Cause of a hypertensive crisis

Back 2

MAOIs taken with tyramine-rich foods (Chianti, cheese, chicken liver, fava beans, cured meats) or sympathomimetics; buildup of catecholamines

Front 3

Venlafaxine
-Trade name
-MOA
-Use
-SE

Back 3

Effexor
Serotonin/norepi reuptake inhibitor
Refractory depression
Same as SSRIs, increase BP (don't use in untreated BP problems), withdrawl with missed doses (zaps, flu sx)

Front 4

Names of TCAs and specific indications/S

Back 4

Imipramine - Tofranil
Amitriptyline - Elavil
Trimipramine - Surmontil
Nortriptyline - Pamelor (least orthostatic hypotension)
Desipramine - Norpramin (least sedating, least anticholinergic SE)
Clomipramine - Anafranil (most 5-HT specific, use in OCD)
Doxepin - Sinequan

Front 5

Side effects of TCAs

Back 5

Anti-HAM:
Anti-histamine (sedation)
Anti-adrenergic (orthostatic hypotension, tachy, arrhythmias, QRS>100ms)
Anit-muscarinic
Weight gain, lethal overdose

Front 6

Names of MAOIs (3)

Back 6

Phenelzine - Nardil
Tranylcypromine - Parnate
Isocarboxazid - Marplan

Front 7

MAOI mechanism of action

Back 7

Prevent inactivation of norepi, 5-HA, dopamine, tyramine (A=5-HT, B=norepi/epi)

Front 8

Bupropion
-Trade name
-MOA
-Use
-SE
-CI

Back 8

Wellbutrin
Norepi/dopamine reuptake inhibitor
Smoking cessation, seasonal affective disorder, adult ADHD
SE similar to SSRI (less sexual SE), exacerbate psychosis and seizures

Not for psychosis, anxiety, seizure disorder, eatin disorders, not with MAOIs

Front 9

Indications of MAOIs

Back 9

Refractory depression

Front 10

Side effects of MAOIs

Back 10

Orthostatic hypotension, drowsiness, weight gain, sexual dysfunction, dry mouth, sleep dysfunction
Serotonin syndrome w/ SSRI, hypertensive crisis w/ tyramine

Front 11

SSRI Names and specific indications/SE

Back 11

Fluoxetine - Prozac (longest half life, no need to taper)
Sertraline - Zoloft (GI disturb)
Paroxetine - Paxil (most 5-HT specific, most activating)
Fluvoxamine - Luvox (only for OCD)
Citalopram - Celexa
Escitalopram - Lexapro (fewer SE)

Front 12

SSRI Mechanism of action

Back 12

Inhibit presynaptic 5-HT pumps

Front 13

SSRI indications

Back 13

Most common antidepressants, OCD, anxiety, premenstrual dysphoric disorder

Front 14

Side effects of SSRIs

Back 14

Sexual dysfunction, GI disturbance, insomnia, headache, anorexia, serotonin syndrome

Front 15

Nefazodone/Trazodone
-Trade name
-MOA
-Use
-SE

Back 15

Serzone, Desyrel
Serotonin antagonist and reuptake inhibitor
Refractory depression, depression with anxiety, insomnia
Nausea, dizziness, orthostatic hypotension, cardiac arrhythmias, sedation, priapism

Front 16

Mirtazapine
-Trade name
-MOA
-Use
-SE

Back 16

Remeron
Norepi/5-HT antagonist
Refractory depression, weight gain
Sedation (at low doses), weight gain, dizziness, somnolence, tremor, agranulocytosis

Front 17

What percent of patients with MDD will respond to medication?

Back 17

70%

Front 18

Which antidepressants are used for OCD?

Back 18

SSRI, TCA

Front 19

Which antidepressants are used for panic disorder?

Back 19

SSRIs, TCAs, MAOIs

Front 20

Which antidepressants are used for eating disorders?

Back 20

SSRIs, TCAs, MAOIs

Front 21

Which antidepressants are used for dysthymia?

Back 21

SSRIs

Front 22

Which antidepressants are used for social phobias?

Back 22

MAOIs, SSRIs

Front 23

Which antidepressants are used for PTSD?

Back 23

SSRIs, TCAs

Front 24

Which antidepressants are used for IBS?

Back 24

SSRIs, TCAs

Front 25

Which antidepressants are used for enuresis?

Back 25

TCAs

Front 26

Which antidepressants are used for neuropathic pain?

Back 26

TCAs

Front 27

Which antidepressants are used for migraines?

Back 27

TCAs, SSRIs, bupropion

Front 28

Which antidepressants are used for smoking cessation?

Back 28

Bupropion

Front 29

Which antidepressants are used for Autism?

Back 29

SSRIs

Front 30

Which antidepressants are used for premenstrual dysphoric disorder?

Back 30

SSRIs

Front 31

Which antidepressants are used for depression in bipolar disorder?

Back 31

SSRIs, bupropion

Front 32

Which antidepressants are used for insomnia?

Back 32

Mirtazapine, TCAs

Front 33

Which TCA is least likely to cause orthostatic hypotension?

Back 33

Nortriptyline (Pamelor)

Front 34

Which TCA is least sedating?

Back 34

Desipramine (Norpramin)

Front 35

Which TCA has the least anticholinergic side effects?

Back 35

Desipramine (Norpramin)

Front 36

Which TCA is most serotonin specific?

Back 36

Clomipramine (Anafranil)

Front 37

Which TCA is useful for OCD?

Back 37

Clomipramine (Anafranil)

Front 38

How is TCA overdose treated?

Back 38

IV sodium bicarbonate

Front 39

What receptors do TCAs act on?

Back 39

Inhibit uptake of: Norepi, Serotonin

Block: histamine, adrenergic and muscarinic

Front 40

What are symptoms of blocking histamine receptors?

Back 40

Sedation

Front 41

What are symptoms of blocking adrenergic receptors?

Back 41

orthostatic hypotension, tachycardia, arrhythmias

Front 42

What are symptoms of blocking muscarinic receptors?

Back 42

dry mouth, constipation, urinary retention, blurred vision, tachycardia

Front 43

What receptors do MAOIs act on?

Back 43

norepi (MAO-B), serotonin (MAO-A), dopamine, tyramine

Front 44

Which SSRI causes the most GI symptoms?

Back 44

Sertraline (Zoloft)

Front 45

Which SSRI is the most serotonin specific?

Back 45

Paroxetine (Paxil)

Front 46

Which SSRI is the most activating?

Back 46

Paroxetine (Paxil)

Front 47

Which SSRI is only approved for OCD?

Back 47

Fluvoxamine (Luvox)