Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/63

Click to flip

63 Cards in this Set

  • Front
  • Back
what is another name for antipsychotics
neuroleptics
name 4 antipsychotic drugs
thioridazine, haloperidol, fluphenazine, chlorpromazine
how do you keep benzos straight from antipsychotics
Benzos help 3rd year Jon Kazam be less anxious around patients: Shazam Kazam! Without antipsychotics patients talk like a crazy 'zine (well, not perfect, but I'm working on it)
what is the mechanism of most antipsychotics
block dopamine D2 receptors
what is the clinical application of antipsychotics
schizophrenia, psychosis
what are the side effects of antipsychotics
extrapyramidal side effects (EPS), sedation, endocrine, muscarinic blockade, alpha blockade, histamine blockade
what is a long-term effect of antipsychotic use
tardive dyskinesia
what is neuroleptic malignant syndrome
a side effect of antipsychotics; rigidity, autonomic instability, hyperpyrexia
how do you treat neuroleptic malignant syndrome
dantrolene, dopamine agonists
what is tardive dyskinesia
side effect of neuroleptics; stereotypic oral-facial movements, may be due to dopamine receptor sensitization
what is the "rule of 4" with EPS side effects from antipsychotic drugs
evolution of EPS side effects: 4 hours -- acite dystonia, 4 days -- akinesia, 4 weeks -- akasthesia, 4 months -- tardvie dyskinesia
is tardvie dyskinesia reversible
often irreversible
what is fluphenazine used for
schizophrenia, psychosis
name 3 atypical antipsychotics
clozapine, olanzapine, risperidone
what type of antipsychotic is clozapine
atypical
what type of antipsychotic is olanzapine
atypical
what type of antipsychotic is risperidone
atypical
what is the mechanism of atypical antipsychotics
block 5-HT2 and dopamine receptors
what is the mechanism of clozapine
block 5-HT2 and dopamine receptors
what is the mechanism of olanzapine
block 5-HT2 and dopamine receptors
what is the mechanism of risperidone
block 5-HT2 and dopamine receptors
what is the clinical application of clozapine
schizophrenia positive and negative symptoms
what is the clinical application of olanzapine
schizophrenia positive and negative symptoms, OCD, anxiety disorder, depression
what is the clinical application of risperidone
schizophrenia positive and negative symptoms
how are atypical antipsychotics different from classic ones
atypicals treat positive and negative symptoms of schizophrenia, fewer extrapyramidal and anticholinergic side effects than classic antipsychotics
which antipsychotics should be used to treat positive and negative symptoms of schizophrenia
atypical ones -- clozapine, olanzapine, risperidone
which antipsychotics should be used for fewer side effects
atypical ones -- clozapine, olanzapine, risperidone
what is a potential toxicity of clozapine
agranulocytosis
which antipsychotic drug can cause agranulocytosis
clozapine
what test must be done weekly on patients taking clozapine
WBC count because of potential agranulocytosis
0
0
what is the mechanism of action of lithium
unknown; may be related to inhibition of phosphoinositol cascade
what is the clinical application of lithium
mood stabilizer for bipolar disorder
how does lithium help people with bipolar disorder
prevents relapse and acute manic episodes
what are the side effects of lithium
tremor, hypothyroidism, polyuria, teratogenic
is it OK for women taking lithium to get pregnant
NO -- teratogenic
what does lithium cause polyuria
ADH antagonist --> nephrogenic diabetes insipidus
What do the following drugs inhibit: 1. MAO inhibitors, 2. Desipramine/maprotilline, 3. Mirtazapine and 4. Fluoxetine/trazodone?
1. MAO 2. NE reuptake 3. Alpha 2-R & 5HT2 R 4. 5HT reuptake
1. MAO inhibitors, 2. Desipramine/maprotilline, 3. Mirtazapine and 4. Fluoxetine/trazodone actions are ------synaptic
PRE
List the Tricyclic Antidepressants
Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin
What are the three C's of Tricyclic Antidepressant toxicity?
Convulsions, Coma, Cardiotoxicity (arrythmias). Also respiratory depression, hypyrexia.
How about tricyclic antidepressant toxicity in the eldery?
confusion and hallucinations due to anticholinergic SE
What is the mechanism of TCA?
block reuptake of NE and 5HT
What is the clinical uses of TCAs?
Endogenous depresion. Bed wetting - imipramine. OCD- clomipramine.
How are tertiary TCA's different than secondary in terms of side effects?
Amitriptyline (tertiary) has more anti-cholinergic effects than do secondary (nortriptyline). Desipramine is the least sedating.
what are the side effects of TCAs?
sedation, alpha blocking effects, atropine-like anti cholinergic side effects (tachycardia, urinary retention)
Fluoxetine, sertraline, paroxetine, citalopram are what class of drugs?
SSRI's for endogenous depression
How long does it take an anti-depressant to have an effect?
2-3weeks
How does the toxicity of SSRI's differ from TCA's and what are they?
Fewer than TCA's. CNS stimulation - anxiety, insomnia, tremor, anorexia, nausea, and vomiting.
What toxicity happens with SSRI's and MAO inhibitors given together?
Seratonin Syndrome! Hyperthermia, muscle rigidity, cardiovascular collapse
What are heterocyclics?
2nd and 3rd generation antidepressants with varied and mixed mechanisms of action. Used major depression.
Examples of heterocyclics?
Buproprion, Venlafaxine, Mirtazapine, Maprotiline, Trazodone BUtane in your VEINs to MURder for a MAP of alcaTRAZ
Which heterocyclic is used for smoking cessation?
Buproprion. Mechanism not known. Toxicity - stimulant effects, dry mouth, aggrevation of pyschosis
Which heterocyclic used in GAD?
Venlafaxine - inhibits 5HT and DA reuptake. Toxicity - stimulant effects
which heterocyclic blocks NE reuptake
maprotiline
Which heterocyclic increases release of NE and 5HT via alpha 2 antagonism?
mirtazapine. Also potent 5HT Rantagonist. Toxicity - sedation, increase serum cholesterol, increase appetite
What is trazodone and it' SE?
primarily inhibits seratonin reuptake. Toxicity - sedation, nausea, priapism, postural hypotension
Give 2 examples of MAO
phenelzine. Tranylcypromine
MAO Mechanism and Clinical Uses?
non selevtive MAO inhibition. Atypical antidepressant, anxiety, hypochondriasis
What is the toxicity of MAOs with tyramine ingestion (in foods) and meperidine?
Hypertensive crisis
Other MAO toxicities? (besides w/ tyramine)
CNS stimulation, contraindicated with SSRI's or B-agonists
What is the mechanims of selgiline (deprenyl)?
Selectively inhibits MAO-B, increasing DA
what is deprenyl's (selgiline) clinical use and toxicity?
adjunctive agent to L-dopa for Parkinsons. May enhance adverse effects of L-dopa