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29 Cards in this Set
- Front
- Back
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What neuroleptics are high potency?
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Haloperidol, Trifluoperazine, Fluphenazine
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What neuroleptics are low potency?
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Thiorixazine, Chlorpromazine
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What are the side effects of high potency neuroleptics?
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EPS: Neuroleptic malignant syndrome (fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles- FEVER; treat with dantrolene or bromocriptine), Tardive dyskinesia (stereotyped oral-facial movements seen with prolonged use), QT prolongation (torsades)
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What are the side effects of low potency neuroleptics?
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Anticholinergic, alpha blockade, antihistamine
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What is the evolution of EPS side effects?
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4 hours- Acute dystonia (muscle stiffness, spasm, oculogyric crisis)
4 days- Akinesia (PD-like) 4 weeks- Akathisia 4 months- tardive dyskinesia |
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What are the atypical antipsychotics?
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Olanzapine, Clozapine, Quetiapine, risperidone, aripiprazole, ziprasidone
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What are atypical antipsychotics used for?
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Schizophrenia (pos and NEG). Depression, mainia, OCD, anxiety disorder (olanzapine)
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What antipsychotic is used for psychosis seen in PD?
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Quetiapine
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How is lithium excreted?
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Kidneys- reabsorbed in the PCT following Na reabsorption
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What are the side effects of lithium?
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LMNOP: Long PR (heart block), Movement (tremor), Nephrogenic DI, hypOthyroidism, Pregnancy problems (Ebstein abnormality).
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Buspirone
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Mechanism- Stimulates 5-HT1a receptors
Use- GAD. Does not cause sedation, addiction, or tolerance and does not interact with EtOH. |
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How do TCAs work?
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Block reuptake of NE and 5-HT
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What are the uses of TCAs?
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Major depression
Bedwetting (imipramine) OCD (clomipramine) Fibromyalgia |
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What are the side effects of TCAs?
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Sedation (H1), orthostatic hypotension and dizziness (alpha 1), tachycardia and urinary retention (anticholinergic)
Tertiary (amitryptyline) have more anticholinergic side effects than secondary (nortriptyline). |
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Which TCA is the least sedating and has a lower seizure threshold?
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Desipramine (tertiary)
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What are the symptoms of TCA toxicity?
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TriCs: Convulsions, Coma, Cardiotoxicity (increases QRS; arrhythmias)
Also respiratory depression and hyperpyrexia. |
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What TCA should be used in the elderly?
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Nortriptyline (secondary and less anticholinergic effects)
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What are the SSRIs?
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Fluoxetine, paroxetine, sertraline, citalopram
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What is the treatment for serotonin syndrome?
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Cyproheptadine (5-HT2 receptor antagonist), cooling, and benzos
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What are the TCAs?
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Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin
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Which antidepressant is indicated for diabetic neuropathy?
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Duloxetine (SNRI- greater effect on NE)
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What are the MAOIs?
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Phenelzine
Tranylcypromine Isocarboxazid Selegiline |
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What are MAOIs used for?
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Atypical depression, anxiety, hypochondriasis
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What are the contraindications of MAOIs?
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Tyramine (stimulates NE release in the gut- causes hypertensive crisis), beta-agonists, SSRIs, meperidine
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Mirtazepine
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Mechanism- Alpha2 antagonist, potent 5-HT2 and 5-HT3 receptor antagonist.
Toxicity: sedation, INCREASED appetite, weight gain, dry mouth |
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Maprotiline
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Mechanism- Blocks NE reuptake
Toxicity- Sedation, orthostatic hypotension |
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Trazodone
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Mechanism- Blocks serotonin reuptake
Use- Insomnia (need to high of a dose for antidepressant effects) Toxicity- Sedation, nausea, priaprism, postural hypotension |
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Which antipsychotic causes corneal deposits?
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Chlorpromazine
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Which antipsychotic causes retinal deposits that look like retinitis pigmentosa?
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Thioridazine
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