Psychiatry Pharmacology For Step 1

Front 1

methyphenidate (ritalin)

Back 1

- increase presynaptic NE release
- used for ADHD

Front 2

antipsychotics
haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine

haloperidol + "-azines"

Back 2

- block dopamine D2 receptors
- used for schizophrenia, psychosis, acute mania, Tourette's

HIGH potency (these bitches cause neuro side effects): haloperidol, trifluoperazine, fluphenazine

LOW potency (non neuro effects): thioridazine, chlorpromazine

toxicity: extrapyramidal system side effects, hyperprolactinemia, muscarinic block effects (dry mouth, constipation), alpha block effects (hypotension), block histamine receptors (sedation)
neuroleptic malignant syndrome- rigidity, myoglobinuria,fever, vitals unstable, encephalopathy, elevated enzymes(tx: dantrolene)
TARDIVE DYSKINESIA- oral facial movements due to long term antipsychotic use.

Front 3

atypical antipsychotics (CORZAQ)
clozapine
olanzapine
risperidione
ziprasidone
apriprazole
quetiapine

Back 3

- block serotonin, alpha, H1, and dopamine receptors
- used for schizophrenia. olanzapine also used for OCD, anxiety disorder, depression, mania, tourette's
tox: clozapine may cause agranulocytosis

Front 4

lithium

Back 4

- possibly inhibits phosphoinositol cascade
used for- mood stabilizer for bipolar disorder, SIADH
- tox: tremor, HYPOTHYROIDISM, polyuria (ADH antag)

Front 5

buspirone

Back 5

-stimulates serotonin receptors
- used for generalized anxiety disorder
- does not cause sedation or interact with alcoohol

Front 6

tricyclic antidepressants
imipramine, *amitriptyline*, desipiramine, nortriptyline, clomipramine, doxepin, amoxapine

Back 6

- block reuptake of NE and serotonin
- used for major depression, bedwetting (imipramine- also decreases stage 4 sleep), OCD (clomipramine), fibromyalgia
- side effects: alpha blocking effects, ATROPINE LIKE ANTICHOLINERGIC SIDE EFFECTS (tachycardia, urinary retention)
desipramine is the LEAST sedating
amitryptaline has more anticholinergic effects than nortriptyline

toxicity: convulsions, coma, cardiotox, resp depression, fever.

Teat tox: NaHCO3 for CV tox

Front 7

SSRIs
fluoxetine, paroxetine, sertraline, citalopram

Back 7

- serotonin reuptake inhibitors
- used for depression & OCD
- tox: GI distress, sexual dysfunction (no orgasm!), "serotonin syndrome" (hyperthermia, muscle rigidity, diarrhea, cardio collapse, flushing)

Front 8

bupropion (Wellbutrin)

Back 8

- increase NE/ dopamine
- used to quit smoking
tox: stimulant effects. headache, THIS SHIT CAUSES SEIZURES IN BULIMICS so don't give it to those bitches

Front 9

venlafaxine

Back 9

- inhibits NE/5HT reuptake
-used for generalized anxiety disorder
tox: increase BP, sedation , nausea

Front 10

duloxetine

Back 10

- inhibits NE/5HT reuptake (more on NE)
- anxiety/ DIABETIC PERIPHERAL NEUROPATHY
tox: same as venlafaxine (increase BP, sedation, nausea)

Front 11

mirtazapine

Back 11

- alpha 2 ANTAGonist (increase release of NE/5HT), potent 5HT2, 3 receptor antagonist
- antidepressant
tox: sedation, increase appetite, weight gain, dry mouth

Front 12

maprotiline

Back 12

- blocks NE uptake
- antidepressant
- tox: sedation, orthostatic hypoTN

Front 13

trazodone

Back 13

- inhibit serotonin reuptake
- antidepressant, insomnia
sedation, nausea, priapism, postural hypotension

Front 14

MAOIs
phenelzine, tranylcypromine, selegeline, isocarboxazid

Back 14

- MAO inhibition
- used for atypical depression, anxiety, hypochondriasis
tox: *** HTN crisis with tyramine ingestine (cheese) as well as beta agonists. contraindication with SSRIs or meperidine

Front 15

what do you use to treat neuroleptic syndrome (rigidity, myoglobinuria, autonomic instability, hyperpyreixa)?

this can happen after someone is given an antipsychotic

Back 15

dantrolene**

could also use a DA agonist

Front 16

You have a patient with bipolar disorder and you are treating her with the drug of choice for this condition. What lab values should you periodically check in her blood?

Back 16

the drug: lithium

lithium can cause HYPOTHYROIDISM so periodically check TSH levels (which would be elevated).
The question could be asked in a different context in which the patient comes in with signs of hypothyroid and they wanna know what med she is on.