Step 1: Psych I Drugs

Front 1

Name some typical antipsychotics.
- what are the two sub-types?
+ special side effects of each of the two drugs in one of the above mentioned types?
- mech?
- two special toxicities (one acute, one long-term)
- general class toxicities?

Back 1

Haloperidol + "-azines."
- (high potency) & (low potency); the low potency have less EPS/neuro SE and more endocrine/muscarinic SE.
+ Chlorpromazine (Corneal deposits), and Thioridazine (retinal deposits) [both low potency]
- inhibit D2 receptors. Also inhibit M, a, and H receptors.
- (1) NMS: fever, rigidity, vitals unstable, elevated enzmes, encephalopaty
+ dantrolene (muscle relaxant) or D2 agonists (bromocriptine)
(2)Tardive Dyskinesia: sterotypic oral-facial movements due to long-term antipsychotic use. Often irreversible.
- v. slow to be removed from body b/c lipid soluble, EPS (parkinsonia, restlessness, tardive), Endocrine effects (hyperprolactinemia), dry mouth and constipation (m-block), hypotension (a-block), and sedation (H block).

Front 2

atypical antipsychotic mnemonic?
- classic examples?
- mechanism?
- SE?

Back 2

It's atypical for old clozets to quietly risper from A to Z.
- olanzapine, clozapine [quetiapine, risperidone, aripiprazole, ziprasidone]
- block 5-HT2, a, H1, and Dopamine receptors.
- less EPS and anticholinergic SE than typical antipsychotics. Still have endocrine side effects, and still stay in the body for awhile.

Front 3

Clozapine specific side effect?

SE clozapine and olanzapine share?

Back 3

agranulocytosis

potentially massive WG.

Front 4

Uses of typical antipsychotics?

atypical?

Back 4

positive sx of schizophrenia, psychosis, acute mania, Tourette's

Schizophrenia (both + and -). Olanzapine is also used for OCD, anxiety, depression, mania, and Tourette's.

Front 5

Side effects of Lithium?

Back 5

Lithium Makes Naggers Happy People (MNHP)
- movement (tremors)
- nephrogenic diabetes insipidis
- hypothyroid
- pregnancy problems (teratogen)

also ht block, sedation, edema.

NARROW TX WINDOW>

Front 6

Mechanism and use of Buspirone?
- does it cause sedation?
- interactions w/ alcohol?
- addiction?
- tolerance risks?

Back 6

Stim 5-HT1a receptors.

Used to tx GAD.

None of these are concerns.

Front 7

Which TCA can be used for bedwetting?

OCD?

What are the other TCAs used for?

Back 7

Imipramine

clomipramine

Major depression; fibromyalgia.

Front 8

Mechanism of TCAs?

Which kind, 2ndary or 3ertiary has more anticholinergic SE?

Which is the least sedating and has the lowest seizure threshold?

Back 8

block 5HT and NE reuptake.

3ertiary ~ Amytriptyline.

Desipramine

Front 9

Toxicities of TCAs?

Back 9

Three C's
convulsions, coma, and cardiotoxicity (arrhythmias).

Also cause respiratory depresion and fever.

Front 10

What can most TCAs cause in the elderly?
- which should be used so this doesn't happen?

Back 10

confusion and hallucinations.
- nortryptilene

Front 11

Treatment of TCA cardiotoxicity?

Back 11

Bicarb (they're acidic).

Front 12

Name the four SSRI's of note.
- common SE?
- uses?

Back 12

fluoxetine, paroxetine, sertraline, citalopram.
- GI distress, sexual dysfunction.
- Depression, OCD, bulemia, social phobias.

Front 13

PT with some psych problem presents with hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, and seizures. What's happening? Which meds might s/he have been on?
- tx?

Back 13

"Serotonin syndrome"

SSRI's or MAOI.

Cyproheptadine (5HT2 receptor antagonist)

Front 14

What are venlafaxine, and duloxetine?
- clinical indication?
- SE?

Back 14

SNRI's.
- depression.
- ^^BP, some stimulant effects, sedation, nausea.

Front 15

Which antidepressant can be used to tx diabetic peripheral neuropathy?

Back 15

duloxetine (SNRI)

Front 16

What are: (say them out loud!)

Phenelzine

Tranylocypromine

isocarboxazid

selegiline
- what's special about this one?

- what is the overall mechanism?
- famous SE... can be caused by two things.

Contraindicated to be used with which two other types of psych drugs? Why?

Back 16

MAOIs

Selegiline is MAO-B specific.

Increase amine nt's by inhibiting breakdown enzyme (MAO).

1. Hypertensive crisis with ingestion of foods with tyramine in them (wine and cheese).
2. HTN crisis b/c co-admined w/B-agonist.

SSRIs and meperidine, to prevent serotonin syndrome.

Front 17

Mirtazapine
- 2 mechanisms
- toxicities?

Back 17

a2 antagonist (inhibits the feedback mechanism) --> ^^NE and serotonin release.
and
potent 5HT2 and 5HT3 receptor antagonist.

WG, dry mouth, increased appetite, sedation

Front 18

Maprotiline
- mechanism?
- tox?

Back 18

- blocks NE reuptake
- sedation, orthostatic hypotension.

Front 19

what psych drug primarily inhibits 5HT reuptake, and is used primarily for insomnia b/c high-ass doses are required for antidepressant effect?
- what's funny about the side effects?

Back 19

Trazodone. [TrazoBONE]
- it's male specific SE: priapism (megabonder).
- sedation, nausea, postural hypotension.