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Pharm - Psych
Psychiatric Pharmacology from First Aid 2013
Question | Answer |
---|---|
CNS Stimulants: names, MOA, Use | Nom: methylphenidate, amphetamines MOA: inc catecholamines at synapse (NE, DA) Use: ADHD, narcolepsy, appetite suppression |
Neuroleptics: names, MOA, Use | Nom: haloperidol + "-azines" MOA: block D2 rec (increasing cAMP) Use: Schizophrenia, mania, psychosis, Tourette |
Describe Neuroleptic Malignant Syndrome (NMS). | FEVER + malignant hyperthermia: Fever, encephalopathy, vitals unstable, elevated enzymes, rigidity |
How is NMS treated? | Dantrolene and DA-agonists (bromocriptine) |
What is tardive diskinesia? | Stereotypic oral-facial movements resulting from long-term antipsychotic use. |
What are the side effects of neuroleptic use? | NMS, Tardive dyskinesia, and Extra-Pyramidal Symptoms (EPS): dystonia -> restlessness -> Parkinsonism -> tardive dyskinesia |
Name some atypical antipsychotics. | "It's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z" Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone |
Atypical neuroleptics: MOA, Use, Tox | MOA: unknown, many NT's affected Use: Schizo, bipolar, OCD, anxiety, mania, Tourettes Tox: Fewer EPS than normal neuroleptics. Clozapine may cause agranulocytosis. "Watch CLOZAPINE CLOSELY!" |
Lithium: MOA, Use, Tox | MOA: unknown, PIP cascade Use: mood stabilizer for bipolar dz, SIADH Tox: "LMNOP" Lithium... Movement (tremor) Nephrogenic DI (treats SIADH) hypO-thyroidism Pregnancy teratogen |
Which birth defects are associated with lithium use during pregnancy? | Ebstein anomaly: atrialized right ventricle |
Buspirone: MOA, Use, Tox | MOA: 5HT-receptor agonist Use: anxiety (will the "BUS" be on time?) Tox: no side effects!!! |
SSRIs: drugs, onset | "Flashbacks paralyze senior citizens" Fluoxetine, paroxetine, sertraline, citalopram Takes 4-8 weeks for onset. |
What are some uses for SSRIs? | Depression, GAD, panic disorder, OCD, bulimia, social phobias, PTSD |
What are the side effects of SSRIs? | Better than TCAs. GI, decreased libido, serotonin syndrome (inc 5HT with any other antidepressant class) |
What are the symptoms of serotonin syndrome? | Hyperthermia, confusion, myoclonus, cardiac arrest, flushing, diarrhea, seizures. |
What is the treatment for serotonin syndrome? | Cyproheptadine (5HT receptor antagonist) |
SNRIs: drugs, MOA, Tox | Nom: venlafaxine, duloxetine MOA: 5HT and NE re-uptake inhibitor Tox: HTN, stimulant sfx, nausea |
What are some uses for SNRIs? | Depression, also... Venlafaxine: GAD, panic disorder Duloxetine: diabetic peripheral neuropathy |
TCAs: naming, MOA | Nom: "-imprimine," "-iptyline," also Doxepin, amoxapine MOA: all are SNRIs |
What are some uses for TCAs? | Major depression, fibromyalgia Bedwetting: imipramine OCD: clomipramine |
What are the toxicities for TCAs? | Tri-C: Convulsions, Coma, Cardiotoxicity (arrhythmias) |
How do you treat TCA toxicity? | NaHCO3 (only treats cardiotoxicity) |
What are the locations of MAO-A, MAO-B? | MAO-A: liver, GI, placenta MAO-B: platelets ...both are found in the CNS. |
What is the MOA of MAO-Is? Why are they used? | MOA: They inhibit the re-uptake of all NT's... 5HT, DA, and NE Use: atypical depression, anxiety, and hypochondriasis |
What is a major complication of MAO-I use? | HTN crisis following tyramine ingestion (wine, cheese, processed meats) |
What else is contraindicated with MAO-I use? | St. John's wort, other antidepressants (SS), dextromethorphan (in addition to opiate agonism it affects NE) |
Name some MAO-Is. | Tranylcypromine, Phenelzine, Isocarboxazid, Selegeline (selective for MAO-B, DA) |
Bupropion: MOA, Use, Tox | MOA: unknown NE and DA increase Use: smoking cessation Tox: stimulant sfx, headache, MAY CAUSE SEIZURES IN BULIMICS, no sexual sfx |
Trazodone: MOA, Use, Tox | MOA: SRI Use: insomnia at low dose, depression at high Tox: Trazo-BONE, priapism! |
Mirtazapine: MOA, Use, Tox | MOA: a2-antagonist, 5HT/NE increased, but potent 5HT receptor antagonist Use: sedation (b/c 5HT antagonist) inc appetite (elderly or anorexia) Tox: dry mouth |