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Pharm - Psych

Psychiatric Pharmacology from First Aid 2013

QuestionAnswer
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
Created by: wmwebb89