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OTA 217 MH MEDS
for 3rd exam
| Question | Answer |
|---|---|
| which drug is the top psychiatric perscription? | Xanax, then lexapro, Zoloft, Prozac |
| categories of psychiatric drugs (7) | Antipsychotic, anti-cholinergic, antidepressant, antimanic, antianxiety, anti-obsessional, CNS stim |
| Dopamine | neurotransmitter assoc w/schizophrenia, increased - mania, schizo; decreased = depression, P symptoms |
| Nor-epinephrine | UP: mania, anxiety states, schizo; DOWN: depression |
| Serotonin | UP: anxiety state DOWN: depression |
| GABA | UP: reduced anxiety; DOWN: anxiety do, schizo |
| Acetylcholine | UP: depression: Down: P, Alzheimer's, Huntington's chorea |
| Abilify, Seoquel, Zyprexia, Respiridal | antipsychotic drug names - atypical |
| uses for antipsychotics | acute psychosis, schizophrenia, psychotic depression, bipolar do, dementia w/agitation |
| Which psychotic drugs were used to treat POSITIVE symptoms? | 1st generation, standard like MOA, anti-cholinergic's |
| What is a positive symptom? | anything that is there that SHOULD NOT be there |
| What is a negative symptom? | Something that is NOT there but SHOULD BE there |
| What is a EPS- extrapyramidal Side Effect | Various movement disorders like acute dystonia, invol spasms, tics, akinesia, akathisia, P syndrome |
| Akithisia | restless legs, tapping feet |
| Tardive Dyskinesia | (Rose) - caused by LT use of 1st Gen antipsychotics. invol mouse movements, blinking, chewing, - irreversible |
| Neuroleptic Malignant Syndrome | most lethal side effect of antipsychotic: onset within hrs to years of Tx - thermoregulator system goes haywire, photosensitivity |
| Atypical/2nd general antipsychotics | work on negative & positive symptoms of schizophrenia, few to no EPS, sedation, excessive salivation, nausea, wt gain |
| How 2nd gen antipsychotics work | block both dopamine & seratonin |
| most prescribed antipsychotic | Abilify, - approved to tx bipolar too |
| clozaril agranulocytosis | a potentially fatal reaction from clozaril (used in most severe cases) - drop in WBC, fever onset, risk of infection - sore throat WARNING |
| Side effect comparison of 1st w/ 2nd generation of antipsychotics | OLD - movement do NEW - metabolism issues |
| What are anti-cholinergic medications & why used? | Used to counteract side effects of anti psychotic meds |
| Tricyclic anti-depressants - eg | Elavil, anafranil, sinequan |
| MAOIs: | Parnate, Nardil, Saphra not used b/c interactions with digestion |
| SSRI - selective serotonin reuptake inhibitors | Paxil, Prozac, Zoloft, Celexa, Lexapro - the first of the New class of drugs |
| Atypical anti-depressants | effexor, wellbutrin (smoking); Pristiq, Cymbalta, Remeron |
| Which anti-depressanta (atypical) are most prescribed? | SSRIs |
| pros of SSRIs | can't OD, good for non-compliant pt, also used for anti anxiety, chronic pain, PMS, PMDD |
| which SSRIs act quickly | Celexa and Lexapro |
| Dangerous interactions with SSRIs | Don't take with MAOIs - serotonin syndrome - too much builds (hyperthermia, muscle rigidity, myoclonus, rapid change in mental status) |
| How long should you wait after stopping one kind of anti-depressant before beginning another? | 6 weeks |
| TCA - tricyclic antidepressants side effects | dry mouth, constipation, blurred vision, metallic taste, urine retention, orthostatic hypotension, drowsiness, weight gain |
| Most serious danger of TCAs | cardiac toxicity - due to increase of norinepinephrine in hear |
| what is a MAOI diet? | no cheese, alcohol, cured meat, fermented items, vinegar |
| Dangers of lithium | narrow window of therapuetic level - early toxicity, can kill if above 2.0, changes conductivity of heart, depresses respiration, renal function, keep hydrated! |
| What are Benzodiazipines? | drugs for antianxiety - potentiates actions of GABA (-pam ending) |