88 terms

USMLE FA Psychiatry Pharmacology

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Alcohol withdrawal rx
Benzodiazepines
(clonazepam)
Bulimia rx
SSRIs
Anxiety rx
Benzodiazepines,
Buspirone,
SSRIs
ADHD rx
Methylphenidate (Ritalin)
Amphetamines (Dexedrine)
Atypical depression rx
MAO inhibitors
SSRIs
Bipolar disorders rx
"Mood stabilizers"
Lithium, Valproic acid, Carbamazepine
Atypical antipsychotics
Depression rx
SSRIs, SNRIs
TCAs
Depression w/ Insomnia rx
Mirtazapine
Obsessive-compulsive disorder rx
SSRIs
Clomipramine
Panic disorder rx
SSRIs
TCAs
Benzodiazepines
PTSD rx
SSRIs
Schizophrenia rx
Antipsychotics
Tourette's Syndrome rx
Antipsychotics (eg holperidol, resperidone)
Social phobias rx
SSRIs
CNS stimulants
Methylphenidate (ritalin), dextroamphetamine (Dexedrine), mixed amphetamine salts
CNS stimulants moa
Inc catecholamines at synaptic cleft, esp NE and dopamine
CNS stimulants clinical
ADHD, narcolepsy, appetite control
Antipsychotics
(haloperidol + "-azines")
Haloperidol, tribluoperazine, fluphenazine, thioridazine, chlorpromazine
Antipsychotics moa
Block D2 receptors (Inc cAMP)
Antipsychotics clinical
Schizophrenia (pos sx), psychosis, acute mania, Tourette's
Antipsychotics high potency
Try to Fly High
Trifluperazine, Fluphenazine, Haloperidol
Neuro side efx (extrapyramidal)
Antipsychotics low potency
Cheating Thieves are low
Chlorpromazine, Thioridazine
non neuro side efx (anticholinergic, antihistamine, alpha blockade)
Antipsychotics toxicity
1. Slowly removed from body (fat)
2. Extra pyramidal sx
3. Endocrine (galactorrhea)
4. muscarinic (dry mouth, constipation), alpha (hypotension), histamine (sedation)
Evolution of Extrapyramidal side efx from Antipsychotics
4h acute dystonia
4d akinesia (parkinsonian)
4wk akthisia (restlessness)
4mo tardive dyskinesia - irreversible
Neuroleptic Malignant Syndrome
FEVER
Fever, Encephalopathy, Vitals unstable, Elevated enzymes, Rigidity of muscles
myoglobinuria,
Treat: Dantrolene, D2 agonists (eg Bromocriptine)
Atypical Antipsychotics
it's atypical for OLd CLOSets to QUIETly RISPER from A to Z
Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone
Clozapine side efx
Agranulocytosis & seizures & Weight Gain
Atypical antipsychotic causes agranulocytosis & seizures
Clozapine
Olanzapine clinical
OCD, anxiety disorder, depression, mania, Tourette's, Schizophrenia
Atypical antipsychotic moa
not completely understood, 5-HT2, dopamine, alpha, H1 receptors
Atypical antipsychotics
Schizophrenia
Olanzapine side efx
Significant weight gain
Lithium clinical
Mood stabilizer: bipolar, blocks relapse & manic. ALso SIADH
Lithium side efx (mnemonic)
LMNOP
Lithium side efx
Movement (tremor)
Nephrogenic diabetes insipidus
hypOthyroidism
Pregnancy probs
Lithium fetal efx
Ebstein anomaly & malformation of the great vessels
Lithium toxicity
Tremor, sedation, edema, heart block, hypothyroidism, polyuria (ADH antagonist nephrogenic diabetes insipidus), teratogenesis
Buspirone moa
Stim 5-HT1A receptors
Buspirone use
Generalized anxiety disorder
few side efx
Tricyclic Antidepressants
Amitriptyline, Nortriptyline, Imipramine, Desipramine, Clomipramine, Doxepin, Amoxepine (-iptyline or -ipramine)
TCAs moa
Block reuptake of NE and serotonin
TCAs clinical
Major depression, fibromyalgia
bedwetting (imipramine), OCD (clomipramine)
Imipramine use
bedwetting
Clomipramine use
OCD
TCAs side efx
Sedation, alpha-blocking efx, atropine-like,
3rd TCA amitriptyline: more anticholinergic than 2nd (nortriptyline)
Least sedating TCAs
Desipramine
TCAs toxicity
Tri-C's: Convulsions, Coma, Cardiotoxicity (arrhythmias); resp depression, hyperpyrexia
Nortriptyline in elderly
TCA toxicity treatment
NaHCO3 for CV toxicity
SSRIs
SExy PARty CITy has the (DeBOPS) FLU
Fluoxetine, Paroxetine, Sertraline, Citalopram
Fluoxetine is a
SSRI
Amitriptiline is a
TCA
Paroxetine is a
SSRI
Sertraline is a
SSRI
Citalopram is a
SSRI
Nortriptiline is a
TCA
Imipramine is a
TCA
Desipramine is a
TCA
Clomipramine is a
TCA
Doxepin is a
TCA
Amoxapine is a
TCA
Venlafaxine is a
SNRI
Duloxetine is a
SNRI
SSRIs moa
Serotonin-specific reuptake inhibitors
Takes 4-8 weeks to have effect
SSRIs clinical
DeBOPS
Depression, Bulimia, OCD, PTSD, Social phobias
Takes 4-8 weeks to have effect
SSRIs toxicity
GI distress, sexual dysfunc (anorgasmia), "Serotonin syndrome"
Serotonin syndrome
hyperthermia, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures
Treat serotonin syndrome
Cyproheptadine (5-HT2 receptor antagonist)
SNRIs
Venlafaxine, Duloxetine
SNRI moa
Inhibit serotonin and NE reuptake
SNRI clinical
Depression
Venlafaxine use
SNRI
Depression & Gen Anxiety Disorder
Duloxetine use
SNRI
Depression & Diabetic peripheral neuropathy
SNRIs toxicity
Inc BP most common, also stimulant efx, sedation, nausea
MAO-Is
MAO Takes Pride In Shanghai
Tranylcypromine, Phenelzine, Isocarboxazid, Selegline (MAO-B inh)
MAOI moa
Monoamine Oxidase inh
Inc levels amine neurotransmitters (NE, serotonin, dopamine)
MAOI clinical
Atypical depression, anxiety, hypochondriacs
MAOI toxicity
Hypertensive crisis w/ tyramine ingestion & beta agonists; CNS stim. Contraindicated w/ SSRIs or meperidine (serotonine syndrome)
Foods with tyramine
wine and cheese, rich foods
Atypical antidepressants
Bupropion, Mirtazapine, Maprotiline, Trazodone
Bupropion moa
Inc NE and dopamine
Bupropion use
smoking cessation, Atypical antidepressant
Bupropion toxicity
Stim efx (tachycardia, insomnia), headache, seizures in bulimics
Mirtazapine moa
Atypical antidepressant
alpha 2 antagonist
Inc NE and serotonin release
Potent 5-HT2 & 5-HT3 antagonist
Mirtazapine toxicity
sedation, Inc appetite, wt gain, dry mouth
Maprotiline moa
Blocks NE reuptake
Atypical antidepressant
Maprotiline toxicity
sedation, orthostatic hypotension
Trazodone moa
Atypical antidepressant
Inh serotonin reuptake
Trazodone use
insomnia
Trazodone tox
sedation, nausea, priapism, postural hypotension
TrazoBONE