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Terms in this set (50)
What are the 4 main classifications of psychiatric medications?
Antipsychotic drugs primarily bind to which receptors? They are considered...?
Antipsychotic drugs also bind to what other 3 receptors?
Muscarinic receptors (anticholinergic)
Alpha 1 adrenergic receptors
Histamine H1 receptors
What side effects occur when an antipsychotic medication binds to muscarinic receptors?
What side effects occur when an antipsychotic medication binds to dopamine receptors?
Extrapyramial side effects
Characterized by involuntary, persistent movements of the tongue, lips, lateral jaw movements, chewing, blinding, rocking back and forth, and facial movements
May result from bruxism, broken teeth, tongue trauma, and ulcerations
What side effects occur when an antipsychotic medication binds to a histamine receptor?
What side effects occur when an antipsychotic medication binds to an alpha 1 adrenergic receptor?
What are the 2 types of antipsychotics?
Atypical antipsychotics are more likely to cause...
Diabetes and higher death incidence in older patients with dementia
What does SSRI stand for?
Selective serotonin reuptake inhibitors
Tricyclic & SSRI antidepressants
Thought to increase the concentration of NE and serotonin by inhibiting the reuptake into synaptic terminals on the neuron
What does MAOI stand for?
Monoamine oxidase inhibitors
Inhibit monoamine oxidase so that it cannot break down neurotransmitters such as E and NE
Drug/Food interactions of MAOIs
Avoid foods with tyramine (aged cheese, bananas, raisins, avocados, aged meat, yeast, beer, wines, yogurt, sauerkraut)
What are the 3 classifications of antidepressant drugs?
Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (SSRIs)
Monoamine oxidase inhibitors (MAOIs)
Inhibits the reuptake or inactivation of NE and serotonin from the synapse which results in elevated levels of these neurotransmitters
Adverse effects of TCAs
Due to nonselective affinity and blockade of other receptors
Not used much anymore due to overdose potential and numerous adverse effects
Drug interactions of TCAs
Limit amount of epinephrine
More selective for the inhibition of serotonin reuptake with fewer side effects
Adverse effects of SSRIs
Can induce bruxism
Contraindications of SSRIs
No special precautions with E
What does SNRI stand for?
Serotonin-Norepinephrine reuptake inhibitors
Inhibits reuptake of serotonin and NE
Action similar to TCAs but classified as atypical
What is dangerous about antidepressants?
It may increase the risk of suicidal thinking and behavior
What are the 2 phases of treatment with bipolar disorder?
Acute therapy - treatment of acute episodes
Maintenance therapy - prevention of relapse
Treatment for mild acute manic episodes
Treatment for mixed episodes
Treatment for severe manic or mixed episodes
2 drug combination therapy
Gold standard mood stabalizer
Black-box warning for narrow therapeutic index
Numerous side effects - xerostomia!
May cause metallic taste
Drug interactions of lithium
Divalproex sodium (Depakote)
First anticonvulsant approved as a mood stabilizer
Treatment of MIXED episodes
Usually combined with lithium to reduce adverse effects and improve therapeutic response
MOA for Divalproex sodium
Increases GABA levels in the brain
Adverse effects of Divalproex sodium
What is a precaution of Divalproex sodium?
Must monitor blood concentration and platelet counts
Black-box warning for hepatic failure
First atypical antipsychotic drug approved as a mood stabilizer
Treatment of MANIC episodes
Only drug FDA approved for relapse prevention of manic episodes
Anticonvulsant drug used to treat bipolar I MANIA and MIXED episodes
Drug interactions of Carbamazepine
Certain antibiotics - use azithromycin!
What is the only proven agent for treatment of bipolar depression?
Drug of choice in treatment of generalized anxiety disorder
Most rapidly acting and effective
Used for short term treatment for acute anxiety; should NOT be used for treatment of mild anxiety/depression
Higher therapeutic index; safe
Adverse effects of benzodiazepines
MOA for benzodiazepines
Bind to GABA receptors
Indications for benzodiazepines
Sedative/Hypnotic drugs can cause...
Not used for anxiety due to ability to cause overdose and tolerance
Produce respiratory and CNS depression
Treated with amphetamine (Adderall)
What is the drug of choice to treat an anxious dental patient?
What are the 2 drugs used to treat nocturnal bruxism?
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