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Flashcards in Psych: Psychiatric Drugs Deck (44)
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1

Anxiolytic Benzodiazepine Drugs?

  • Benzodiazepines ("azepam" or "azolom")

    • Diazepam

    • Lorazepam

    • Midazolam

    • Clonazepam

2

What is the mechanism of action for Benzodiazepines?

What is the mechanism of action for Benzodiazepines?

  • Potentiate GABAA – mediated inhibition

3

What are the side effects of Benzodiazepines?

What are the side effects of Benzodiazepines?

  • Ataxia

  • Dizziness

  • Somnolence

  • Fatigue

  • Memory difficulties

4

Name the Anxiolytic Barbiturate drug?

Name the Anxiolytic Barbiturate drug?

  • Phenobarbital

5

What is the mechanism of action of Phenobarbital?

What is the mechanism of action of Phenobarbital?

Potentiate GABAA – mediated inhibition

6

What are the side effects of Phenobarbital?

What are the side effects of Phenobarbital?

  • Sedation

  • Ataxia

  • Confusion

  • Dizziness

  • Decreased Libido

  • Depression

7

What class of drug is Buspirone
and what is the mechanism of action?

What class of drug is Buspirone
and what is the mechanism of action?

  • Anxiolytic

  • Serotonin 5-HT1A receptor

  • Partial Agonist

8

What are the side effects of Buspirone?

What are the side effects of Buspirone?

  • Dizziness

  • Confusion

  • Headache

  • Blurred vision

  • Nervousness

9

What are the Typical Antipsychotics?

What are the Typical Antipsychotics?

  • Try to Fly High (High potency)

    • ​Trifluoperazine

    • Fluphenazine

    • Haloperidol (NMS, Tardive dyskinesia)

      • ​NMS - "FEVER!"

  • Cheating Thieves are Low (Low potency)

  • Cholarpromazine (Corneal deposits)

  • Thioridazine (reTinal deposits)

10

What is the mechanism of action

for Typical Antipsychotics?

What is the mechanism of action

for Typical Antipsychotics?

  • Antagonize Dopamine D2 receptors (↑ [cAMP])
  • Chlorpromazine
    • Antagonize α-adrenergic
    • Antagonize Cholinergic

11

What are the side effects to Typical Antipsychotics?

What are the side effects to Typical Antipsychotics?

  • Parkinsonian symptoms

  • Neuroleptic malignant syndrome

  • Tardive dyskinesia (involuntary, repetative, body movements)

  • Anticholinergic symptoms
  • Orthostatic HyoTN, Hyperprolactinemia (esp. w/ Halo.)
  • Weight gain

12

What are some Atypical Antipsychotic drugs?

What are some Atypical Antipsychotic drugs?

  • Its Atypical for Old Clozets to Quitetly Risper from A to Z

  •  

    Olanzapine
  • Clozapine
  • Quetiapine

  • Risperidone

  • Aripiprazole (Dopamine system stabilizer)

  • Ziprasidone

13

What is the mechanism of action

for Atypical Antipsychotics?

What is the mechanism of action

for Atypical Antipsychotics?

  • Antagonize Dopamine D2 and Serotonin 5-HT2 receptors
     

  • Clozapine and Olanzapine also antagonize Dopamine D4 receptors

  • Quetiapine / Ziprasidone also blocks H1 Histamine

  • Aripiprazole is a D2 and 5-HT1 partial Agonist

14

What are the side effects of Atypical Antipsychotics?

What are the side effects of Atypical Antipsychotics?

  • Mild extrapyramidal symptoms

    • ​Tardive symptoms, Dystonia (cont. spasm), Akathesia (motor restlessness), Parkinsonism

  • Anticholinergic symptoms

    • ​Flushing, Dry skin, Mydriasis (pupil dilation), Loss of Accomodation, Altered Mental Status (AMS), Fever  

  • Sedation

  • Ziprasidone = Long QT

  • Weight gain (Olanzapine and Clozapine)
  • Agranulocytosis (Clozapine, req's weekly monitoring)

15

What are the SSRI drugs?
(Selective Serotonin Re-Uptake Inhibitors)

What are the SSRI drugs?
(Selective Serotonin Re-Uptake Inhibitors)

  • Sertraline

  • Paroxetine

  • Fluoxetine (can also be used for Bulimia Nervosa)

  • Citalopram

  • Escitalopram

16

What is the mechanism of action of SSRIs?

What is the mechanism of action of SSRIs?

  • Inhibit re-uptake of Serotonin --> Increase Synaptic Serotonin lvls

  • Takes 4-6 weeks before start to see the effect

17

What are the side effects of SSRIs?

What are the side effects of SSRIs?

  • Serotonin syndrome (when used concomitantly with an MAOI, other SSRIs, or SNRIs, St. John’s Wart, Kava Kava, Tryptophan, Cocaine, Amphetamines)

  • Sexual dysfunction (loss of Labidio, Anorgasmia)

  • GI distress

18

What is the clinical presentation of Serotonin syndrome?

What is the clinical presentation of Serotonin syndrome?

  • Hyperthermia

  • Hyperreflexia

  • Myoclonus

  • Autonomic instability

  • Flushing

  • Diarrhea

  • Mental status change

19

How do you Tx Serotonin syndrome?

How do you Tx Serotonin syndrome?

  • Cool the pt. down

  • Benzodiazepines

  • Cyproheptadine

20

What are the SNRI drugs?
(Serotonin-Norepinephrine Re-uptake Inhibitors)

What are the SNRI drugs?
(Serotonin-Norepinephrine Re-uptake Inhibitors)

  • Venlafaxine

  • Duloxetine (also used for Chronic Pain conditions, Neuropathic pain, Fibromyalgia)

  • Desvenlafaxine

21

What is the mechanism of action of SNRIs?

What is the mechanism of action of SNRIs?

  • Inhibit Serotonin re-uptake at the Synapse
  • Inhibit Norepinephrine re-uptake at the Synapse

22

What are the side effects of SNRIs?

What are the side effects of SNRIs?

  • HTN

  • Sweating

  • Weight Loss

  • GI distress

  • Blurred vision

  • Sexual dysfunction

  • Neuroleptic malignant syndrome

23

What is the name of the Atypical Antidepressant drugs?

What is the name of the Atypical Antidepressant drugs?

  • Bupropion (used for smoking cessation and anti-depressant)

  • Mirtazapine

  • Trazadone

24

What is the mechanism of action of Bupropion (NDRI)?

What is the mechanism of action of Bupropion (NDRI)?

  • Weakly inhibit uptake of Serotonin

  • Inhibit re-uptake of Norepinephrine, and Dopamine

25

What are the side effects of Bupropion?

What are the side effects of Bupropion?

  • Tachyarrhythmia

  • Pruritus

  • Sweating

  • Rash

  • Dyspepsia

  • Constipation

  • Dizziness

  • Seizure risk (Bullimics - mal nutritioned)

  • BUT it does not cause Sexual dysfunction

26

What is the mechanism of action of Mirtazapine?

What is the mechanism of action of Mirtazapine?

  • NaSSA (Noradrenergic and Specific Seretonergic Antidepressant)

  • α-2 Antagonist

  • α-2 are on the presynaptic nerve terminals on Adrenergic neurons

  • Stimulate release of α-2, inhibits further Norepinephrine release

  • Inhibiting stimulation causes an increase in Norepinephrine

27

What are the side effects of Mirtazapine?

What are the side effects of Mirtazapine?

  • Sedation

  • Increased appetite

  • Weight gain

  • Dry mouth

28

What is the mechanism of action of Trazadone?

What is the mechanism of action of Trazadone?

  • Inhibits Serotonin re-uptake

  • Useful for Insomnia

29

What are the side effects of Trazadone?

What are the side effects of Trazadone?

  • Sedation

  • Priapism (persitant painful penile erection)

30

What are the TCA drugs?

What are the TCA drugs?

  • Amitriptyline (also used for Fibromyalgia and Neuropathic pain) --> Nortriptyline

  • Imipramine (also used for Enuresis – bed wetting) --> Desipramine

  • Clomipramine (also used for OCD)

  • Doxepin

  • Amoxapine