What is the drug class of choice for treating anorexia and bulimia?
Selective serotonin reuptake inhibitors
What are the three first-line drug classes for the treatment of anxiety?
Selective serotonin reuptake inhibitors, benzodiazepines, and buspirone
What are the three first-line drugs (all mood stabilizers) for the treatment of bipolar disorder?
Lithium, valproic acid, and carbamazepine; atypical antipsychotics can also be used
What are the three first-line drug classes for the treatment of depression?
Serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants
A patient presents with depressed mood, decreased interest, decreased appetite, and poor sleep. He reports sleeping only approximately 3 hours a night. What are two treatment options for this patient?
Trazodone and mirtazapine; both are sedating antidepressants
What two drug classes are used in the treatment of atypical depression?
Monoamine oxidase inhibitors and selective serotonin reuptake inhibitors
What drug classes are used in the treatment of panic disorder?
Selective serotonin reuptake inhibitors, tricyclic antidepressants, and benzodiazepines
What two drugs or drug types are used in the treatment of obsessive-compulsive disorder?
Selective serotonin reuptake inhibitors and clomipramine
What is the drug class of choice for the treatment of schizophrenia?
Antipsychotics; typical or atypical
What is the treatment for Tourette's syndrome?
Antipsychotics; often haloperidol
What are the two drugs (one is a drug class) used to treat attention-deficit hyperactivity disorder?
Methylphenidate and amphetamines
A Vietnam War veteran presents with flashbacks, nightmares, and avoidance of his closet where his wife keeps his uniform. What is a treatment option for this patient?
Selective serotonin reuptake inhibitors could be used to treat his posttraumatic stress disorder
Explain the mechanism of action of methylphenidate.
It increases presynaptic norepinephrine vesicular release (like amphetamines) and is used to treat attention-deficit hyperactivity disorder
Name the typical antipsychotics
Thioridazine, haloperidol, fluphenazine, trifluoperazine, and chlorpromazine
How do antipsychotics cause galactorrhea?
Dopamine receptor antagonism releases inhibition on the prolactin-secreting cells of the pituitary
Approximately 4 weeks ago, a patient started taking a neuroleptic medication. She now states that she is unable to sit still and that she has a desire to be constantly fidgeting and moving. What adverse effect is she experiencing?
What adverse effect of neuroleptic medications is characterized by the inability to initiate purposeful movement?
What are the symptoms of acute dystonia? When does dystonia develop after use of neuroleptics?
Abnormal muscle contractions and involuntary twisting movements; it usually develops 4 hours after drug administration
Typical antipsychotics block which receptors?
What extrapyramidal adverse effect of neuroleptics is irreversible?
A patient presents with rigidity, myoglobinuria, autonomic instability, and hyperpyrexia after recently starting a medication for schizophrenia. What adverse effect is this patient experiencing?
Neuroleptic malignant syndrome; he should be treated with dantrolene and bromocriptine
The antimuscarinic effects of neuroleptics cause what adverse effects?
Dry mouth and constipation
The antihistamine effects of neuroleptics cause what adverse effect?
Blockade of the α-receptors by neuroleptics cause what adverse effect?
What is the treatment for neuroleptic malignant syndrome?
Dopamine agonists and dantrolene
Which neuroleptics are low-potency drugs with a low incidence of neurologic adverse effects?
Thioridazine and chlorpromazine
Which neuroleptics are high-potency drugs with neurologic adverse effects?
Haloperidol, fluphenazine, and trifluoperazine
Place the following extrapyramidal adverse effects of neuroleptics in the order in which they occur: akathisia, akinesia, dystonia, tardive dyskinesia.
Dystonia (within 4 hours), akinesia (within 4 days), akathisia (within 4 weeks), and tardive dyskinesia (after 4 months)
In reference to neuroleptic malignant syndrome, what is the FEVER mnemonic?
FEVER: Fever, Encephalopathy, Vitals unstable, Elevated enzymes, Rigidity of muscles
Which two neuroleptics cause ocular adverse effects?
Thioridazine causes retinal deposits whereas chlorpromazine causes corneal deposits