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Psycopharm1

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wegufavi's version from 2017-02-01 08:46

Preferred Treat

ConditionDrugs
Alcohol W/dwlBenzodiazepines
AnxietySSRIs/SNRIS/buspirone/benzodiazepines/pregabalin
ADHDMethylphenidate/amphetamines
BipolarMood stabilizers (Lithium/Valproic acid/Carbamazepine)/atypical antipsychotics
DepressionSSRIs/SNRIs/TCAs/buspirone/mirtazapine
Depression w/insomniaTrazodone/nefazodone/mirtazepine
Depression w/peripheral neuropathyAmitriptyline/duloxetine
Obsessive-compulsiveSSRIs/clomipramine
PanicSSRIs/venlafaxine/benzodiazepines
PTSDSSRIs
SchizophreniaAntipsychotics
Social phobiasSSRIs
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ID

DrugAnswer
CNS StimulantsMethylphenidate/dextroamphetamine/methamphetamine
High potency antipsychoticsTrifluoperazine/fluphenazine/haloperidol
Low potency antipsychoticsChlorpromazine/thioridazine
SNRIsVenlafaxine/duloxetine
MAOiTranylcypromine/Phenelzine/Isocarboxazid/Selegiline
Atypical antidepressantsBuproprion/Mirtazapine/Maprotiline/Trazodone
TCAs/tertiary aminesAmitriptyline/imipramine/clomipramine/doxepine
TCAs/secondary aminesNortriptyline/desipramine/amoxapine
SSRIsFluoxetine/paroxetine/sertraline/citalopram
Atypical antipsychoticsOlanzapine/clozapine/quetiapine/risperidone/aripiprazole/ziprasidone
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MoA

DrugAnswer
CNS StimulantsIncrease catecholamines at synpatic cleft/esp NE and Dopa
Antipsychotics/neurolepticsBlock D2 receptors/raise cAMP
Atypical antipsychoticsNot completely understood/varied on 5-HT2/D/alpha/H
LithiumNot established/possible inhibition of phosphoinositol cascade
BuspironeStimulates 5-HT1A receptors
SSRIsSerotonin specific reuptake inhibitors
SNRIsInhibit 5-HT and NE reuptake
TCAsInhibit 5-HT and NE reuptake
MAOiNonselective/increases levels of amine neurotransmitters (NE/5-HT/dopa)
BuproprionIncreases NE/dopa via unknown mechanism/Nicotinic antagonistm
MaprotilineBlocks NE reuptake
MirtazapineAlpha-2-antagonist (increases NE 5-HT)/5-HT2/5-HT3 receptor antagonist
TrazodoneSerotonin antagonist and reuptake inhibitors (SARI)
NefazodoneSerotonin antagonist and reuptake inhibitors (SARI)
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Use

DrugAnswer
CNS StimulantsADHD/narcolepsy/appetite control
Antipsychotics/neurolepticsSchizophrenia (+ Sx)/psychosis/acute mania/Tourette's
Atypical antipsychoticsSchizophrenia (+/- Sx)/bipolar/OCD/anxiety/dep/mania/Tourette's
LithiumMood stabilizer for bipolar/blocs relapse or acute manic events/SIADH
BuspironeGAD
SSRIsDep/GAD/panic disorder/OCD/bulimia/social phobias/PTSD
VenlafaxineDep/GAD/panic disorder
DuloxetineDep/diabetic peripheral neuropathy
TCAsMajor dep/fibromyalgia
ImipramineMajor dep/fibromyalgia/bedwetting
ClomipramineMajor dep/fibromyalgia/OCD
BuproprionDep/smoking cessation
Trazodone/nefazodoneInsomnia primarily/dep (needs high dose)
MAOiAtypical dep/anxiety/hypchondriasis
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SE

DrugAnswer
Antipsychotics/neurolepticsLipid soluble-slow removal/extrapyramidal
Antipsychotics/neurolepticsD antagonism (prolactinemia)/antimuscarinic/anti-alpha-1/anti histamine
Antipsychotics/neurolepticsNeuroleptic malignant syndrome/tardive diskinesia
Extrapyramidal Sx4h (acute dystonia)/4d (akinesia)/4w (akathisia)/4m (tardive dyskinesia)
OlanzapineWeight gain
Clozapineagranulocytosis/seizure
QuetiapineCataracts
RisperidoneElevates prolactin (gynecomastia/galactoria/amenorrhea)
AripiprazoleLow effect on weight gain/glucose/lipids/QT
ZiprasidoneQT elongation
Neuroleptic malignant syndromeFever/Encephalopathy/Vitals unstable/Elevated CPK-leukocytosis/Rigidity of muscles/myoglobinuria
Tardive dyskinesiaStereotypic oral-facial movements/result of long term use/often irreversible
Atypical antipsychoticsFewer (extrapyramida/anticholinergic) than typical antipsychotics
Atypical antipsychoticsanti-D (prolactinemia)/anti-5-HT/anti-alpha-1/anti-H1
Chlorpromazinelow BP by blocking alpha 1/blue-gray skin discoloration
ThioridazineRetinopathy
LithiumTremor/Nephrogenic DI/hypOthyroidism/Epsteins
Lithiumsedation/edema/heart block
SSRIsGI distress/sexual dysfunction/5-HT syndrome
Serotonin syndromeHyperthermia/confusion/myoclonus/CV collapse/flushing/diarrhea/seizures
Serotonin syndromeCyproheptadine (5HT2 receptor antagonist)
SNRIsHTN/Serotonin syndrome
TCAsConvulsions/Coma/Cardiotoxicity
TCAssedation/alpha-1-blocking/anticholinergic
BuproprionStimulant/headache/seizure in bulimic (no weight gain/sexual)
MAOiHTN crisis/CNS stimulation
MirtazapineAnticholinergic
MaprotilineSedation/orthostatic hypotension
TrazodoneSedation/nausea/priapism
BuspironeHeadache/dizziness/nervousness
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ID

DrugCategory
Methylphenidate (Ritalin)CNS Stimulants
Dextroamphetamine (Adderol)CNS Stimulants
MethamphetamineCNS Stimulants
HaloperidolHigh potency antipsychotics
FluphenazineHigh potency antipsychotics
TrifluoperazineHigh potency antipsychotics
ChlorpromazineLow potency antipsychotics
ThioridazineLow potency antipsychotics
VenlafaxineSNRIs
DuloxetineSNRIs
TranylcyprominensMAOi
PhenelzinensMAOi
IsocarboxazidnsMAOi
SelegilinesMAOi (B)
RasagilinesMAOi (B)
BuproprionAtypical antidepressants
MirtazapineAtypical (TetraCyclic) antidepressants
MaprotilineAtypical antidepressants
TrazodoneAtypical (SARI) antidepressants
NefazodoneAtypical (SARI) antidepressants
AmitriptylineTCAs/tertiary amine
NortriptylineTCAs/secondary amine
ImipramineTCAs/tertiary amine
DespramineTCAs/secondary amine
ClomipramineTCAs/tertiary amine
DoxepineTCAs/tertiary amine
AmoxapineTCAs/secondary amine
FluoxetineSSRIs
ParoxetineSSRIs
SertralineSSRIs
CitalopramSSRIs
OlanzapineAtypical antipsychotics
ClozapineAtypical antipsychotics
QuitiapineAtypical antipsychotics
RisperidoneAtypical antipsychotics
AripiprazoleAtypical antipsychotics
ZiprasidoneAtypical antipsychotics
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USMLE Psychology Pharmacology

Psychiatry Drugs

DrugType
haloperidolantipsychotic
trifluoperazineantipsychotic
fluphenazineantipsychotic
thioridazineantipsychotic
chlorpromazineantipsychotic
olanzapineatypical antipsychotic
clozapineatypical antipsychotic
quetiapineatypical antipsychotic
risperidoneatypical antipsychotic
aripiprazoleatypical antipsychotic
ziprasidoneatypical antipsychotic
imipramineTCA
amitriptylineTCA
desipramineTCA
nortriptylineTCA
clomipramineTCA
doxepinTCA
amoxapineTCA
fluoxetineSSRI
paroxetineSSRI
sertralineSSRI
citalopramSSRI
venlafaxineSSRI
duloxetineSSRI
phenelzineMAO inhibitor
tranylcypromineMAO inhibitor
isocarboxazidMAO inhibitor
selegilineMAO-B inhibitor
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DrugMechanism of Action
typical antipsychoticsblock dopamine D2 receptors (increase cAMP)
atypical antipsychoticsblock 5-HT2, a, H1, and dopamine receptors
lithiumpossibly related to inhibition of phosphoinositol cascade
buspironestimulates 5-HT1A receptors
tricyclicsblock reuptake of NE and serotonin
SSRIssertonin-specific reuptake inhibitors
SNRIsinhibit serotonin and NE reuptake
MAOInonselective MAO inhibition, increases levels of amine neurotransmitters
selegilineselective MAO-B inhibitor
bupropionincreases NE and dopamine via unknown mechanism
mirtazapinea2 antagonist, increases release of NE and serotonin, and potent 5-HT2 and 5-HT3 receptor antagonists
maprotilineblocks NE reuptake
trazodoneinhibits serotonin reuptake
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Tx for selected psych conditions

Question Answer
alcohol withdrawalbenzodiazepines
anxietySSRIs, SNRIs, buspirone
ADHDmethylphenidate, amphetamines
Bipolar"mood stabilizers" (lithium, valproic acid, carbamazepine), atypical antipsychotics
bulimiaSSRIs
depressionSSRIs, SNRIs, TCAs,buspirone, mirtazapine (esp with insomnia)
obsessive-compulsive disorderSSRIs, clomipramine
panic disorderSSRIs, venlafaxine, benzodiazepines
PTSDSSRIs
schizophreniaantipsychotics
social phobiasSSRIs
tourettes's syndromeantipsychotics (haloperidol, respiridone)
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CNS stimulants

Question Answer
examples of CNS stimulantsmethylphenidate, dextroamphetamine, methamphetamine
mechanism of CNS stimulantsincrease catecholamines at synaptic cleft, esp NE and dopamine
clinical use of CNS stimulantsADHD, narcolepsy, appetite control
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Atypical antipsychotics

Question Answer
examples of atypical antipsychoticsolanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone
mechanism of atypical antipsychoticsvaried effects on 5-HT2, dopamine, alpha and H1 receptors
clinical use of atypical antipsychoticsschizophrenia positive and negative symptoms; bipolar, OCD, anxiety, depression, mania, tourette's
olanzapine/clozapine may cause significantweight gain
Significant side effect of ziprasidoneProlongs the QT interval
Important side effects of Clozapineagranulocytosis & seizure
atypical antipsychotics have fewer of these side effects than traditional antipsychoticsextrapyrimidal and anticholinergic
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Lithium & Buspirone

Question Answer
mechanism of lithiumpossibly related to inhibition of phosphoinositol casade
LMNOP of lithiumLithium side effects - Movement (tremor), Nephrogenic diabetes insipidus, hypOthyroidism, Pregancy problems
clinical use of lithiummood stabilizer (bipolar - blocks relapse and acute manic events), SIADH
toxicities of lithiumLMNOP + sedation, edema, heart block
fetal cardiac defectsEbstein anomaly and malformation of great vessels assoc w lithium
lithium requires close monitoring of serum levels because ofnarrow therapeutic window
lithium almost exclusively excreted inkidneys
where is lithium reabsorbed?proximal convoluted tubule, following Na reabsorption
mechanism of buspironestimulates 5-HT1A receptors
number of weeks it takes for buspirone to take effect1-2 weeks
buspirone does not causesedation, addiction, tolerance
clinical use of buspironegeneralized anxiety disorder
buspirone does not interact withalcohol
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Antidepressants

Question Answer
SSRIsfluoxetine, paroxetine, sertraline, citalopram
Flashbacks paralyze senior citizens
mechanism of SSRIsserotonin-specific reuptake inhibitors
serotonin syndromehyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures
treatment of serotonin syndromecyproheptadine (5-HT2 receptor antagonist)
toxicities of serotonin syndromeGI distress, sexual dysfunction (anorgasmia and decreased libido)
SNRIsvenlafaxine, duloxetine
mechanism of SNRIsinhibit serotonin and NE reuptake
clinical use of SNRIsdepression
duloxetine has greater effect onNE
venlafaxine also used forgeneralized anxiety and panic disorders
duloxetine also used fordiabetic peripheral neuropathy
toxicities of SNRIsincreased BP
stimulant effects, sedation, nausea
examples of tricyclic antidepressantsamitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
"triptylines, ipramines, doxepin and amoxapine"
mechanism of tricyclicsblock reuptake of NE and serotonin
clinical use of tricyclicsmajor depression, fibromyalgia
clinical use of imipraminebedwetting
clinical use of clomipramineOCD
toxicity profile of desipramineless sedating, higher seizure threshold
3° tricylcics like amitriptyline have more of these effects than 2° tricyclics like nortriptylinanticholinergic
toxicities of tricyclicsalpha blockade (postural hypotension)
anticholinergic (tachycardia, urinary retention, dry mouth)
sedation
Tri-Cs of tricyclicsconvulsions, coma, cardiotoxicity
additional side effects of tricyclicsrespiratory depression, fever, confusion and hallucinations in elderly
treatment of cardiovascular toxicity of tricyclicsNaHCO3
MAOIsTranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B)
MAO Takes Pride In Shanghai
selective MAO-B inhibitorselegiline
mechanism of MAOIsincrease levels of amine neurotransmitters (NE, serotonin, dopamine)
clinical use of MAOIsatypical depression, anxiety, hypochondriasis
MAOIs are contraindicated withSSRIs, TCAs, St. John's Wort, meperidine, dextromethorphan (to prevent serotonin syndrome)
toxicities of MAOIshypertensive crisis (with ingestion of tyramines), CNS stimulation
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Atypical antidepressants

Question Answer
Buproprion clinical useatypical antidepressant
buproprion also used forsmoking cessation
buproprion actionincreases NE and dopamine by unknown mechanism
toxicity of buproprionstimulant effects (tachycardia, insomnia)
headache
seizure in bulimic pts
buproprion causes seizures inbulimic patients
buproprion does not cause these side effectssexual side effects
mirtazapine actionalpha-2 antagonist (increases release of NE and serotonin)
potent 5-HT2 and 5-HT3 antagonist
mirtazapine toxicitysedation, increased appetite and weight gain, dry mouth
maprotiline mechanismblocks NE reuptake
maprotiline toxicitysedation, orthostatic hypotension
Trazodone mechanisminhibits serotonin reuptake
trazodone used forinsomnia (very high doses needed for antidepressant effect)
toxicities of trazodonesedation, nausea, postural hypotension, priapism (trazoBONE)
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Rapid-fire: Class of Drug

DrugClass
MethylphenidateCNS stimulant
DextroamphetamineCNS stimulant
MethamphetamineCNS stimulant
Haloperidolantipsychotic
Trifluoperazineantipsychotic
fluphenazineantipsychotic
thioridazineantipsychotic
chlorpromazineantipsychotic
Olanzapineatypical antipsychotic
Clozapineatypical antipsychotic
Quetiapineatypical antipsychotic
Risperidoneatypical antipsychotic
Aripiprazoleatypical antipsychotic
Ziprasidoneatypical antipsychotic
Buspirone5-HT1A stimulator
FluoxetineSSRI
ParoxetineSSRI
SertralineSSRI
CitalopramSSRI
VenlafaxineSNRI
DuloxetineSNRI
AmitriptylineTricyclic antidepressant
NortriptylineTricyclic antidepressant
ImipramineTricyclic antidepressant
DesipramineTricyclic antidepressant
ClomipramineTricyclic antidepressant
DoxepinTricyclic antidepressant
AmoxapineTricyclic antidepressant
TranylcypromineMAO inhibitor
PhenelzineMAO inhibitor
IsocarboxazidMAO inhibitor
SelegilineMAO inhibitor (selective)
BupropionAtypical antidepressant also used for smoking cessation
MirtazapineAtypical antidepressant with sedation and ↑ appetite qualities
Antagonizes α2, 5-HT2, and 5-HT3 receptors
MaprotilineAtypical antidepressant - blocks NE reuptake
Trazodoneatypical antidepressant - inhibits serotonin reuptake - used mostly for insomnia
Tazobone
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