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USMLE- Psych Drugs

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sipikujo's version from 2016-06-09 01:36

Section

Question Answer
Trifluoperazinetypical anti-psychotic
Fluphenazinetypical anti-psychotic
Haloperidoltypical anti-psychotic
Chlorpromazinetypical low potentcy anti-psychotic, corneal deposits
Thioridazinetypical anti-psychotic
Chlorpromazinetypical antipsychotic w/ increased anti-cholinergic SEs
Thioridazinelots of anti-HAM effects - anti-cholinergic, antihistamine, a-blockade; typical antipsychotic, low potency
Chlorpromazinecorneal deposits
Thioridazineretinal deposits; retinitis pigmentosa
Olanzapineatypical antipsychotic
Clozapineatypical antipsychotic
Quetiapineatypical antipsychotic
Riserpidoneatypical antipsychotic
Arpiprazoleatypical antipsychotic
Zipraisidoneatypical antipsychotic
Olanzapine/clozapineweight gain
Clozapinecauses weight gain, agranulocytosis, seizures
ZipraisidoneQT prolongation
Typicalblock D2 receptors
Typical anti-psychoticsschizophrenia (+ sx), psychosis, acute mania, Tourettes
Atypical antipsychotic1st line tx for schizophrenia without agitation
Lithiumtx bipolar, SE: nephrogenic diabetes insipidus
Lithiumtremor, nephrogenic DI, hypothyroidism, teratogen
LithiumEbstein anomaly, opening of the tricuspid valve is displaced towards the apex of the right ventricle of the heart
Buspironestimulates 5-HT1A receptors
Buspironegeneralized anxiety disorder
Buspironetx for GAD; low SE profile - no sedation, tolerance, addiction, does not interact with alcohol
TCAstypical antidepressant drug group which blocks reuptake of NE and serotonin
TCAsDrug of choice for fibromyalgia
Imipramine3rd line tx for bedwetting
Clomipraminegold standard tx for OCD (although not 1st line)
TCAs major SEscause significant sedation, anti-HAM, atropine-like (anticholinergic)
TCAsconvulsions, coma, cardiotoxicity
NortriptylineTCA for elderly (-confusin, hallucinations)
TCAsNaHCO3 for o/d
SSRItreats depression, OCD, bulimia, social phobias, PTSD
Serotonin syndrome treatmentCyproheptadine for o/d
VenlafaxineSNRI- GAD, depression
DuloxetineSNRI- diabetic neuropathy, depression
SNRIincreased BP
Selegilineselective MAO-B inhibitor
PhenelzineMAOI
TranylcypromideMAOI
IsocarboxazidMAOI
MAOIs*atypical depression*, anxiety, hypochondriasis
MAOIshypertensive crisis with tyramine ingestion and b-agonists
MAOIscontraindicated with SSRIs or meperidine
Buproprionatypical anti-depressant, NDRI, lack of sexual side effects, assist in smkg cessation, caution: can lower seizure threshold
Buproprionsmoking cessation
Buproprionno sexual side effects
Mirtazapineatypical anti-depressant, NASA, good for weight gain and treats insomnia
Mirtazapinea2, 5HT2 and 3 antagonist
Trazodoneatypical anti-depressant used for insomnia
TrazodoneSARI which primarily inhibits serotonin reuptake
Trazodonetx insomnia; causes sedation, SARI (serotonin antagonist and reuptake inhibitor)
Trazodonepriapism
barbiturates intox txalkalinize urine w/ sodium bicarb (promotes renal excretion)
benzo o/d txflumazenil
activated charcoalprevents further gi absorb in sed-hypn intox
amphet, pcp, lsddrug intox which appear similar to schizo
anhedoniaseen in post pardum depression, not in post pardum blues
chlordiazepoxide or lorazepamtx for acute etoh withdrawal
orthostatic hypotensionmost common SE of MAOi's
MAOitx refractory panic disorder
Venlafaxinetx refractory depression (can also use trazadone, MAOi's)
diphenhydramine, benztropineNMS tx
sedate w/ bzd, paralyze, iv fluidstx for serotonin syndrome
dantrolenetx for malignant hyperthermia
hydroxyzine or zolpidemtx sleeping issues in the elderly after addressing underlying probs
phentolaminehypertensive emergency
sxs resolve within 1 yrnormal grief
sxs persist more than one yearabnormal grief (major depression)
meperidineopioid agonist,
serotonin syndromemaoi + meperidine equals?
opioid withdrawalmiosis + resp depression and ams
meperidineexception to opioids producing miosis
tramadolopioid analgesic and SNRI; mix with SSRI-->SS
family/group therapybest psychotherapy for schizo
valproic acidtx for bipolar with kidney issues?
carbamazapine/valproic acidtx for rapid cycling bipolarism
nortriptylinetca least likely to cause orthostatic hypotension
desipramineleast sedating tca, least anticholinergic side effects
clomipraminemost serotonin specific, useful in treatment of ocd
fluoxetinessri longest t1/2 w/ active metabolites; no need to taper
sertralinessri w/ highest risk for GI disturbances
paroxetinessri most serotonin specific, most activating (stimulant)
fluvoxaminessri currently approved only for use in ocd
ssripatient depressed and wants to lose weight, rx?
venlafaxinewithdrawal from this med produces flu-like sxs and electric-like shocks/zaps
venlafaxineavoid this drug in pts with htn or labile bp
buproprionatypical antidepressant used in seasonal affective disorder an adhd
buproprionpt depressed and does not want sexual side effects, rx?
increased DA receptors, less AcH receptorswhat causes tardive dyskinesia?
chlorpromazineblue gray skin discoloration
FALTERNMS Acronym
dantrolene, bromocriptine, amantadinetx for NMS
quetiapine/ziprasidoneatypical anti-psychs for tx of mania
clozapineneed weekly blood draws and cell counts for this drug
olanzipinecauses HLD, glucose intolerance, wt gain, liver tox
olanzipinemonitor LFTs when on this atypical antipsychotic
quetiapinedrug might cause cataracts, monitor with slit lamp q6 mos
carbamazapineblocks Na channels, inhibits action potentials = moa
carbamazapinerx SEs include leukopenia, hyponatremia, aplastic anemia, agranulocytosis
carbamazapine/valproic acidpretreatment cbc and lfts must be obtained before rxing this
valproic acidSEs include alopecia, hemorrhagic pancreatitis, hepatotoxicity, thrombocytopenia
diazepambzd w/ rapid onset and long acting
lithiumneeds thyroid function test, creatinine, and urinalysis monitoring
divalproextx for cyclothymia after psychotherapy
amitryptilinedepression + chronic pain rx?
paroxitinessri not safe in preg women
carbamazapine2nd line tx for bipolar after lithium?
lithium, dialysiselderly pt with renal failure, hyponatremia, n/v, =/- seizures, think?
serotonin syndromssri + triptans (pt with migraines) can precipitate?
lorazepam, oxazepamacute etoh tx, pt with liver disease, rx?
chlordiazepoxide/diazepoxideacute etoh tx, pt without liver disease, rx?
activates GABA (inhib) and serotonin receptors and inhibits glutamate (excit)neurotransmitter/reception action of etoh intox
MAOIsmoa is to increase the amount of biogenic amine NTs in the synaptic cleft
MAOI'sbest drugs for refractory depression?
orthostatic hypotensionmost common side effect of maois
tcatx for nightmare disorder
non-remsleep terror takes place during this period of sleep
non-rem, stages 3/4sleepwalking takes place during this period of sleep
NE and serotoninTCA prevent reuptake of these
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