Term
1st generation anti-psychotics
definition & examples |
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Definition
"Typical" anti-psychotics produced between 1950 and 1989 as a part of the deinstitutionalization process with broad actions, and more side-effects
EX: Thorazine, haldol |
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Term
2nd generation anti-psychotics
definition and examples |
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Definition
"Atypical" antipsychotics produced since 1990 as an answer to the generality and side-effects of typical anti-psychotics, but are more expensive
EX: Seroquel, abilify |
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Term
Anti-psychotic MOA:
Typical vs. Atypical |
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Definition
T: block all post-synaptic dopamine receptors
A: most are dopamine and/or serotonin antagonists |
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Term
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Definition
don't Be So MAD
Behavioral disorders: aggression
Schizophrenia/schizoaffective disorders
Mood stabilization
Agitation/acute psychosis
Depression |
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Term
| Black Box Warning against use of anti-psychotics for dementia in the elderly |
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Definition
| increased mortality rate due to heart failure, sudden cardiac death, and pneumonia |
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Term
| cardiovascular side-effects of anti-psychotics |
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Definition
| sinus tachycardia, orthostatic hypotension |
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Term
| Metabolic side-effects of anti-psychotics |
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Definition
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Term
| F/E side-effects of anti-psychotics |
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Definition
blurred vision/dry eyes
nasal congestion
dry mouth
urinary retention/edema
constipation |
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Term
| Endocrine side-effects of anti-psychotics |
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Definition
| photosensitivity, dermatitis, and sexual/menstrual dysfunction |
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Term
| CNS side-effects of anti-psychotics |
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Definition
| impaired psychomotor function, drowsiness/sedation |
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Term
| Antipsychotics with increased risk for weight gain/diabetes |
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Definition
all the "apines": clozapine, olanzapine, and quetiapine
higher mortality rate (comorbidities play a role) |
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Term
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Definition
anti-psychotic which hightens risk for agranulocytosis (potentially deadly drop in WBCs)
for this reason it is only given in 7 day increments, and the pharmacy has to check the WBC results before refilling it |
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Term
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Definition
Extrapyramidal Syndromes
pseudoparkinsonism: shuffling gait, mask-like facial expression, muscular rigidity
akathesia: restlessness
dystonia: involuntary spasm of the face, neck, arms, legs |
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Term
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Definition
potentially irreversible, involuntary facial/trunk/limb movement
stop medication immediately to avoid irreversibility
assess with Abnormal Involuntary Movement Scale (AIMS) test |
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Term
| Neuroleptic Malignant Syndrome (NMS) |
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Definition
Sx: sweating, drooling, labile HTN, tachycardia & muscle rigidity
Tx: Immediately care for physical symptoms, then STOP ALL ANTI-PSYCHOTICS |
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Term
| Examples of mood stabilizers |
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Definition
Lithium carbonate
Anti-convulsives: valproic acid, carbamazepine, and lamotrigine
Anti-psychotics |
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Term
| Indications for mood stabilizers |
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Definition
manic episodes
mood instability (duh)
impulse control issues |
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Term
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Definition
classic drug for mania/bipolar
takes ~2 weeks to take effect (may use safe anti-psychotics in the mean time)
narrow therapeutic window: 0.6-1.2 mEq/L |
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Term
| Lithium toxicity: definition and stages |
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Definition
Lithium competes with sodium, can easily lead to toxicity
First: blurred vision, ataxia, N/V/D, tinnitus
Second: polyuria, tremors, confusion, & psychomotor retardation
Last: seizures, coma, anuria, and CV collapse |
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Term
| Depakote: MOA, metabolism, contraindications |
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Definition
MOA: targets GABA, CNS depression
Met: metabolized by liver, 50-100 mg/L in blood
Contr: pregnancy (class D: NTD), NSAIDs: raises valproic acid level (competes in liver) |
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Term
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Definition
GI: N/V, weight change, liver/pancreas problems
CNS: HA, ataxia, tremors
Thrombocytopenia: bleeding/infection risk! |
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Term
| Lamictal: MOA and considerations |
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Definition
MOA: prevents release of glutamate
consids: titrate slowly to minimize/avoid side-effects |
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Term
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Definition
Integ: hypersensitivity skin reaction--> Stevens-Johnson's syndrome; avoid any and all skin irritants around administration
CNS: HA, dizziness, sedation, ataxia
GI: Nausea
Resp: Rhinitis |
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Term
| 5 subcategories of anti-depressants, and examples |
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Definition
SSRIs: Prozac, Zoloft, Lexapro
SNRIs: Pristiq, Cymbalta, Effexor
NDRIs: Wellbutrin
MAOIs: marplan, nardil, parnate
TCAs: amitriptyline, clomipramine, doxepin
others: remeron, desyrel |
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Term
| med interactions of SSRIs/SNRIs |
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Definition
increases effects of: beta-blockers/warfarin
decreases effects of: digoxin
interacts with MAOIs
safe in overdose |
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Term
| TCA drug contraindications |
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Definition
| MAOIs, alcohol, benzodiazepines |
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Term
| uses for antidepressants other than depression |
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Definition
anxiety and pain
wellbutrin: bupropion: smoking cessation/ADHD
Desyrel: sleep |
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Term
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Definition
muscle rigidity, nausea, restlessness
caused by SSRI/SNRI + narcotic interaction (can be caused by ecstasy) |
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Term
| MAOI important interaction |
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Definition
food-drug interaction: if tyramine fails to be metabolized (by MAO)--> hypertensive crisis
Foods: think Sports Party:
guac dip: avocado, fig, banana
pizza: sausage, aged meats, cheeses
Beer & wine |
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Term
| Anti-anxiety meds: subtypes and examples |
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Definition
benzodiazapines (bad for pregnancy): valium, atavan, xanax
non-benzodiazapines: BuSpar (buspirone) |
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Term
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Definition
benz: increase GABA receptor affinity
BuSpar: Serotonin/Dopamine agonist |
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Term
| anti-anxiety uses besides anxiety |
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Definition
pre-op sedation (versed)
alcohol withdrawal
seizures |
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Term
| anti-anxiety side effects |
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Definition
sedation
dependence (BZ)
paradoxical excitement |
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Term
| anti-anxiety interactions |
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Definition
BZs, and BuSpar are downers.
They increase the effects of other downers (alcohol, CNS depressants, except cigarettes).
They decrease the effects of uppers (caffeine) |
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