Term
| What disease states can cause depression? |
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Definition
| Endocrine issues, deficiency in certain vitamins, infections, metabolic disorders, CVD, neurologic disorders. |
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Term
| Drugs from what classes can induce a depressive state? |
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Definition
| Alcohol, antihypertensives, steroids, oral contraceptives |
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Term
| What are some namees of SSRI's? |
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Definition
| Prozac (fluoxetine), Zoloft (Sertraline), Paxil (paroxetine), Celexa (citalopram), Lexapro (Escitalopram). |
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Term
| What are some names of some tricyclic antidepressants currently in use? |
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Definition
| Norpramin (desipramine), Pamelor (nortriptyline), Elavil (Amitriptyline), Tofranil (imipramine), Sinequan (doxepin). |
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Term
| What dietary restrictions are important to teach patients who are using monoamine oxidase inhibitors (MAOI's)? |
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Definition
| Pts must avoid tyramine containing foods, including fava beans, all tap beer, vermouth, aged cheeses, avocados, sauerkraut, processed meats, soy products, chocolate. |
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Term
| What can tyramine-foods and MAOI's induce (when taken together)? |
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Definition
|
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Term
| Do MAOI's cause anticholinergic effects? |
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Definition
|
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Term
| What drug class is preferred when treating atypical depression? |
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Definition
|
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Term
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Definition
| Phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Emsam Transdermal $$$). |
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Term
| What's the basic mechanism of action for tricyclic antidepressants? |
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Definition
| TCA's increase NE and 5-HT within neuronal synapses by blocking their reuptake. |
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Term
| Do tricyclic antidepressants have anticholinergic side effects? |
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Definition
|
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Term
| Summarize anticholinergic effects. |
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Definition
| dry mouth, constipation, blurred vision, tachycardia, urinary retention, dizziness, memory impairment. |
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Term
| Are labs routinely monitored in patients using TCA's? |
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Definition
| No, unless inadequate response, relapse, high doses are used, or there's suspected toxicity. |
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Term
| Name some tricyclic antidepressants. |
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Definition
| (tertiary amines) Amitriptyline (Elavil), doxepine (Adapin, Sinequan), imipramine (Tofranil), trimipramine (Surmontil); (secondary amines) desipramine (Norpramin), nortriptyline (Pamelor), protriptyline (Vivactil). |
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Term
| What other common condition does imipramine treat? |
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Definition
|
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Term
| Does fluoxetine (Prozac) cause increased agitation or sedation? |
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Definition
|
|
Term
| What are SSRI's basic mechanism of action? |
|
Definition
| Increase 5-HT within neuronal synapses by blocking its reuptake. |
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Term
| Does paroxetine (Paxil) cause increased agitation or sedation? |
|
Definition
|
|
Term
|
Definition
| fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), Escitalopram (Lexapro). |
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Term
| What reuptake inhibition does buproprion induce? |
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Definition
| Norepinephrine and dopamine. |
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Term
| Buproprion lowers the threshold for what condition? |
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Definition
|
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Term
| Duloxeine (Cymbalta) treats psych illnesses, but recently it's also been used to treat what difficult-to-treat condition? |
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Definition
|
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Term
| Depression relapse occurs within what timeframe after primary symptoms cease? |
|
Definition
| Relapse occurs within 6 months following remission. |
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Term
| Does recurrence of a psych condition describe a return of symptoms within 6 months, or years later? |
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Definition
| Recurrence is years later. |
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Term
| How many previous episodes to a current complaint of major depressive disorder indicates pt should receive indefinite antidepressive therapy? |
|
Definition
| 3 (regardless of age); 2 or more (>50 years); 1 or more (>60 years). |
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Term
| What drug class should first be used in uncomplicated major depression? |
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Definition
|
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Term
| What's the abuse potential of Buspirone (BuSpar)? |
|
Definition
| None. There is not a tolerance to develop either. |
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Term
| What is first line pharmaceutical treatment for panic disorder? |
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Definition
|
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Term
| Which has higher abuse potential, a benzodiazepine with a short or a long half-life? |
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Definition
|
|
Term
| What drug class is the first-line agent used to treat social anxiety disorder? |
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Definition
|
|
Term
| What percentage of schizophrenic patients will attempt suicide? |
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Definition
|
|
Term
| Name some traditional antipsychotics. |
|
Definition
| chloropromazine (Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), molindone (Moban), Mesoridazine (serentil), perphenazine (Trilafon), thioridazine (Mellaril), thiothixene (Navane), trifluoperazine (Stelazine). |
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|
Term
| Name some atypical antipsychotics. |
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Definition
| Aripiprazole (Abilify), clozapine (Clozaril), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), ziprasidone (Geodon). |
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Term
| Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are an an increased risk of what? |
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Definition
| Risk of death (CV and stroke). |
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|
Term
| What movement disorder can be induced by use of atypical antipsychotics? |
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Definition
|
|
Term
| What movement disorder is characterized by repetitive, involuntary, purposeless movements including grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips and rapid eye blinking? |
|
Definition
|
|
Term
| Blocking dopamine receptors with antipsychotics can cause what life-threatening circumstance characterized by hyperpyrexia, muscle rigidity, altered mental status and autonomic instability? |
|
Definition
| Neuroleptic malignant syndrome. |
|
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Term
| What is antipsychotic drugs relationship to diabetes? |
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Definition
| Antipsychotics can cause weight gain and impaired glucose metabolism, contributing to the development of DM. |
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|
Term
| The atypical antipsychotic clozapine (Clozaril) requires WBC and ANC counts with followup labs because of its risk to cause what? |
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Definition
|
|
Term
| Is aripiprazole (Abilify) notorious for weight gain? |
|
Definition
| No. It's chance of causing >7% body weight gain is 5%. |
|
|
Term
| Is Abilify able to be used for acute agitation? |
|
Definition
| Yes & it can be repeated q2h. |
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Term
| Name an atypical antipsychotic that can be given IM for acute treatment. |
|
Definition
| Olanzapine (Zyprexa), ziprasidone (Geodon). |
|
|
Term
| What drug class is paliperidone (Invega)? |
|
Definition
| It's an atypical antipsychotic. |
|
|
Term
| What eye condition can quetiapine (Seroquel) cause that necessitates eye exams every 6 months? |
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Definition
|
|
Term
| What major cardiac anomaly that can be seen on an EKG does ziprasidone (Geodon) cause? |
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Definition
|
|
Term
| What percentage weight gain would indicate to the practitioner that changing the antipsychotic to a different antipsychotic is appropriate? |
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Definition
|
|
Term
| Which of the following drugs is least likely to cause EPS effects, fluphenazine, thiothixine or olanzapine? |
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Definition
|
|
Term
| which agent has the most data in tx-resistant schizophrenia, valproic acid, clozapine, thioridazine? |
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Definition
|
|
Term
| Which agent can be used for long-term tx of EPS related ADRs if haloperidal is restarted, benztropine, propranolol, clonidine, or lorazepam? |
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Definition
|
|
Term
| How effective are benzodiazepines in reducing tardive dyskinesia symptoms? |
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Definition
|
|
Term
| Which agent can be given in long-acting parenteral form to improve compliance, ziprasidone, olanzapine, risperidone? |
|
Definition
|
|
Term
| The patient was started on olanzapine - which tests should be monitored as a result, SCr, FSBS, serum transaminases, lipid profile? |
|
Definition
|
|
Term
| Iis BuSpar (buspirone) used for depression or anxiety and is it PRN or maintenance? |
|
Definition
| BuSpar is used for anxiety and it is not PRN. |
|
|
Term
| What organ can lithium cause the dysfunction of? |
|
Definition
|
|
Term
| What is the sexual side effect of SSRI use? |
|
Definition
|
|
Term
| Should fluoxetine (Prozac) or paroxetine (Paxil) be avoided in pts that are anxious? |
|
Definition
| Prozac should be avoided in anxious people. |
|
|
Term
| Should fluoxetine (Prozac) or paroxetine (Paxil) be avoided in pts who, symptomatically, cannot get out of bed d/t depression? |
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Definition
| Paxil should be avoided in pts who cannot get out of bed d/t emotional issues. |
|
|
Term
| Will family hx of using certain medications for the tx of mental health issues play a role in the practitioner's decision-making? |
|
Definition
| Yes - i.e. if the family's had success with TCA's, then the pt will likely have success with TCA's as well. |
|
|
Term
| What are atypical antipsychotic medication's concerning side effects? |
|
Definition
| Weight gain, insulin resistance, dyslipidemia. |
|
|
Term
| Can atypical antipsychotics be used to treat bipolar disorder? |
|
Definition
| Yes, but only during the manic phase. |
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