Term
|
Definition
| responsible for higher reasoning |
|
|
Term
|
Definition
| responsible for homeostasis, blood pressure/respiration |
|
|
Term
|
Definition
| responsible for relaying auditory and visual systems, contains substantia nigra |
|
|
Term
|
Definition
| regulate levels of awareness and emotional aspects of sensory experiences |
|
|
Term
|
Definition
| coupled to Gq and its located in the endocrine and cns |
|
|
Term
|
Definition
| coupled to Gi located in the heart (slows it down) |
|
|
Term
|
Definition
| coupled to Gq located in smooth muscle and cns causes vasodialation and emesis |
|
|
Term
|
Definition
| coupled to Gi located in the cns causes decreased locomotion |
|
|
Term
| cholinergic effect in eye |
|
Definition
| miosis- constriction of the iris |
|
|
Term
| synthesis pathway for neurotransmitters |
|
Definition
| tyrosine->L-dopa->dopamine->norepinephrine->epinephrine |
|
|
Term
|
Definition
| monoamino oxidase with higher selectivity for dopamine, present in the cns |
|
|
Term
|
Definition
| monoamino oxidase with higher selectivity for norepinephrine |
|
|
Term
|
Definition
| coupled to Gq increases CAMP |
|
|
Term
|
Definition
| coupled to Gi decreases cAMP |
|
|
Term
|
Definition
| decrease in dopamine releasing neurons in mainly the substantia nigra |
|
|
Term
| effect of low dose dopamine in vasculature |
|
Definition
|
|
Term
| effect of high dose dopamine in vasculature |
|
Definition
|
|
Term
| effect of H1 receptor in the CNS |
|
Definition
| coupled to Gi, inhibits appetite causes vertigo and increases wakefulness |
|
|
Term
|
Definition
| ligand gated, causes emesis |
|
|
Term
| main metabolite of serotonin |
|
Definition
|
|
Term
|
Definition
| coupled to Gq, regulate dopamine release in cns , causes appetite suppression |
|
|
Term
|
Definition
| coupled to Gi, affects Sleep, feeding, thermoregulation, aggression, anxiety |
|
|
Term
|
Definition
| blocks vmat and exposes norepinephrine to mao causes a depletion of NE |
|
|
Term
| MOA of tricyclic antidepressants |
|
Definition
| non selective serotonin and norepinephrine reuptake inhibitor |
|
|
Term
| tertiary amine tricyclic antidepressants |
|
Definition
imipramine(tofranil)
amitriptyline (elavil)
doxepine (adapin) |
|
|
Term
| secondary amine tricylic antidepressants |
|
Definition
desipramine (norpramin)
nortriptyline (pamelor)
protriptyline (vivactil) |
|
|
Term
| selectivity of secondary amine tricyclic antidepressants |
|
Definition
|
|
Term
| selectivity of tertiary amine tricyclic antidepressants |
|
Definition
| serotonin over norepinephine |
|
|
Term
| which receptors down regulate with chronic use of tricyclic antidepressants |
|
Definition
|
|
Term
|
Definition
phenelzine (nardil)
tranylcypromine (parnate)
selegiline (ensam) |
|
|
Term
| chronic use of MAOI's cause downregulation of which receptors |
|
Definition
|
|
Term
| dietary restriction of MAOI's |
|
Definition
| cannot eat tyramine because it displaces norepinephrine from storage and causes a hypertensive crisis |
|
|
Term
| foods that contain tyramine |
|
Definition
| aged cheese, red wine, tap beer, chocolate |
|
|
Term
| signs of serotonin syndrome |
|
Definition
Mental status: confused, psychotic, anxious
Autonomic: shivering, hyperthermia, blood pressure changes, tachycardia, diaphoresis
Neuromuscular: rigidity, tremor, hyperreflexia, seizures, oculogyric crisis |
|
|
Term
| treatments of serotonin syndrome |
|
Definition
| abc's, lavage and charcoal in some cases, benzodiazepines and dantrolene |
|
|
Term
|
Definition
|
|
Term
|
Definition
| paroxetine and sertraline |
|
|
Term
| which ssri has the greatest effect in weight gain |
|
Definition
|
|
Term
|
Definition
milnacipran (savella)
Venlafaxine (effexor)
desvenlafaxine (pristiq)
duloxetine (cymbalta) |
|
|
Term
| atypical antidepressants (brand and generic) |
|
Definition
| trazodone(desyrel) nefazodone (serzone) bupropion (wellbutrin) mirtazapine (remeron) |
|
|
Term
|
Definition
| weak to moderate 5ht reuptake inhibitor and strong 5ht2c antagonist |
|
|
Term
|
Definition
sedation
orthostatic hypertension
nausea
piaprism |
|
|
Term
|
Definition
| weak to moderate dopamine/norepinephrine reuptake blocker |
|
|
Term
| medications to be avoided in epileptics |
|
Definition
| bupropion, clozapine, olanzapine, chlorpromazine, thiothexene |
|
|
Term
|
Definition
|
|
Term
| limiting step of dopamine production |
|
Definition
|
|
Term
|
Definition
| responsible for storage of long term memory and learning |
|
|
Term
| major adverse effect of nefazodone |
|
Definition
|
|
Term
| effect of antidopaminergics in prolactin |
|
Definition
|
|
Term
| effect of dopamine blockade in endocrine system |
|
Definition
| prolacteniemia, amenorrhea, galactorrhea, infertility, inpotence |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| trimester in which disturbances can result in schizophrenia |
|
Definition
|
|
Term
| typical AP treat ---- symptoms |
|
Definition
|
|
Term
| atypical AP treat ------ symptoms |
|
Definition
|
|
Term
|
Definition
fluphenazine
perphenazine
trifluroperazine
haloperidol |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
marked muscle rigidity
fever caused by impaired sweating
autonomic instability
followed by severe eps |
|
|
Term
|
Definition
| repetitive painless involuntary tic like movements, most inportant unwanted side effect |
|
|
Term
| rapid cycling bipolar disorder |
|
Definition
| more than 4 mood episodes per year |
|
|
Term
| allowed substitutions for phenothiazines |
|
Definition
| electron withdrawing in c#2 and small chain in beta carbon |
|
|
Term
|
Definition
| chlorpromazine, thioridazine, fluphenazine, perphenazine |
|
|
Term
| difference between phenothiazine and thioxanthene (thiothixene) |
|
Definition
| N in middle ring substituted for C |
|
|
Term
| active isomer of thiothixene |
|
Definition
|
|
Term
| toxic metabolite of haloperidol |
|
Definition
HPP (causes pseudoparkinson)
caused by the quartinary amine |
|
|
Term
|
Definition
| loxapine, clozapine, olanzapine, quetiapine |
|
|
Term
| n-demethylation metabolite of loxapine |
|
Definition
|
|
Term
|
Definition
risperidone,(risperdal)
paliperidone( invega)
Iloperidone(fanapt) |
|
|
Term
| metabolite of risperdal via 2d6 |
|
Definition
| paliperidone(hydroxyrisperidone) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| more potent isomer of doxepine |
|
Definition
|
|
Term
| potent inhibitors of 3A4 and 2D6 |
|
Definition
| fluoxetine and norfluoxetine |
|
|
Term
|
Definition
| paroxetine, fluoxetine and bupropion |
|
|
Term
| diagnostic criteria for mdd |
|
Definition
5 of sigecaps for 2 weeks
on has to be anhedonia or depressed mood |
|
|
Term
|
Definition
suicide
interest (anhedonia)
guilt
energy
concentration
appetite
psychomotor agitation or retardation
sleep (increase or decrease) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| chronic less severe form of depression over 2 years |
|
|
Term
| goals of treatment for mdd |
|
Definition
achieve remission
return to optimal level of functioning
prevent relapse
prevent recurrence |
|
|
Term
| 3 phases of mdd treatment |
|
Definition
acute phase (6 to 12 weekss)
continuation phase (4-9 mos after remission is achieved)
maintenance phase (if patient has more than 3 mdd episodes) |
|
|
Term
| first few days of AD therapy |
|
Definition
increase in agitation, n/v, diarrhea
improvement in sleep and appetite |
|
|
Term
|
Definition
| increase in activity, improved hygiene, normalization of memory and concentration, sleep and eating back to normal |
|
|
Term
symptoms in ad therapy
2-4 weeks (but up to 8) |
|
Definition
| relief of depressed mood, decrease in thoughts of suicide, increase in enjoyment of activities |
|
|
Term
|
Definition
|
|
Term
| must wait ---- weeks after fluoxetine before initiating MAOI |
|
Definition
|
|
Term
|
Definition
|
|
Term
| interaction between fluvoxamine and clozapine |
|
Definition
| inhibition of 1A2 cause increased levels of clozapine |
|
|
Term
| onset of serotonin syndrome |
|
Definition
|
|
Term
| snri that has dual action at all doses |
|
Definition
|
|
Term
|
Definition
|
|
Term
| discontinue nefazodone if lfts.... |
|
Definition
|
|
Term
| qt elongation can happen with |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| cardinal symptoms of tca poisoning |
|
Definition
cardiac arrythmias
convulsions
coma
hypotension
altered conciousness |
|
|
Term
| treatment of tca poisoning |
|
Definition
administer sodium bicarb if patient
ph< 7.1
qrs interval > 100msec
arrythmias
hypotensive |
|
|
Term
| no dietary restrictions for this MAOI |
|
Definition
|
|
Term
| wash out period of MAOI when changing to AD (except fluoxetine) |
|
Definition
|
|
Term
| tyramine containing food should be avoided for --- after dc of MAOI |
|
Definition
|
|
Term
| appropiate length of AD trial |
|
Definition
|
|
Term
| antidepresants that do not have sexual side effects |
|
Definition
| bupropion and mirtazapine |
|
|
Term
| ssri's with highest breast milk concentrations |
|
Definition
| fluoxetine and citalopram |
|
|
Term
| ssri with low to undetectable breast milk conc |
|
Definition
| sertraline and paroxetine |
|
|
Term
| effect of d2 blockade in mesolimbic tract |
|
Definition
| decrese in positive symptoms |
|
|
Term
| effect of d2 blockade in mesocortical tract |
|
Definition
| increase in negative symptoms |
|
|
Term
| effect of d2 blockade in tuberofundibular tract |
|
Definition
| increase in hyperprolactinemia |
|
|
Term
| diagnostic criteria for schizophrenia |
|
Definition
2 or more symptoms for 1 month hallucinations, dellusions, disorganized speech, disorganized/catatonic behavior,
negative symptoms plus 1 or more social/occupational disorder |
|
|
Term
|
Definition
| 4 weeks at therapeutic dose |
|
|
Term
|
Definition
| >20% in reduction of positive symptoms |
|
|
Term
| dosing frequency of haloperidol decanoate injection |
|
Definition
|
|
Term
| dosing frequency of fluphenazine decanoate injection |
|
Definition
|
|
Term
| maintanace dose conversion for haloperidol |
|
Definition
| 10 to 15 times oral daily dose(overlap oral dose for 1 month then taper) |
|
|
Term
| loading dose conversion for haloperidol decanoate |
|
Definition
| 20 times daily oral dose (max of 200mg)then administer rest, overlap for 4 days then taper |
|
|
Term
| fluphenazine decanoate conversion |
|
Definition
1.25 x maintenance daily oral dose
with 1 week oral overlap or
1.6x po qd dose with no overlap |
|
|
Term
| fluphenazine decanoate dosing frequency |
|
Definition
| q week for 4 to 6 weeks then increase till q 2 weeks (week ovelap with oral) |
|
|
Term
|
Definition
| first few weeks or months |
|
|
Term
| onset of acute dystonic reactions |
|
Definition
|
|
Term
| onset of pseudoparkinsonism |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when can a pt be put back on AP after NMS event |
|
Definition
| 2 weeks after resolution of symptoms |
|
|
Term
| dosing frequency for risperdal consta |
|
Definition
|
|
Term
| dosing frequency for invega sutenna |
|
Definition
|
|
Term
| dosing frequency for zyprexa relprevv |
|
Definition
|
|
Term
| ddi bupropion and abilify |
|
Definition
| bupropion inhibits 2d6 decrease ablify dose by 0.5 |
|
|
Term
|
Definition
|
|
Term
| iloperidone (fanapt) titration must be restarted if dose is missed ---- |
|
Definition
| 3 or more days due to risk of orhtostatic hypotension |
|
|
Term
| lurasidone is contraindicated with |
|
Definition
| ketoconazole and carbamazepine due to 3A4 metabolism |
|
|
Term
| black box warning for zypreza relprevv |
|
Definition
| post injection delirium and sedation (must be watched for 3 hours |
|
|
Term
| olanzapine and benzodiazepines should be separated by |
|
Definition
|
|
Term
| risperdal consta overlap with oral dose |
|
Definition
|
|
Term
|
Definition
| desvenlafaxine, paliperidone |
|
|
Term
| oral overlap for invega sutenna |
|
Definition
|
|
Term
|
Definition
lurasidone (latuda)
and ziprasidone (geodon)
benzothiazoles |
|
|
Term
| drugs that decrease suicide |
|
Definition
|
|
Term
|
Definition
q week for first 6 months
q 2 weeks for the next 6 months
then q 4 weeks |
|
|
Term
| wbc levels for initiation, maintenance and discontinuation |
|
Definition
initiate 3500/2000
maintain 3000/1500
d/c 2000/1000 |
|
|
Term
| clozapine need to reinitiate titration if missed for or more than --- |
|
Definition
|
|
Term
| starting dose of clozapine |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| clozapine, olanzapine, asenapine |
|
|
Term
|
Definition
| aripiprazole, iloperidone, lurasidone, ziprasidone, quetiapine |
|
|
Term
|
Definition
|
|
Term
| manic episode diagnostic criteria |
|
Definition
expansive or irritable mood lasting for 1 week
3 or more digfast symptoms for at least a weak |
|
|
Term
|
Definition
distractability
inflated self-esteem
goal directed activities
flight of ideas
activities with painful consequences
sleep
talkativeness |
|
|
Term
|
Definition
acute mania 1-1.2
acute depression 0.8 -1
maintenance 0.6 to 0.8
toxic more than 1.5 |
|
|
Term
| how long should you wait before drawing lithium levels |
|
Definition
| 5 days after last dose increse 12 hour after last dose |
|
|
Term
|
Definition
| malformation of tricuspid caused by lithium use in the 1st trimester |
|
|
Term
| potentially beneficial se of lithium |
|
Definition
| leukocytosis when used with clozapine |
|
|
Term
|
Definition
| rythm disturbances,av delay, heart block, st segment and t wave abnormalities |
|
|
Term
| how long should you wait to draw divalproex levels |
|
Definition
| 3 days after dose increase |
|
|
Term
| divalproex monitoring parameter |
|
Definition
| cbc and platelet (thrombocytopenia) lft (hepatotoxicity) renal funtion and bun (hyperammonemia) pregnancy test (tetarogenicity) |
|
|
Term
| serum concentration levels for carbamazepine checked after--- |
|
Definition
|
|
Term
|
Definition
valproex-3 days
tegretol-4 days
litium- 5 days |
|
|
Term
| drugs that can cause steven-johnsons syndrome |
|
Definition
| carbamazepine, oxcarbazepine and lamictal |
|
|
Term
| bc options with carbamazepine |
|
Definition
depo-provera
progestion only iud
barrier methods |
|
|
Term
| mini pill bc can only be used with what mood stabilizer |
|
Definition
|
|
Term
| stage 1 treatment for acute mania |
|
Definition
|
|
Term
| stage 2 treatment of mania |
|
Definition
| choose 2 out of lithium, vpa, sga |
|
|
Term
| stage 1 for acute depressive episode |
|
Definition
mood stabilizer and lamotrigine
(if lithium increase level to 0.8 to 1 |
|
|
Term
| stage 2 for acute depressive episode |
|
Definition
| switch to quetiapine or symbiax |
|
|
Term
| alopecia could most likely be caused by |
|
Definition
|
|
