USMLE (Fach) / Pharmacology - Psychiatry (Lektion)

In dieser Lektion befinden sich 62 Karteikarten

USMLE

Diese Lektion wurde von estoffel erstellt.

Lektion lernen

zurück  |  weiter 1 / 2

  • Alcohol Intoxication:- emotional lability- slurred speech- ataxia- coma, blackouts- serum γ-glutamyltransferase (GGT) indicator- AST > ALT (>2:1) Withdrawal:- autonomic hyperactivity- delirium tremens --> Treatment ...
  • Delirium tremens Life-threatening alcohol withdrawal syndrom that peaks 2-4 days after last drink - autonomic hyperactivity (eg tachycardia, temors, anxiety, seizures) - Treatment: benzodiazepines
  • Cocain Intoxication:- impaired judgement- pupillary dilation- hallucinations (including tactile)- paranoid ideations- angina- sudden cardiac death--> Treatment: α-blockers, benzodiazepines, β-blockers not ...
  • Nicotine Intoxication: restlessness Withdrawal:- irritability- anxiety- restlessness- difficulty concentrating--> Treatment: nicotine patch, bupropion/varenicline
  • LSD (lysergic acid diethylamide) Hallucinogen Intoxication:- perceptual distortion (visual, auditory)- depersonalization- anxiety- paranoia- psychosis- possible flashbacks
  • Marijuana (cannabinoid) Hallucinogen Intoxication:- euphoria- anxiety- paranoid delusions- perception of slowed time- impaired judgement- social withdrawal- ↑ appetite- dry mouth- conjunctival injection- hallucinations - ...
  • MDMA (ecstasy) Hallucinogenic stimulant Intoxication:- euphoria- disinhibition- hyperactivityLife-threatening effects include hypertension, tachycardia, hyperthermia, serotonin syndrome Withdrawal:- depression- fatigue- ...
  • Heroin addiction Users at ↑ risk for hepatitis, HIV, abscesses, bacteriemia, right-heart endocarditis Treatment:- Methadone- Naloxone + buprenorphine- Naltrexone
  • Preferred medications for selected psychiatric conditions ... ADHD: Stimulants (methyphenidate, amphetamines)Alcohol withdrawal: Benzodiazepines (chlordiazepoxide, lorazepam, diazepam)Bipolar disorder: Lithium, valproic acid, atypical antipsychoticsBulimia nervosa: ...
  • CNS stimulants Methylphenidate, dextroamphetamine, methamphetamine Mechanism: ↑ catecholamines in the synaptic cleft, especially norepinephrine and dopamine Clinical use: ADHD, narcolepsy, appetite control Adverse ...
  • Typical antipsychotics High potency: Haloperidol, pimozide, fluphenazine, trifluoperazine Low potency: Thioridazine, chlorpromazine Mechanism: Block dopamine D2 receptors (↑ cAMP) Clinical use: Schizophrenia (1° positive ...
  • Atypical antipsychotics Aripiprazole, asenapine, clozapine, olanzapine, quetiapine, iloperidone, paliperidone, risperidone, lurasidone, ziprasidone Mechanism: Most are D2 antagonists; aripiprazole is D2 partial agonist.Varied ...
  • Lithium Mechanism: not established; possibly related to inhibition of phosphoinositol cascade. Indications:- Acute mania- Bipolar maintenance Baseline studies:- Blood urea nitrogen, creatinine, calcium, urinalysis- ...
  • Buspirone Stimulates 5-HT1A receptors. Clinical use: Generalized anxiety disorder - Does not cause sedation, addiction, or tolerance.- Takes 1-2 weeks to take effect.- Does not interact with alcohol (vs. barbiturates, ...
  • Selective serotonin reuptake inhibitors (SSRIs) Fluoxetine, fluvoxamine, paroxetine, sertraline, escitalopram, citalopram. Mechanism: 5-HT-specific reuptake inhibitors Clinical use: Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, ...
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) ... Venlaflaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran. Mechanism: Inhibit 5-HT and norepinephrine reuptake Clinical use: Depression, general anxiety disorder, diabetic neuropathy. Venlafaxine ...
  • Serotonin syndrome Can occur with any drug that ↑ 5-HT (eg, MAO inhibitors, SNRIs, TCAs) - 3A's: neuromuscular Activity (clonus, hyperreflexia, hypertonus, tremor, seizure)Autonomic stimulation (hyperthermia, diaphoresis, ...
  • Tricyclic antidepressants (TCA) Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine. Mechanism: Inhibit 5-HT and norepinephrine reuptake. Clinical use: Major depression, OCD (clomipramine), peripheral ...
  • Monoamine oxidase inhibitors Tranylcypromine, phenelzine, isocarboxazide, selegiline (selective MAO-B inhibitor) Mechanism: nonselective MAO inhibition ↑ levels of amine neurotransmitters (NE, 5-HT, dopamine) Clinical use: Atypical ...
  • Atypical antidepressants Bupropion: ↑ NE and dopamine- Also used for smoking cessation Mirtazapine: α2-antagonist (↑ release of NE and 5-HT), potent 5-HT2 and 5-HT3 receptor antagonist Trazodone: Primarily blocks 5-HT2, ...
  • Bipolar disorder - Lithium- Valproic acid- Carbamazepine- Lamotrigine- Atypical antipsychotics
  • OCD - SSRIs- Venlafaxine- Clomipramine
  • Panic disorder - SSRI- Venlafaxine- Benzodiazepines
  • Tourette syndrome - Antipsychotics (eg, fluphenazine, risperidone)- Tetrabenazine
  • Generalized anxiety disorder - SSRIs- SNRIs
  • Extrapyrimidal symptoms Hours to days: Acute dystonia (muscle spasm, stiffness, oculogyric crisis). - Treatment: benztropine, diphenhydramine Days to months:- Akathisia (restlessness). Treatment: β-blockers, benztropine, benzodiazepines- ...
  • Bupropion Inhibits NE and dopamine reuptake (does not affect serotonin). Approved for depression and smoking cessation. Toxicity: stimulant effects (tachycardia, insomnia), headache, seizures in anorexic/bulimic ...
  • Mirtazapine α2-antagonist (↑ release of NE and 5-HT), potent 5-HT2 and 5-HT3 receptor antagonist and H1 antagonist. Toxicity: - Sedation (which may be desirable in depressed patients with insomnia)- ↑ appetite, ...
  • Trazodone Primarily blocks 5-HT2, α1-adrenergic, and H1 receptors; also weakly inhibits 5-HT reuptake. Used primarily for insomnia, as high doses are needed for antidepressant effects. Toxicity: sedation, nausea, ...
  • Vareniciline Nicotinic ACh receptor partial agonist. Used for smoking cessation. Helps nicotine cravings decline. Toxicity: Sleep disturbance, may depress mood.
  • Vilazodone Inhibits 5-HT reuptake; 5-HT1A receptor partial agonist. Used for major depressive disorder. Toxicity: headache, diarrhea, nausea, ↑ weight, anticholinergic effects.May cause serotonin syndrome if ...
  • Vortioxetine Inhibits 5-HT reuptake; 5-HT1A receptor agonist and 5-HT3 receptor antagonist. Used for major depressive disorder. Toxicity: nausea, sexual dysfunction, sleep disturbances (abnormal dreams), anticholinergic ...
  • Opioid withdrawal and detoxification Intravenous drug users at ↑ risk for hepatitis, HIV, abscesses, bacteremia, right-heart endocarditis. - Methadone: Long-acting opiate used for heroin detoxification or long-term maintenance therapy. ...
  • Atomoxetin Norepinephrine uptake inhibitor Used in ADHD
  • Trifluoperazine High potency typical antipsychotic
  • Fluphenazine High potency typical antipsychotic Side effect:- Impaired thermoregulation leading to intolerance of extremes in environmental temperature (i.e., hypothermia or hyperthermia) 
  • Chlorpromazine Low potency typical antipsychotic
  • Thioridazine Low potency typical antipsychotic
  • Phenelzine MAO inhibitor
  • Isocarboxazid MAO inhibitor
  • Tranylcypromine MAO inhibitor
  • Doxepin TCA
  • Amoxapine TCA
  • Levomilnacipran SNRI
  • Fluvoxamine SSRI
  • Aripiprazole Atypical antipsychotic - D2 partial agonist
  • Lurasidone Atypical antipsychotic
  • Paliperidone Atypical antipsychotic
  • Asenapine Atypical antipsychotic
  • Ziprasidone Atypical antipsychotic - Prolongs QT interval

zurück  |  weiter 1 / 2