Pharmacology of Antipsychotics and Benzodiazepines
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Questions and Answers

Which side effect is specifically associated with Haloperidol?

  • Urinary retention
  • Tardive dyskinesia (correct)
  • Dry mouth
  • Sedation

What is the primary purpose of adding a benzodiazepine like Lorazepam when administering Haloperidol?

  • To control aggressive behavior (correct)
  • To prevent sedation
  • To enhance mood stabilization
  • To increase dopamine levels

Which medication is indicated for treating severe anxiety but is also known to have a high potential for addiction?

  • Olanzapine
  • Midazolam (correct)
  • Fluoxetine
  • Hydroxyzine

What is a common side effect of the second-generation antipsychotic Olanzapine?

<p>Weight gain (A)</p> Signup and view all the answers

Which of the following medications is a beta-blocker used to alleviate physical symptoms of anxiety?

<p>Propranolol (C)</p> Signup and view all the answers

Which antipsychotic has the potential to cause agranulocytosis and requires regular blood monitoring?

<p>Clozapine (A)</p> Signup and view all the answers

What is a notable side effect of Fluoxetine?

<p>Decreased libido (A)</p> Signup and view all the answers

Which symptom is a sign of Neuroleptic Malignant Syndrome that requires immediate attention?

<p>High fever (C)</p> Signup and view all the answers

Which of the following side effects is common with first-generation antipsychotics like Haloperidol?

<p>Akathisia (D)</p> Signup and view all the answers

What is the typical duration of action for Clonazepam when used as an anxiety medication?

<p>6-12 hours (A)</p> Signup and view all the answers

What is a potential side effect of taking Amitriptyline?

<p>Sedation (C)</p> Signup and view all the answers

Which medication interacts with tyramine and could lead to a hypertensive crisis when taken together?

<p>Selegiline (C)</p> Signup and view all the answers

What is the therapeutic range for Lithium, above which toxicity is a concern?

<p>0.6-1.2 mEq/L (B)</p> Signup and view all the answers

Which medication should NOT be combined with SSRIs?

<p>Venlafaxine (A)</p> Signup and view all the answers

What is a common side effect of Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)?

<p>Dry mouth (D)</p> Signup and view all the answers

Which mood stabilizer requires monitoring of liver function due to potential hepatotoxicity?

<p>Divalproex Sodium (B)</p> Signup and view all the answers

What is a reported side effect of the antipsychotic medication Clozapine?

<p>Agranulocytosis (C)</p> Signup and view all the answers

Which of the following is a common side effect of Bupropion?

<p>Seizures (C)</p> Signup and view all the answers

What condition is treated with propranolol as part of its therapeutic indications?

<p>Performance anxiety (A)</p> Signup and view all the answers

Which class of antidepressants is usually considered first-line treatment for depression?

<p>Selective serotonin reuptake inhibitors (SSRIs) (A)</p> Signup and view all the answers

Which of the following medications can lead to serotonin syndrome if not used carefully?

<p>Fluoxetine (C)</p> Signup and view all the answers

The use of which of the following medications involves a risk of inducing mania without a mood stabilizer?

<p>Venlafaxine (B)</p> Signup and view all the answers

What dietary restriction is crucial for patients taking Monoamine oxidase inhibitors (MAOIs)?

<p>Low tyramine (B)</p> Signup and view all the answers

Which of the following medications is used as a first-line treatment for opioid withdrawal?

<p>Methadone (D)</p> Signup and view all the answers

Flashcards

Haloperidol (Typical Antipsychotic)

A first-generation antipsychotic used to manage positive symptoms of schizophrenia and related conditions, like hallucinations. It is sometimes given with a benzodiazepine like Lorazepam to help control aggressive behavior.

EPS (Extrapyramidal Symptoms)

A range of movement-related side effects caused by some psych meds, including dystonia, parkinsonism, and akathisia.

Tardive Dyskinesia

A potentially irreversible movement disorder that's a long-term side effect of some antipsychotic medications.

Neuroleptic Malignant Syndrome (NMS)

A serious and potentially fatal reaction to antipsychotic medications characterized by high fever, muscle rigidity, and altered mental status.

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Olanzapine (Atypical Antipsychotic)

A second-generation antipsychotic used to manage both positive and negative symptoms of schizophrenia (like lack of motivation).

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Propranolol (Beta-blocker)

Used for anxiety to manage physical symptoms like sweating/trembling.

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Benzodiazepines

A class of medications (like Lorazepam) used for treating anxiety, characterized by a short to intermediate acting duration.

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SSRI (Fluoxetine)

A type of antidepressant that stops the reabsorption of serotonin.

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Anticholinergic effects

Side effects of certain psych meds including dry mouth, constipation, and blurred vision.

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Weight Gain

A possible side effect of some atypical antipsychotics (e.g., Olanzapine).

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Amitriptyline use

Older tricyclic antidepressant, used for sleep or when other antidepressants don't work. Also used for neuropathic pain and fibromyalgia.

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Selegiline/Phenelzine

Older MAOI antidepressants, rarely used due to many drug interactions.

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SSRI medications

First-line treatment for depression (Fluoxetine, Sertraline, Citalopram), selective serotonin reuptake inhibitors.

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SNRI medications

Second-line treatment for depression (Venlafaxine, Duloxetine), serotonin and norepinephrine reuptake inhibitors.

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Bupropion use

Norepinephrine-dopamine reuptake inhibitor, used for depression, ADHD, and smoking cessation. Avoid with alcohol.

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Lithium therapeutic range

0.6-1.2 mEq/L, higher levels cause toxicity.

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Lithium side effects

Tremors, kidney problems, and toxicity (seizures, dehydration) are possible with Lithium.

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Valproate (Divalproex) therapeutic range

50-125 mcg/mL. Higher levels can lead to toxicity.

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Lamotrigine side effect

Steven Johnson's syndrome (a serious skin rash) is a risk, especially within the first few weeks of starting the medication.

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Methylphenidate use

CNS stimulant used for ADHD; exists in short-acting, intermediate-acting, and long-acting forms.

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Atomoxetine

Non-stimulant ADHD medication; a norepinephrine reuptake inhibitor; second-line treatment.

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Naltrexone

Medication that reduces alcohol cravings and decreases alcohol effects.

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Disulfiram

Medication that causes unpleasant effects if alcohol is consumed while taking it.

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Naloxone

Opioid antagonist, typically used in opioid overdose situations, poor oral absorption.

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Study Notes

Haloperidol

  • First-generation typical antipsychotic, controls positive symptoms of schizophrenia and Tourette's.
  • Used with benzodiazepines (like Lorazepam) to manage aggressive behavior.
  • Side effects include extrapyramidal symptoms (EPS), tardive dyskinesia, and sedation.
  • Risk of neuroleptic malignant syndrome (NMS), characterized by high fever and tremors.
  • Benztropine may be used to reduce EPS.

Diphenhydramine

  • Antihistamine, a first-generation antihistamine.
  • Side effects include sedation, urinary retention, and difficulty with bowel movements (constipation).
  • Can be used to prevent dystonic reactions.

Midazolam

  • Fast-acting benzodiazepine.
  • Highly addictive and not suitable for long-term use.
  • Common side effects include sedation and suppression of vital signs (ABCs) and should avoid activities that require alertness.
  • Should not be stopped abruptly.

Olanzapine

  • Second-generation atypical antipsychotic.
  • Controls positive and negative symptoms of schizophrenia.
  • Side effects include weight gain, decreased libido, and neutropenia (low white blood cell count).
  • Monitor blood sugar and signs of infection.

Ziprasidone

  • Atypical antipsychotic, balancing dopamine levels in the brain.

Hydroxyzine

  • Antihistamine (PRN).
  • Immediate action (15-30 minutes).
  • Side effects include dry mouth and drowsiness.
  • Dosage: 25-50mg 4 times daily with a maximum dose of 100mg.

Lorazepam

  • Benzodiazepine (short-intermediate acting, PRN).
  • 20-40 minutes to take effect, with duration of 4-6 hours.
  • Side effects include drowsiness and sedation.
  • Dosage: 0.5-2mg 2-3 times daily, with a maximum of 10mg/day.

Clonazepam

  • Intermediate-acting benzodiazepine (PRN).
  • Take effect in 20-40 minutes, lasting 6-12 hours.
  • Side effects include ataxia (loss of coordination), dizziness, and drowsiness.
  • Dosage: 0.25-1mg 1-2 times daily, with a maximum of 4mg daily.

Fluoxetine

  • Selective serotonin reuptake inhibitor (SSRI)
  • May need 2-12 weeks to show improvements
  • Side effects include decreased libido, sexual dysfunction, dry mouth, headache, insomnia, and tremors, in addition to common GI issues
  • Dosage: 10-20 mg daily, maximum 60mg daily.

Propranolol

  • Beta-blocker (PRN).
  • Takes 30-60 minutes to act, lasting 6-12 hours.
  • Side effect includes hypotension
  • Dosage: 10-20 mg 30-60 minutes prior to anxiety-provoking situations.

Other Antipsychotics (First and Second Generation)

  • First-generation antipsychotics (typical) include Haloperidol and Fluphenazine. They primarily target positive symptoms of psychosis.
  • Second-generation antipsychotics (atypical) such as Aripiprazole, Clozapine, Olanzapine, Risperidone, Quetiapine, and Ziprasidone target both positive and negative symptoms.

Other Medications

  • Amitriptyline (TCA) - older antidepressant for sleep issues (when other meds don't work).
  • Bupropion - can be used with SSRIs with a focus on the treatment of depression, ADHD, and smoking cessation.
  • Methylphenidate and dextroamphetamine - stimulants used to treat ADHD, with possible side effects including mania or growth suppression.
  • Atomoxetine - non-stimulant ADHD medication.
  • Clonidine - Anti-hypertensive; used in severe cases of withdrawal.
  • Guanfacine - Anti-hypertensive.
  • Lithium - Mood stabilizer with therapeutic range from 0.6-1.2 mEq/L
  • Divalproex Sodium (Valproate) Mood stabilizer and anticonvulsant
  • Lamotrigine - used in bipolar disorder.

Withdrawal from Nicotine

  • Nicotine gum, lozenge, or patches can be used for cessation.
  • Place the gum between the cheek and gum, and bite slowly until tingling stops.

Important Considerations

  • Monitoring: Close monitoring of vital signs and potential side effects is crucial for psychiatric medications.
  • Interactions: Many psychiatric medications interact with other medications, including those over-the-counter and herbal remedies.
  • Patient Education: Educating patients about their medications, potential side effects, and interactions is vital.
  • Diet: Tyramine-containing foods are avoided when taking certain medications.
  • Pregnancy: Not all medications are safe to take during pregnancy. Consult with healthcare provider.
  • Risk and side effects of different medications: Be aware of the range of side effects and the seriousness of some of them, like the risks of seizures, strokes, and heart problems, or liver issues. There are also issues surrounding drug interactions
  • Important warnings: Be aware of severe risks from medications with warning labels.

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Description

This quiz covers the key features and side effects of various psychiatric medications including Haloperidol, Diphenhydramine, Midazolam, and Olanzapine. Delve into the mechanisms, risks, and therapeutic uses of these drugs in managing mental health conditions and treating aggressive behavior.

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