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Challenging Psych Issues
Special Populations Exam 1
38
Pharmacology
Professional
02/18/2014

Additional Pharmacology Flashcards

 


 

Cards

Term
ACHe-I SEs
Definition
GI, bradycardia, bronchospasm
Term
citalopram
Definition
good choice for anxiety
Term
SNRIs, fluoxetine, sertraline, paroxetine
Definition
may be more stimulating
Term
sertraline and citalopram
Definition
preferred SSRIs in elderly
Term
low dose SSRI (citalopram 5 mg)
Definition
reduce fall risk and avoid GI effects
Term
QTc interval prolongation
Definition
citalopram max dose of 20 mg/day in >60 year old
Term
fluoxetine
Definition
most stimulating
Term
sertraline
Definition
second most stimulating
Term
paroxetine
Definition
wild card
Term
escitalopram
Definition
most neutral
Term
citalopram
Definition
most calming
Term
mirtazapine
Definition
useful for depression, inducing sleep, appetite stimulation
Term
more drowsiness at lower doses (7.5-15mg)
Definition
mirtazapine
Term
norepinephrine
Definition
greater effect at higher doses
Term
mirtazapine blockade
Definition
strong H1 blocker but low anticholinergic
Term
BPSD more acute situations
Definition
aggressiveness threat to oneself or others; hallucinations with distress
Term
melatonin
Definition
may be useful in more mild cases or sensitive patients
Term
trazodone
Definition
may be calming for some
Term
low doses of trazodone
Definition
avoids orthostatic hypotension (25-50mg)
Term
agressiveness
Definition
anti-convulsants (carbamazepine)
Term
induces CYP2C19 and 3A4
Definition
carbamazepine
Term
depakote (valproate)
Definition
may accelerate brain damage in dementia (evidence does not support use in aggressive BPSD)
Term
benzos generally not recommended
Definition
may be effective for anxiousness/ lack of sleep
Term
paradoxical response can be caused by
Definition
benzos
Term
benzos of choice for BPSD
Definition
lorazepam, temazepam and oxazepam
Term
long-acting benzos with active metabolites
Definition
diazepam, flurazepam, chlorazepate (avoid use in dementia patients)
Term
danger from the hallucinations
Definition
anti-psychotics are most effective
Term
atypicals and typicals
Definition
carry a black box warning in dementia patients; increased risk of death
Term
when should anti-psychotics be used
Definition
only if patient is at risk of harming his/herself or others
Term
using anti-psychotics
Definition
try other meds first, check for appropriate dose, monitor carefully for CNS depression
Term
risperidone (Risperdal)
Definition
strongest evidence dementia overall, psychosis and agitation
Term
Olanzapine (zyprexa)
Definition
may worsen psychosis in some patients, ok data for agitation
Term
aripiprazole (abilify)
Definition
may help more in areas other than psychosis or agitation, not generally used in dementia patients
Term
quetiapine (seroquel)
Definition
lacks evidence , no benefit for agitation/ psychosis in dementia over placebo
Term
2nd generation (atypicals)
Definition
have a broader effect on additional neurotransmitters (besides dopamine)
Term
1st generation (typicals)
Definition
haloperidol, only good for aggression
Term
akathisia
Definition
not common in eldery (wandering worse, looks like agitation); SE of antiphych
Term
SEs of antiphychotics
Definition
parkinsonism, dystonia, akathisia and tardive dyskinesia
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