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Psychiatric Medications and Adverse Effects
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Psychiatric Medications and Adverse Effects
Psychiatric Medications and Adverse Effects
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1
Question
How does the typical antipsychotic class reduce psychotic symptoms, and what movement risk accompanies it?
Page 3
Answer
Typical antipsychotics primarily block dopamine D2 receptors. This class has a high risk of extrapyramidal symptoms; examples include haloperidol and chlorpromazine.
2
Question
How does risperidone act, and which enzyme affects its concentration?
Page 2
Answer
Risperidone blocks dopamine D2 and serotonin 5-HT2A receptors. CYP2D6 metabolizes it, so inhibitors such as fluoxetine and paroxetine can elevate its blood concentration. Fluoxetine and paroxetine also inhibit serotonin reuptake.
3
Question
What therapeutic lithium level range is identified in this deck?
Page 4
Answer
0.4–1.0.
4
Question
What serious blood adverse effect flags clozapine, and how does it act?
Page 1
Answer
Clozapine can cause agranulocytosis and neutropenia. It acts at multiple receptors, including dopamine D4 and serotonin 5-HT2A receptors.
5
Question
How do benzodiazepines act, and what risks accompany their use?
Page 8
Answer
Benzodiazepines enhance GABA-A receptor activity as positive allosteric modulators. They can cause tolerance and dependence; examples include diazepam, lorazepam, and alprazolam.
6
Question
How does haloperidol act, and which antipsychotic generation is it?
Page 3
Answer
Haloperidol is a conventional (typical) antipsychotic that primarily blocks dopamine D2 receptors.
7
Question
How does aripiprazole act, and which antipsychotic generation is it?
Page 1
Answer
Aripiprazole is an atypical (second-generation) antipsychotic. It is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at 5-HT2A receptors.
8
Question
What characterizes tardive dyskinesia, and how is it linked to antipsychotics?
Page 3
Answer
Tardive dyskinesia involves repetitive involuntary movements of the mouth, face, and tongue and is associated with prolonged dopamine D2 receptor blockade by antipsychotics.
9
Question
How does haloperidol’s mechanism relate to its movement-related adverse effects?
Page 3
Answer
Haloperidol blocks dopamine D2 receptors and has a high risk of extrapyramidal symptoms and tardive dyskinesia.
10
Question
How does aripiprazole act, and which listed conditions is it used for?
Page 1
Answer
Aripiprazole is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at 5-HT2A receptors. Listed uses include schizophrenia, mania and bipolar disorder, autism, and general psychotic symptoms.
11
Question
What rare adverse effect is listed for aripiprazole, and how does it act?
Page 1
Answer
Bone marrow suppression is described as rare. Aripiprazole acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and an antagonist at 5-HT2A receptors.
12
Question
Which movement-related risks are low with aripiprazole, and why?
Page 1
Answer
Extrapyramidal symptoms and tardive dyskinesia risks are low. Aripiprazole’s partial agonism at dopamine D2 receptors differs from the stronger D2 blockade of many antipsychotics.
13
Question
Which serious blood effects can clozapine cause, and how does it act?
Page 1
Answer
Clozapine can cause agranulocytosis and neutropenia. It acts at multiple receptors, including dopamine D4 and serotonin 5-HT2A receptors.
14
Question
What effect do clozapine and olanzapine share, and how do they act?
Page 1
Answer
Both can cause significant weight gain. Clozapine acts at multiple receptors, including D4 and 5-HT2A; olanzapine primarily blocks dopamine D2 and serotonin 5-HT2A receptors.
15
Question
Which anticholinergic effects are listed for olanzapine, and how does it act?
Page 1
Answer
Olanzapine can cause dry mouth, blurry vision, urinary retention or hesitancy, constipation, and memory impairment. It primarily blocks dopamine D2 and serotonin 5-HT2A receptors.
16
Question
How does ziprasidone act, and what listed use and cardiac risk distinguish it?
Page 3
Answer
Ziprasidone blocks dopamine D2 and serotonin 5-HT2A receptors and inhibits serotonin and norepinephrine reuptake. Autism is among its listed indications, and QTc interval prolongation is a listed adverse effect.
17
Question
How does risperidone act, and which prolactin-related effects can occur?
Page 2
Answer
Risperidone blocks dopamine D2 and serotonin 5-HT2A receptors. Prolactin-related effects include gynecomastia, galactorrhea, amenorrhea, menstrual irregularities, decreased libido, and sexual dysfunction.
18
Question
How does risperidone act, and which extrapyramidal symptoms are specified?
Page 2
Answer
Risperidone blocks dopamine D2 and serotonin 5-HT2A receptors. Specified extrapyramidal symptoms include acute dystonia, pseudoparkinsonism, and akathisia.
19
Question
How does quetiapine act, and which psychotic or mood conditions are listed?
Page 2
Answer
Quetiapine blocks serotonin 5-HT2A and dopamine D2 receptors. Listed conditions include schizophrenia, psychotic disorders, and mania.
20
Question
How does haloperidol act, and what additional condition is listed?
Page 3
Answer
Haloperidol primarily blocks dopamine D2 receptors. Tourette syndrome is listed as an additional use beyond psychotic and mood disorders.
21
Question
How does chlorpromazine act, and which nonpsychiatric uses are listed?
Page 3
Answer
Chlorpromazine primarily blocks dopamine D2 receptors. Listed nonpsychiatric uses include antiemetic treatment and treatment of postoperative intractable hiccups.
22
Question
How does lithium act, and what bipolar treatment roles are listed?
Page 4
Answer
Lithium modulates intracellular signaling, including inositol pathways and GSK-3 activity. It is listed for bipolar maintenance treatment and acute mania.
23
Question
How does lithium act, and which non-bipolar uses are listed?
Page 4
Answer
Lithium modulates intracellular signaling, including inositol pathways and GSK-3 activity. Listed non-bipolar uses include augmentation for major depressive disorder, impulsivity, and aggression.
24
Question
How does lithium act, and what long-term organ dysfunction can occur?
Page 4
Answer
Lithium modulates intracellular signaling, including inositol pathways and GSK-3 activity. Long-term kidney dysfunction is a listed adverse effect.
25
Question
How does lithium act, and which endocrine-related effects are listed?
Page 4
Answer
Lithium modulates intracellular signaling, including inositol pathways and GSK-3 activity. Listed endocrine-related adverse effects include elevated TSH and hypoparathyroidism.
26
Question
How does lithium act, and what pregnancy-related risk is listed?
Page 4
Answer
Lithium modulates intracellular signaling, including inositol pathways and GSK-3 activity. Teratogenicity is a listed pregnancy-related risk.
27
Question
How does valproic acid act, and which mood conditions are listed?
Page 4
Answer
Valproic acid increases GABA activity and also affects voltage-gated sodium channels. It is listed for bipolar disorder and mania as a mood stabilizer.
28
Question
How does carbamazepine act, and which serious blood effects can occur?
Page 5
Answer
Carbamazepine blocks voltage-gated sodium channels. Serious listed blood effects include aplastic anemia, agranulocytosis, and leukopenia.
29
Question
How does lamotrigine act, and which pediatric risk is highlighted?
Page 5
Answer
Lamotrigine blocks voltage-gated sodium channels and reduces glutamate release. It has a higher stated risk of Stevens–Johnson syndrome in children.
30
Question
How do SSRIs act, and which shared serious risks are listed?
Page 5
Answer
SSRIs inhibit the serotonin transporter, reducing serotonin reuptake. The listed shared risks are a boxed warning for increased suicidal behavior and serotonin syndrome.