Psychiatry Week 9 Mega Cool Flashcard Set

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What is the MOA for Zurzuvae (Zuranolone)?

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1

What is the MOA for Zurzuvae (Zuranolone)?

Neuroactive steroid gamma-aminobutyric (GABA) A receptor positive modulator

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2

What are some precautions for Zurzuvae (Zuranolone)?

  1. Patients should not be performing hazardous activities for at least 12 hours after administration

  2. Eat some fat ass food

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3

What is the MOA for Exxua (Gepirone)?

Selective serotonin 1A (5HT1A) agonist

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4

What are the precautions for Exxua (Gepirone)?

  1. Dizziness, nausea, and insomnia

  2. QT prolongation is a no no

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5

Is it normal to take a MAO-inhibitor with other antidepressants?

Fuck no, you take this BY ITSELF

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6

What antidepressant class can be used as a patch?

Mao-I

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7

Why is MAO-I not a popular choice for depression?

It has many food and drug interactions that can cause hypertension crisis for patients (you can treat this with stopping the drug)

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8

What serotonin syndrome symptoms are common?

  1. Having too much serotonin

  2. Restlessness

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9

What serotonin withdrawal symptoms are common?

  1. Brain zaps, ooo ow dont hurt em

  2. Losing serotonin asf

  3. Need to be tapered off (not a symptom but whatever)

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10

Is Electroconvulsive therapy (ECT) good? How long is it and when do you resort to this?

> 90% efficacy with 6-12 weeks of treatment. Usually used for severe mood

disorders, psychotic depression, pregnancy, and patients with intense SI/SA

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11

What is Transcranial magnetic stimulation (TMS)?

External device that delivers focused MRI strength magnetic pulses to the brain

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12

What is Vagus nerve stimulation (VNS)?

Mild electrical pulses applied to the for transmission to the brain; FDA approved

for epilepsy

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13

Is St. John’s wort an inhibitor or an inducer?

CYP3A4 inducer

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14

Why is taking tramadol and SSRI a no no?

Both affect serotonin so you can get serotonin syndrome

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15

How do you treat bipolar depression compared to major depression?

Mood stabilizer and an atypical antipsychotic

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16

What is DIGFAST?

Its an acronym for the symptoms of mania:

Distractibility

Indiscretion

Grandiosity

Flight of ideas or racing thoughts

Activity increased

Sleep deficit

Talkativeness

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17

When you put someone on lithium, what are the base labs yhu must do?

BUN, SCr, urine specificity gravity, CBC with differential, T3, T4, and TSH

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18

When do you take plasma levels to check therapteuc lithium levels?

8-12 hours after the dose is administered

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19

What are the acute and maintain phase levels for lithium?

Acute phase: .8-1.2mEq/L

Maintenance phase: .6-1.2 mEq/L

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20

Someone on lithium wants to take a pain med, which one do you tell them to avoid?

Dont take NSAIDS

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21

Lets say you get on valproic acid instead of lithium, what are the advantages and disadvantages?

Advantages: Lower risk of overdose and less DDI

Disadvantages: Not as good for preventing suicide and it is not as efficacious

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22

Usually lithium is the gold standard, when would we choose valproic acid over lithium?

  1. There’s no response to lithium

  2. The pt is at a high risk for overdose

  3. Pt has renal disease

  4. Pt is a rapid cycler

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23

Because carbamazepine is an inducer what should you be aware of in terms of taking birth control?

They can decrease the concentration of an oral contraceptives

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24

Which drugs can cause Stevens-johnson syndrome?

Carbamazepine and lamotrigine

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25

When do we use atypical antipsychotics?

As an adjunct with a mood stabilizer

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26

What are some long term ADR that come with taking an atypical antipsychotic?

Lipids and triglycerides go up

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27

What type of channel is GABAa receptor?

Chloride ion

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28

What activates GABAa?

GABA neurotransmitter

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29

What kinda structure is the GABAa receptor?

It is pentameric

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30

What is the MOA for benzodiazepines?

Facilitate the GABA action on the GABAA receptor → increases the open probability of the GABAA receptor

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31

What kind of drug is buspirone?

Partial 5HT1a agonist

Antagonist at D2 receptor

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32

What is the MOA for beta blockers?

block the beta 1 adrenergic receptor → reduces peripheral autonomic symptoms

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33

What do beta blockers do to your blood pressure?

Lower it

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