Psychiatry Week 9 Mega Cool Flashcard Set

What is the MOA for Zurzuvae (Zuranolone)?

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

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

What is the MOA for Exxua (Gepirone)?

Selective serotonin 1A (5HT1A) agonist

What are the precautions for Exxua (Gepirone)?

1. Dizziness, nausea, and insomnia

2. QT prolongation is a no no

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

Fuck no, you take this BY ITSELF

What antidepressant class can be used as a patch?

Mao-I

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)

What serotonin syndrome symptoms are common?

1. Having too much serotonin

2. Restlessness

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)

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

What is Transcranial magnetic stimulation (TMS)?

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

What is Vagus nerve stimulation (VNS)?

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

for epilepsy

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

CYP3A4 inducer

Why is taking tramadol and SSRI a no no?

Both affect serotonin so you can get serotonin syndrome

How do you treat bipolar depression compared to major depression?

Mood stabilizer and an atypical antipsychotic

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

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

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

8-12 hours after the dose is administered

What are the acute and maintain phase levels for lithium?

Acute phase: .8-1.2mEq/L

Maintenance phase: .6-1.2 mEq/L

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

Dont take NSAIDS

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

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

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

Which drugs can cause Stevens-johnson syndrome?

Carbamazepine and lamotrigine

When do we use atypical antipsychotics?

As an adjunct with a mood stabilizer

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

Lipids and triglycerides go up

What type of channel is GABAa receptor?

Chloride ion

What activates GABAa?

GABA neurotransmitter

What kinda structure is the GABAa receptor?

It is pentameric

What is the MOA for benzodiazepines?

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

What kind of drug is buspirone?

Partial 5HT1a agonist

Antagonist at D2 receptor

What is the MOA for beta blockers?

block the beta 1 adrenergic receptor → reduces peripheral autonomic symptoms

What do beta blockers do to your blood pressure?

Lower it