HAM side effects: - ANSWER-1. anti-Histamine: sedation, weight gain
2. anti-Adrenergic: hypotension
3. anti-Muscarinic: dry mouth, blurred vision, urinary retention
In which medications do you see HAM side effects? - ANSWER-TCAs
and low-potency antipsychotics
What is Serotonin Syndrome? - ANSWER-Confusion
Flushing, Diaphoresis, Hyperthermia
Tremor
Hypertonicity, Rhabdomyolysis, Renal failure
Death
When does Serotonin Syndrome occur? - ANSWER-Classically when
SSRIs and MAOIs are combined
What causes a hypertensive crisis? - ANSWER-Buildup of stored
catecholamines: MAOIs + foods with Tyramine or/+
Sympathomimetics
What are Extrapyramidal Side Effects? - ANSWER-1. Parkinsonism
2. Akathisia
3. Dystonia
,EPS traditionally occur with which class of medications? - ANSWER-
High Potency traditional antipsychotics
EPS occur within what time frame of starting meds? - ANSWER-
Within days
EPS can be life threatening, why? - ANSWER-Dystonia of
diaphragm=Asphyxia
Choice drug to treat EPS produced by neuroleptics is? - ANSWER-
Benztropine/Cogentin
Hyperprolactinemia occurs with what meds? - ANSWER-High potency
traditional antipsychotics and risperidone
Tardive dyskinesia is? - ANSWER-Choreoathetoid muscle
movements, usually of mouth and tongue. Occurs YEARS after
antipsychotic use. Can be irreversible. Looks like grimacing and
tongue protrusion.
What is Neuroleptic Malignant Syndrome? - ANSWER-Fever, Tachy,
Hypertension, Tremor
Elevated CPK
Lead pipe rigidity
, NMS can be caused by? - ANSWER-Caused by antipsychotics after
short or long term. MED EMERGENCY with 20% mortality rate
What are common CYP450 enzymes important in metabolizing
psychiatric drugs? - ANSWER-CYP1A2
CYP2C9, CYP2C19
CYP2D6 CYP3A4
CYP450 Inducers: decreases level of drugs in the system due to
"Inducing metabolism," include: - ANSWER-Smoking (1A2)
Carbamezipine (1A2, 2C9, 3A4)
Barbiturates (2C9)
St. John's Wort (2C19, 3A4)
Anticholinergics are known to exacerbate what disease? - ANSWER-
Alzheimer's disease
Fluoxetine (Prozac): - ANSWER-1. longest half-life: no need to taper
2. safe in pregnancy
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