2023 Pharmacology ATI Proctored
Benzodiazepines - CORRECT ANSWER-Includes "Pams" Alprazolam, diazepam,
lorazepam, oxazepam, clonazepam, chlordiazepoxide, chlorazepate
Enhances GABA: increased GABA means decreased neuron activity
Treats anxiety, PTSD, seizures, alcohol withdrawal, muscle spasm, induction
of anesthesia
Usually short term; if long term do NOT stop
abruptly Antidote is flumazenil
Side effects: CNS depression - sedation and respiratory depression,
amnesia, dependency, and withdrawal effects
Atypical anxiolytic - CORRECT ANSWER-
Buspirone Can take 2-6 weeks to work, but
can be long term!
Treats panic disorder, anxiety, OCD, and PTSD
Side effects: dizziness, nausea (take w/ food to relieve), headache (sedation and
dependency is not seen like in benzo)
Trick to remember difference between Benzodiazepine and buspirone -
CORRECT ANSWER-"Pam" has anxiety, so she goes on a "benzo" and takes
it for a long time but realizes that it is not healthy. So she takes a "bus" to a
"pier" to sit "alone" and decides to treat her anxiety long term with
"buspirone"
Selective Serotonin Reuptake Inhibitors (SSRIs) - CORRECT ANSWER-Usually
end in "ine": paroxetine, sertraline, citalopram, escitalopram, fluoxetine,
fluvoxamine
Inhibits serotonin reuptake" increases
serotonin Treats anxiety, OCD, PTSD, and
depression
Side effects: nausea, fatigue, sexual dysfunction, weight gain, insomnia
(paroxetine), serotonin syndrome (agitation, hallucinations, tremors, fever,
diaphoresis)
Takes about four weeks after treatment begins to take full effect.
Atypical Antidepressants - CORRECT ANSWER-Bupropion, Trazodone - more
important
Others: Vilazodone, mirtazapine, reboxetine
Treats depression and aid for smoking
cessation
Side effects: headache, GI distress, insomnia, nausea, weight loss, seizures
Tricyclic antidepressants - CORRECT ANSWER-Amitriptyline
Treats depression, neuropathic pain, fibromyalgia, anxiety
disorders, insomnia Side effects: Anticholinergic effects, Sedation,
Seizures, Sweating (SSS) "Amy tripped over a tricycle in the
,desert."
Amitriptyline is a tricyclic antidepressant and causes effects that make you
feel like you're in the desert.
,Anticholinergic efffects - CORRECT ANSWER-dry mouth, blurred vision,
photophobia, urinary hesitancy or retention, constipation, tachycardia
Monoamine oxidase inhibitors - CORRECT ANSWER-Phenelzine (Prototype),
Isocarboxazid, tranylcypromine, selegiline
Side effects: CNS stimulation, Orthostatic hypotension, hypertensive crisis
(especially with phenelzine).
Tyramine rich foods can lead to hypertensive crisis
Foods that contain tyramine - CORRECT ANSWER-aged cheese, pepperoni,
salami, avocados, figs, bananas, smoked fish, protein dietary supplements,
soups, soy sauce, some beers, and red wine
Mood stabilizer - CORRECT ANSWER-Lithium
Carbonate Treats bipolar disorder
Side effects: GI distress, fine hand tremors, polyuria, weight gain, renal toxicity,
renal toxicity, hypothyroidism, electrolyte imbalance
Lithium toxicity: occurs with levels over 1.5; presents with COARSE (not
fine) hand tremors, confusion, tinnitus, seizures, hypotension, coma,
possibly death.
Do not give with diuretics, NSAIDs, or
anticholinergics Need a balance of sodium and
water.
Mood - stabilizing antiepileptic - CORRECT ANSWER-Carbamazepine,
valproic acid Treats Bipolar disorder and seizure disorder
Carbamazepine side effects: blood dyscrasias, hypo-osmolality
Valproic acid side effects: *hepatotoxicity,* pancreatitis, thrombocytopenia
Antipsychotics: First-generation (conventional) - CORRECT ANSWER-
Chlorpromazine, Haloperidol
TONS of side effects-will only list important ones
Extrapyramidal side effects: Acute dystonia- spasms of tongue, neck, face,
or back; Parkinsonism- rigidity, shuffling gait, drooling, tremors; akathisia-
unable to sit or stand still; tardive dyskinesia - involuntary movement of
tongue and face
EPS effects may be able to be treated with anticholinergic medication if the
patient does not have anticholinergic side effects.
Neuroleptic Malignant Syndrome: sudden high grade fever, dysrhythmias,
muscle rigidity
There is a long lasting injection for non-compliant patients.
Antipsychotics: second and third generation (atypical) - CORRECT ANSWER-
Risperidone and Clozapine - most important
Often first line in treating
schizophrenia Treats negative and
positive symptoms
Side effects: diabetes mellitus, weight gain, hypercholesterolemia,
orthostatic hypotension, anticholinergic effects
, Do not take with alcohol.
IM every two weeks available for those who are not compliant
Central Nervous system stimulants - CORRECT ANSWER-Methylphenidate and
Amphetamine mixture
Treats ADHD and Conduct disorder
Can cause insomnia, decreased appetite, weight loss, and growth
suppression Do not give at night. Give immediately before or after a
meal. Monitor weight.
Medications to support withdrawal from alcohol - CORRECT ANSWER-
Benzodiazepines:
Chlordiazepoxide, lorazepam,
diazepam First line treatment of
alcohol withdrawal
Keeps vitals within expected limits, decreases risk of seizures
Clonidine and Propranolol depress autonomic response and decrease vitals
Carbamazepine Further decreases risk of seizure
Disulfiram - CORRECT ANSWER-Daily oral medication to sustain abstinence
of alcohol; type of aversion therapy
Causes nausea, vomiting, sweating, palpitations, and hypotension if alcohol
is consumed
Naltrexone - CORRECT ANSWER-Suppresses the craving and pleasurable effects
of alcohol.
Can have monthly IM injection
Acamprosate - CORRECT ANSWER-Decreases unpleasant effects resulting from
abstinence like dysphoria, anxiety, restlessness
Medications to support withdrawal/abstinence from opiods - CORRECT ANSWER-
Methadone Substitution
Slow weening process
Methadone substitution is an oral opioid agonist that replaces the opioid to
which the client has a physical dependence
It prevents abstinence syndrome and removes the need for the client to obtain
illegal substances.
Used for withdrawal and long term maintenance.
Withdrawal/abstinence from nicotine - CORRECT ANSWER-
Bupropion Nicotie gum, patch, or nasal spray
Varenicline: a nicotine receptor agonist. Reduces cravings as well as
withdrawal effects. Depression and suicidal effects can occur.
Cholinesterase inhibitors - CORRECT ANSWER-Neostigmine, Physostigmine,
Edrophonium (dx MG)
Benzodiazepines - CORRECT ANSWER-Includes "Pams" Alprazolam, diazepam,
lorazepam, oxazepam, clonazepam, chlordiazepoxide, chlorazepate
Enhances GABA: increased GABA means decreased neuron activity
Treats anxiety, PTSD, seizures, alcohol withdrawal, muscle spasm, induction
of anesthesia
Usually short term; if long term do NOT stop
abruptly Antidote is flumazenil
Side effects: CNS depression - sedation and respiratory depression,
amnesia, dependency, and withdrawal effects
Atypical anxiolytic - CORRECT ANSWER-
Buspirone Can take 2-6 weeks to work, but
can be long term!
Treats panic disorder, anxiety, OCD, and PTSD
Side effects: dizziness, nausea (take w/ food to relieve), headache (sedation and
dependency is not seen like in benzo)
Trick to remember difference between Benzodiazepine and buspirone -
CORRECT ANSWER-"Pam" has anxiety, so she goes on a "benzo" and takes
it for a long time but realizes that it is not healthy. So she takes a "bus" to a
"pier" to sit "alone" and decides to treat her anxiety long term with
"buspirone"
Selective Serotonin Reuptake Inhibitors (SSRIs) - CORRECT ANSWER-Usually
end in "ine": paroxetine, sertraline, citalopram, escitalopram, fluoxetine,
fluvoxamine
Inhibits serotonin reuptake" increases
serotonin Treats anxiety, OCD, PTSD, and
depression
Side effects: nausea, fatigue, sexual dysfunction, weight gain, insomnia
(paroxetine), serotonin syndrome (agitation, hallucinations, tremors, fever,
diaphoresis)
Takes about four weeks after treatment begins to take full effect.
Atypical Antidepressants - CORRECT ANSWER-Bupropion, Trazodone - more
important
Others: Vilazodone, mirtazapine, reboxetine
Treats depression and aid for smoking
cessation
Side effects: headache, GI distress, insomnia, nausea, weight loss, seizures
Tricyclic antidepressants - CORRECT ANSWER-Amitriptyline
Treats depression, neuropathic pain, fibromyalgia, anxiety
disorders, insomnia Side effects: Anticholinergic effects, Sedation,
Seizures, Sweating (SSS) "Amy tripped over a tricycle in the
,desert."
Amitriptyline is a tricyclic antidepressant and causes effects that make you
feel like you're in the desert.
,Anticholinergic efffects - CORRECT ANSWER-dry mouth, blurred vision,
photophobia, urinary hesitancy or retention, constipation, tachycardia
Monoamine oxidase inhibitors - CORRECT ANSWER-Phenelzine (Prototype),
Isocarboxazid, tranylcypromine, selegiline
Side effects: CNS stimulation, Orthostatic hypotension, hypertensive crisis
(especially with phenelzine).
Tyramine rich foods can lead to hypertensive crisis
Foods that contain tyramine - CORRECT ANSWER-aged cheese, pepperoni,
salami, avocados, figs, bananas, smoked fish, protein dietary supplements,
soups, soy sauce, some beers, and red wine
Mood stabilizer - CORRECT ANSWER-Lithium
Carbonate Treats bipolar disorder
Side effects: GI distress, fine hand tremors, polyuria, weight gain, renal toxicity,
renal toxicity, hypothyroidism, electrolyte imbalance
Lithium toxicity: occurs with levels over 1.5; presents with COARSE (not
fine) hand tremors, confusion, tinnitus, seizures, hypotension, coma,
possibly death.
Do not give with diuretics, NSAIDs, or
anticholinergics Need a balance of sodium and
water.
Mood - stabilizing antiepileptic - CORRECT ANSWER-Carbamazepine,
valproic acid Treats Bipolar disorder and seizure disorder
Carbamazepine side effects: blood dyscrasias, hypo-osmolality
Valproic acid side effects: *hepatotoxicity,* pancreatitis, thrombocytopenia
Antipsychotics: First-generation (conventional) - CORRECT ANSWER-
Chlorpromazine, Haloperidol
TONS of side effects-will only list important ones
Extrapyramidal side effects: Acute dystonia- spasms of tongue, neck, face,
or back; Parkinsonism- rigidity, shuffling gait, drooling, tremors; akathisia-
unable to sit or stand still; tardive dyskinesia - involuntary movement of
tongue and face
EPS effects may be able to be treated with anticholinergic medication if the
patient does not have anticholinergic side effects.
Neuroleptic Malignant Syndrome: sudden high grade fever, dysrhythmias,
muscle rigidity
There is a long lasting injection for non-compliant patients.
Antipsychotics: second and third generation (atypical) - CORRECT ANSWER-
Risperidone and Clozapine - most important
Often first line in treating
schizophrenia Treats negative and
positive symptoms
Side effects: diabetes mellitus, weight gain, hypercholesterolemia,
orthostatic hypotension, anticholinergic effects
, Do not take with alcohol.
IM every two weeks available for those who are not compliant
Central Nervous system stimulants - CORRECT ANSWER-Methylphenidate and
Amphetamine mixture
Treats ADHD and Conduct disorder
Can cause insomnia, decreased appetite, weight loss, and growth
suppression Do not give at night. Give immediately before or after a
meal. Monitor weight.
Medications to support withdrawal from alcohol - CORRECT ANSWER-
Benzodiazepines:
Chlordiazepoxide, lorazepam,
diazepam First line treatment of
alcohol withdrawal
Keeps vitals within expected limits, decreases risk of seizures
Clonidine and Propranolol depress autonomic response and decrease vitals
Carbamazepine Further decreases risk of seizure
Disulfiram - CORRECT ANSWER-Daily oral medication to sustain abstinence
of alcohol; type of aversion therapy
Causes nausea, vomiting, sweating, palpitations, and hypotension if alcohol
is consumed
Naltrexone - CORRECT ANSWER-Suppresses the craving and pleasurable effects
of alcohol.
Can have monthly IM injection
Acamprosate - CORRECT ANSWER-Decreases unpleasant effects resulting from
abstinence like dysphoria, anxiety, restlessness
Medications to support withdrawal/abstinence from opiods - CORRECT ANSWER-
Methadone Substitution
Slow weening process
Methadone substitution is an oral opioid agonist that replaces the opioid to
which the client has a physical dependence
It prevents abstinence syndrome and removes the need for the client to obtain
illegal substances.
Used for withdrawal and long term maintenance.
Withdrawal/abstinence from nicotine - CORRECT ANSWER-
Bupropion Nicotie gum, patch, or nasal spray
Varenicline: a nicotine receptor agonist. Reduces cravings as well as
withdrawal effects. Depression and suicidal effects can occur.
Cholinesterase inhibitors - CORRECT ANSWER-Neostigmine, Physostigmine,
Edrophonium (dx MG)
