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34 Cards in this Set
- Front
- Back
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classic Tricyclic Antidepressant used in treatment of enuresis. a prototype tricyclic antidepressant
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Imipramine (TOFRANIL, JANIMINE)
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a mood stabilizer that inhibits regeneration of Inositol(pnt suffering from clinical depression generally have decreased levels of inositol in cerebrospinal fluid) (notorious for drug interactions)
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*Lithium (treatment of manic depressive (bipolar) disorders is becoming common)
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difficult to distinguish between alcohol intoxication and intoxication with this drug. to treat intox: sympt support, hemodialysis, induce diuresis
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*Lithium
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list some toxic effects of *Lithium a Ginger Jensen's drug of choice
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hypothyroidism
polydipsia and polyuria kidney damage-nephrogenic diabetes insipidus weight gain, derm, teratogenic |
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Second generation antidepressants to treat general anxiety disorder. Less cardiovascular SE. A mild stimulant->"energizes" depressed individuals, treatment of ADHD in children
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Venlafaxine (EFFEXOR) and Desvenlafaxine (PRISTIQ)
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Second generation antidepressant useful in pnts with high levels of anxiety. novel mechanism of action: blocks presynaptic alpha-2 adrenergic receptors
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Mirtazepine (REMERON)
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the only MAO(Monoamine oxidase) Inhibitor (P.E.T.)that contains a hydriazide group that can form a covalent bond with MAO
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Phenelzine (NARDIL). After the rx has been used it takes several weeks for new MAO to be synthesized
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a newer Second generation antidepressant that resembles Venlafaxine (EFFEXOR)
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Duloxetine (CYMBALTA)
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Selective Norepinephrine Reuptake Inhibitor approved for treatment of ADHD in children and adults. SE: suppression of appetite, decreased weight gain, increased BP->HTN!!!, tachycardia, sexual dysfunction in adult dudes
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Atomoxetime (STRATTERA)
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Second generation antidepressant used for treatment of cocaine, nicotine and amphetamine dependence. less likely to produce seizures
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Bupropion (WELLBUTRIN)
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Selective Serotonin Reuptake Inhibitor (SSRI)with much less sedation, anticholinergic and cardiovascular effects than tryciclics; metabolized in liver and metabolites are active unlike paroxetine (PAXIL)(potential drug interactions)
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Fluoxetine (PROZAC)
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Selective Serotonin Reuptake Inhibitor (SSRI) for treatment of OCB (obsessive-compulsive disorder)
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Fluvoxamine (LUVOX)
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MAO(Monoamine oxidase) Inhibitor available in patch preparations. MAO-B inhibitor (MAO-B metabolizes preferentially DA )
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Eldepryl (EMSAM)
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classic (Tricyclic) Antidepressant with the worst anticholinergic SE(worst dry mouth, constipation, urine retention, loss of visual accommodation, etc), most powerful sedation and CV effects of all tricyclic
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Amitriptyline (ELAVIL)
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Mood stabilizer. Caution in pnts with impaired renal function
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Lithium carbonate (ESKALITH & others) therapeutic 0.8-1.4
toxic above 2.0 mEq/l 4-5 days to reach steady state plasma concentration |
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Mood stabilizer, anti-epileptic. Treatment of manic depressive (bipolar) disorders is becoming common
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Valproic Acid Analogs (DEPAKENE/DEPAKOTE)
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newest Selective Serotonin Reuptake Inhibitor (SSRI)for treatment of Affective disorders
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Escitalopram (LEXAPRO)
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Mood Stabilizer, anti-epileptic. Treatment of manic depressive (bipolar) disorders is becoming common
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Carbamazepine (TEGRETOL)
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Mood Stabilizer, anti-epileptic. Treatment of manic depressive (bipolar) disorders is becoming common
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Clonazepam (KLONOPIN)
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Second generation antidepressant that is very sedating, thus used as a night time drug in depressed pnts
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Trazadone (DESYREL)
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Second generation antidepressant, similar to Trazadone (DESYREL)
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Nefazodone (SERZONE)
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Selective Serotonin Reuptake Inhibitor (SSRI) that is metabolized rapidly (T1/2 10 hrs vs 2-3days for fluoxetine(PROZAC)
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Paroxetine (PAXIL)
does not form active metabolites. 5HT reuptake inhibitor like Sertraline (ZOLOFT) and Fluvoxamine (LUVOX) |
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normalize sleep patterns
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MAO(Monoamine oxidase) inhibitors: phenelzine (NARDIL), tranylcypromine (PARNATE), selegine & eldepryl (EMSAM),
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hypertension caused by interaction with tyramine (cheese toxicity)
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MAO(Monoamine oxidase) inhibitors: phenelzine (NARDIL), tranylcypromine (PARNATE), eldepryl (EMSAM)
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a useful alternative to stimulants to treat attention deficit disorders in children, a second generation antidepressant that "energizes" depressed individuals, fewer CV effects
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Venlafaxine (EFFEXOR)
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the only second generation that changes receptor density with chronic use (also a strong reuptake inhibitor of DA). a stimulant activity of a "psychic energizer". treatment of cocaine, amphetamine and nicotine dependence
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Bupropion (WELLBUTRIN)
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in OD with tricyclic antidepressants (Imipramine and Amitriptyline)
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Na2HCO3 Sodium bicarb
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make sure tryciclics are cleared before switching to a new antidepressant
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2-4 weeks
btw: weight gain is more common with tricyclics |
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SSRI's have the least anticholinergic effect
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Fluoxetine (PROZAC), Fluvoxamine (LUVOX), Sertraline (ZOLOFT), Paroxetine (PAXIL), Citalopram (CELEXA), Escitalopram (LEXAPRO)
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serotonin syndrome is characterized by:
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tremors hypertension, hyperpyrexia and seizures
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MAO -A
MAO-B |
-preferentially metabolizes NE & 5HT
- -//- DA |
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MOA inhibitors: (P.E.T.) Phenelzine, Eldepryl, Tranylcypromine - all have potentially lethal interactions with tyramine (present in foods) except...
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Eldepryl (EMSAM)- selective MAO-B inhibitor, patch preparations
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like with switching from tricyclic to any other drug, switching from MAO inhibitor to tricyclic wait for...
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3-4 weeks
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bulimia, obsessive-compulsive disorder, post-traumatic stress syndrome, narcolepsy treated with
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MAO inhibitors (P.E.T.) Phenelzine, Eldepryl, Tranylcypromine
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