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58 Cards in this Set

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what is the most important neurotranmitter when it comes to depression?
serotonin 5ht...also other catecholamines (dopamin, Nepi, epi)
There is no way to measure the levels of NT so treatment is mainly a good assessmnte ant trial and error
k
4 classes of drugs that can cause or worsen depression (important)
CV (BB, clonidine, methyldopa, procainamide, reserpine), hormonal (anabolic steroids, corticosteroids, estrogen or prog), cns (barbs, benzos, ethanol), other (indomethacin, interferon, narcotics)
If a patient is having suicidal ideation how do we deal with them?
ER
which SSRI has thelongest Half life and CAN be stopped suddenly?
fluoxetine
what is the SE pneumogram for paroxetine?
flat and fat (flat affect and weight gainO...anticholinergic
what are other SE of SSRI's
decreased libido, ejaculation diff, anorgasmia, GI effects, restless legs, HA
what is the dose conversion of paroxeting IR to ER?
10 ir is 12.5 CR
citalopram brand
celexa
escitalopram brand
lexapro
MAOI inh and ssri inxn, how long washout for going to maoi FROM fluoxetin?...ho wlong if going from maoi to fluoxetine?)
5 weeks...2 weeks
ssri inxn with warf?
increase bleeding risk
Venlafaxine brand
effexor
typical dosing of fluox
10-40
typical dosing of paroxeting IR, CR
10-40...25-62.5
typical dosing of sert and citaloprma and escital?
50-200...20-40...10
which SNRI is good if pt also has pain?
duloxetine (cyumbalta)
Venlafaxin SE
GI, increase in BP, insomnia
what is the SE profile of duloxetine related to?
antichol
brand of desvenlafaxine?
pristiq
common SE to all SNRI's
sexual SE, increased Sweating, restless leg
washout period for maoi?
2 weeks going both ways
what is the major cyp for the ssri and snri?
2d6 (duloxetine..
tricyclics moa?
sert and NE and ACH and histamin inh
the 2 main teriarty amines? seconaray amines?
amitrypt, doxepin, nortripytline
amitriptyline brand, doxepin, nortrypt
elavil, sinequan, pamelor
SE of the tricyclics?
prolonged QT interval (can be used for suicide)..orthohypo...antichol...vividreams
inxn with maoi?
hypertensive crisis...2 week washout either way
Cyps for tricyclics..and ssri and snri?
2d6
general practitioner would rarely prescribe moais, only psychiatrist
k
name the 3 moai's
isocarboxazid (marplan), phenelzine (nardil), tranylcypromide (parnate)
SE of the moa
htn crisis with inxns, antichol, ortho hypo, sedation, sexual dysfunction
WAtch tyramine and mao
k
what does bupropion do to weight?
neutral
what is the brand for bupropion when used for smoking?
zyban...as opposued to wellbutrin
What main risk does bupropion carry?
seizure at high doses
what is the max dose for buproion?
450mg/day
what property does mirtaz have that makes it great for the elderly who have depressoin?
SEDATION and WEIGHT GAIN
what SE for trazodone
emergency pripaism, SEDATION
what is the unique SE of nefazodone?
hepatoxicity
when is aripiprazole and olanzapin/fluoxetine indicated?
treatment resistant depression and suicidal ideation pts
what are the major se with aripip and olanzapine?
metabolic issues
brand of aripiprazole?
abilify
what is the treatment timeline for alzheimers pts?
progression regardless of treamtne
pathophys of alzhe
neuritic plaques and tangles in brain tissue, alter NT (lower acetylcholinelacetylcholinesterase inh donepezil)) amyloid
other meds for alz
Vit E sometime tried, but carries a risk, ginkgo for memory, no benefit, do not recommend (increased bleeding risk)
drugs that can worsen dementia?
antichol, anti histamine, antiemetcis, antipsych, barbs, benzos, muscle relaxants, tricyclic antidep
donepezil moa
acetylcholinesterase inh
donepezil brand?
aricept
donepezil se
bradycardia, fainting, GI, make sure you titrate dose upward
what sort of medications are rivastigmine (exelon) and galantamine (razadyne)?
acetylcholinesterase inh
why is tacrine not used? its an acethylcholinesterase inh
hepatotoxic
MOA of memantine?
blocks nmda (which inh glutamine
when is memantin indicated?
mod to severe ADqdo
dosing consideratoien for memantine
CrCl
donepezile is taken at night to help wthe nausea
k
all the alz meds will be gradually increased
k