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232 Cards in this Set
- Front
- Back
Lithium: Superclass
|
Mood Stabilizer
|
|
Lithium: Mechanism
|
unknown. possibly PLC cascade and/or neuroprotection
|
|
Lithium: Class Side Effects
|
1. tremor
2. N/V 3. diarrhea 4. nephrogenic DI 5. kidney damage 6. birth defects (Ebstein's anomaly) 7. CV condutction system issues 8. metabolic disturbances |
|
Lithium: Class interactions/other info
|
Diuretics; TINY THERAPUTIC WINDOW
|
|
Lithium: Class Indications
|
1. bipolar disorder
2. schizophrenia (augmentation treatment) |
|
Mood stabilizing anticonvulsants: superclass
|
Mood Stabilizers
|
|
Mood stabilizing anticonvulsants: Class indications
|
bipolar disorder
|
|
Valproate: Drug class
|
Mood stabilizing anticonvulsants in the mood stabilizer category
|
|
Valproate: Drug side effects
|
1. GI upset
2. tremor 3. sedation 4. weight gain 5. liver toxicity in young children 6. contraindicated in pregnancy |
|
Valproate: Drug indications
|
rapid-cycling or mixed variant, or in combination with Li
|
|
Valproate: Drug interactions
|
1. aspirin (decreases metabolism --> higher levels)
2. carbamazepine & phenytoin (P450 induction) |
|
Valproate: other info
|
protein binding saturates. Elderly pts have higher free fraction (so same blood level will have more active drug)
|
|
Carbamazepine: drug class
|
mood stabilizing anticonvulsants in the mood stabilizer category
|
|
Carbamazepine: drug side effects
|
1. GI upset
2. sedation 3. ataxia 4. dizziness 5. diplopia 6. SIADH |
|
Carbamazepine: drug interactions
|
1. valproate & antipsychotics (P450 induction)
2. oral contraceptives (may decrease efficacy) |
|
Carbamazepine: drug other info
|
autoinduces its own metabolism (steady-state levels will fall over time)
|
|
Lamotrigine: drug class
|
mood stabilizing anticonvulsants in the mood stabilizer category
|
|
Lamotrigine: drug side effects
|
Stevens-Johnson syndrome
|
|
Lamotrigine: Drug indications
|
depressed phase
|
|
Lamotrigine: drug interactions
|
other anticonvulsants
|
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Lamotrigine: drug other info
|
some autoinduction (not as much as CBZ)
|
|
Atypical Antipsychotics: drug class
|
Mood stabilizer
|
|
Atypical Antipsychotics: mechanism
|
1. block dopamine (D2) receptors and 5-HT receptors
2. blockade of 5-HT cancels out some extrapyramidal side effects of D2 blockade |
|
Atypical Antipsychotics: class side effects
|
1. weight gain
2. glucose & lipid metabolism problems 3. fewer movement disorder SE than typical antipsychotics |
|
Atypical Antipsychotics: class indications
|
bipolar disorder (acute episodes of mania, in combination with another mood stabilizer when starting therapy)
|
|
First-generation (neuroleptic or typical) antipsychotics: superclass
|
Antipsychotics
|
|
First-generation (neuroleptic or typical) antipsychotics: Mechanism
|
block dopamine (D2) receptors
|
|
First-generation (neuroleptic or typical) antipsychotics: Class side effects
|
1. sedation
2. orthostatic hypotension 3. anticholinergic effects 4. movement disorders: dystonia, akathesia, Parkinsonism 5. rare: neuroleptic malignant syndrome or anticholinergic delirium 6. long-term: tardive dyskniesia high-potency = more movement SE, fewer sedative/orthostat/antichol SE low-potency = fewer movement SE, more sedative/orthostat/antichol SE |
|
First-generation (neuroleptic or typical) antipsychotics: Class indications
|
schizophrenia
|
|
Haloperidol: drug class
|
first-generation (neuroleptic or typical) antipsychotic
|
|
Haloperidol: drug side effects
|
High potency side effects: more movement SE, fewer sedative/orthostat/antichol SE
1. sedation 2. orthostatic hypotension 3. anticholinergic effects 4. movement disorders: dystonia, akathesia, Parkinsonism 5. rare: neuroleptic malignant syndrome or anticholinergic delirium 6. long-term: tardive dyskniesia |
|
Compazine: drug class
|
first-generation (neuroleptic or typical) antipsychotic
|
|
Compazine: drug side effects
|
High potency side effects: more movement SE, fewer sedative/orthostat/antichol SE
1. sedation 2. orthostatic hypotension 3. anticholinergic effects 4. movement disorders: dystonia, akathesia, Parkinsonism 5. rare: neuroleptic malignant syndrome or anticholinergic delirium 6. long-term: tardive dyskniesia |
|
Compazine (prochlorperazine): drug indications
|
mainly used for nausea
|
|
Chlorpromazine: drug class
|
first-generation (neuroleptic or typical) antipsychotic
|
|
Chlorpromazine: drug side effects
|
low potency: fewer movement SE, more sedative/orthostat/antichol SE
1. sedation 2. orthostatic hypotension 3. anticholinergic effects 4. movement disorders: dystonia, akathesia, Parkinsonism 5. rare: neuroleptic malignant syndrome or anticholinergic delirium 6. long-term: tardive dyskniesia |
|
Second-generation (atypical) antipsychotics: drug class
|
Antipsychotics
|
|
Second-generation (atypical) antipsychotics: mechanism
|
block dopamine (D2) receptors and 5-HT receptors (blockade of 5-HT cancels out some extrapyramidal side effects of D2 blockade)
|
|
Second-generation (atypical) antipsychotics: Class side effects
|
1. weight gain
2. glucose & lipid metabolism problems 3. fewer movement disorder SE than typical antipsychotics |
|
Second-generation (atypical) antipsychotics: Class indications
|
1. schizophrenia
2. bipolar disorder (see under bipolar disorder) 3. tourette's |
|
Clozapine: drug class
|
second-generation (atypical) antipsychotics
|
|
Clozapine: drug side effects
|
1. potentially fatal agranulocytosis
2. major weight gain (on par with olanzapine) 3. seizures 4. sedation |
|
Clozapine: drug indications
|
treatment-refractory schizophrenia
|
|
Clozapine: other info
|
requires blood monitoring
|
|
Risperidone: drug class
|
second-generation (atypical) antipsychotics
|
|
Risperidone: other info
|
"total active moiety" concept: metabolite is also active
|
|
Olanzapine: drug class
|
second-generation (atypical) antipsychotics
|
|
Olanzapine: drug side effects
|
most problematic in terms of weight gain
|
|
Quetiapine: drug class
|
second-generation (atypical) antipsychotics
|
|
Quetiapine: drug side effects
|
least amount of movement disorder SE
|
|
Quetiapine: drug indications
|
useful in all phases of bipolar disorder & treatment of psychosis in PD
|
|
Quetiapine: drug other info
|
relatively short half-life (6 hrs)
|
|
Ziprasidone: drug class
|
second-generation (atypical) antipsychotics
|
|
Ziprasidone: drug side effects
|
1. mild weight gain
2. QT issues (not usually clinically significant) |
|
Ziprasidone: drug other info
|
relatively short half-life (5-10 hrs)
|
|
Aripiprazole: Drug class
|
second-generation (atypical) antipsychotics
|
|
Aripiprazole: drug side effects
|
1. no weight gain
2. very few movement disorder problems |
|
Aripiprazole: drug interactions
|
levels of this drug may increase greatly in presence of P450 3A4 and/or 2D6 inhibitors
|
|
Aripiprazole: drug other info
|
1. partial agonist at D2 and 5HT1a
2. relatively long half-life (active metabolite- 90+ hrs) |
|
TCA's: superclass
|
antidepressants
|
|
TCAs: mechanism
|
inhibition of NE and 5-HT reuptake (secondary > tertiary at NE reuptake)
|
|
TCAs: Class side effects
|
1. alpha-1 adrenergic blockade: orthostatic hypotension, reflex tachy, dizziness
2. anticholinergic symptoms: sedation, drowsiness, weight gain, cardiac toxicity (tachycardias) 3. lag between SE and efficacy (weeks) |
|
TCAs: class indications
|
major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer)
|
|
Nortriptyline: drug class
|
secondary amine TCAs
|
|
Nortriptyline: drug side effects
|
Less alpha-1 and anticholinergic SE than tertiary:
1. alpha-1 adrenergic blockade: orthostatic hypotension, reflex tachy, dizziness 2. anticholinergic symptoms: sedation, drowsiness, weight gain, cardiac toxicity (tachycardias) 3. lag between SE and efficacy (weeks) |
|
Nortriptyline: other drug info
|
1. more effective NE reuptake block than tertiary
2. nortriptyline specifically needs to have plasma levels monitored (ineffective if too high or low) |
|
Amitriptyline: drug class
|
tertiary amine TCAs
|
|
Amitriptyline: drug side effects
|
more alpha-1 and anticholinergic SE than secondary
1. alpha-1 adrenergic blockade: orthostatic hypotension, reflex tachy, dizziness 2. anticholinergic symptoms: sedation, drowsiness, weight gain, cardiac toxicity (tachycardias) 3. lag between SE and efficacy (weeks) |
|
MAO Inhibitors: superclass
|
Antidepressants
|
|
MAO Inhibitors: Mechanism
|
inhibit MAO --> increased levels of 5-HT, NE, DA
|
|
MAO inhibitors: class interactions
|
1. dietary tyramine: HTN crisis
2. SSRIs: serotonin syndrome 3. meperidine: mimic of serotonin syndrome 4. oral hypoglycemics: dangerously low glucose 5. sympathomimetics, L-dopa, TCAs, venlaxafine, bupropion: HTN crisis |
|
MAO inhibitors: class indications
|
major depressive disorder (especially "atypical" types)
|
|
Phenelzine: drug class
|
MAO inhibitors in antidepressant category
|
|
Phenelzine: drug other info
|
irreversible, non-selective MAOI
|
|
Tranylcypromine: drug class
|
MAO inhibitors in antidepressant category
|
|
Tranylcypromine: Drug other info
|
irreversible, non-selective MAOI
|
|
Selegiline: drug class
|
MAO inhibitors in antidepressant category
|
|
Selegiline: drug other info
|
1. irreversible; selective for MAO B at low doses, but loses selectivity at high doses (e.g. from patch)
2. can be given as a patch to avoid first-pass metabolism |
|
SSRI's: superclass
|
Antidepressants
|
|
SSRI's: mechanism
|
relatively specific blockade of 5-HT reuptake, possible downregulation of postsynaptic NE and 5-HT receptors (lag effects)
|
|
SSRI's: Class side effects
|
1. GI disturbances: N/V, diarrhea
2. initial increase in anxiety 3. sexual dysfunction 4. less likely to be fatal in OD than TCA or MAOI |
|
SSRI's: class interactions
|
act as P450 inhibitors
|
|
SSRI's: class indications
|
major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer), anxiety disorders
|
|
Fluoxetine: Drug class
|
SSRI's in antidepressant category
|
|
Fluoxetine: Drug interactions
|
interacts with P450 2D6 (many TCAs)
|
|
Fluoxetine: Drug other info
|
very long half-life (80+ hrs), kinetics NOT first order
|
|
Sertraline: drug class
|
SSRI's in antidepressant category
|
|
Sertraline: drug interactions
|
less P450 interaactions than fluoxetine
|
|
Citalopram: drug class
|
SSRI's in antidepressant category
|
|
Citalopram: drug interactions
|
less P450 interactions than fluoxetine
|
|
Paroxetine: drug class
|
SSRI's in antidepressant category
|
|
Paroxetine: drug side effects
|
mildly anticholinergic
|
|
Paroxetine: Drug interactions
|
interacts with P450 2D6 (many TCAs)
|
|
Paroxetine: Drug other info
|
kinetics NOT first order
|
|
Fluvoxamine: drug class
|
SSRI's in antidepressant category
|
|
Fluvoxamine: drug indications
|
OCD
|
|
Fluvoxamine: Drug interactions
|
1. strongly inhibits P450 1A2
2. can increase levels of theophylline |
|
SNRI's (serotonin-norepinephrine reuptake inhibitors): superclass
|
Antidepressants
|
|
SNRI's: mechanism
|
inhibit 5-HT and NE reuptake (5-HT > NE)
|
|
SNRI's: class side effects
|
mild side effect profile; similar to tertiary amine TCA w/o many of the SE
|
|
SNRI's: class indications
|
major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer)
|
|
Venlafaxine: drug class
|
SNRI's in antidepressant category
|
|
Duloxetine: drug class
|
SNRI's in antidepressant category
|
|
5-HT2 antagonists: superclass
|
Antidepressants
|
|
5-HT2 antagonists: mechanism
|
block 5-HT signaling postsynaptically at 5-HT2
|
|
5-HT2 antagonists: class indications
|
major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer)
|
|
Trazodone: drug class
|
5-HT2 antagonists in antidepressant category
|
|
Trazodone: drug side effects
|
1. very sedating
2. rare potentially irreversible priapism |
|
Trazodone: drug indications
|
can be used to complement SSRI in depression with severe insomnia. only antidepressant that's actually worse than the others
|
|
Nefazodone: Drug side effects
|
less than trazodone, but rare cases of liver failure
|
|
Nefazodone: Drug interactions
|
inhibits P450 3A4 system (CBZ, birth control pills)
|
|
Nefazodone: Drug other info
|
1. may block serotonin & NE reputake
2. kinetics are NOT first order |
|
Buproprion: superclass
|
Antidepressants
|
|
Bupropion: mechanism
|
unclear dopaminergic effects
|
|
Bupropion: Class side effects
|
1. fewer problems with sexual dysfunction & weight gain than SSRIs
2. poses seizure risk (especially in BN and AN) |
|
Bupropion: class indications
|
1. major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer)
2. smoking cessation |
|
Mirtazapine: superclass
|
Antidepressant
|
|
Mirtazapine: mechanism
|
1. presynaptic alpha-2 blockade
2. enhanced release of NE and 5-HT 3. blocks 5-HT2 and 5-HT3 receptors |
|
Mirtazapine: Class side effects
|
1. fewer GI SE than SSRIs
2. weight gain 3. some sedation |
|
Mirtazapine: class interactions
|
1. metabolized by P450 2D6 and 3A systems
2. half-life longer in females! |
|
Mirtazapine: class indications
|
major depressive disorder (unipolar as monotherapy, psychotic unipolar w/ mood stabilizer)
|
|
Benzodiazepines: superclass
|
Anxiolytics
|
|
Benzodiazepines: mechanism
|
1. enhance effectiveness of GABA signaling (increased opening frequency of Cl channel)
2. bind to full BDZ receptor |
|
Benzodiazepines: class side effects
|
1. potential for addiction
2. interaction with alcohol 3. disinhibition (rare) 4. confusion 5. sedation 6. ataxia 7. falls (especially in elderly) |
|
Benzodiazepines: class indication
|
1. anxiety disorders
2. symptomatic treatment of anxiety in other conditions |
|
Chlordiazepoxide: drug class
|
Benzodiazepine in anxiolytics category
|
|
Chlordiazepoxide: Drug other info
|
1. intermediate absorption
2. VERY variable half-life (8-100 hrs) |
|
Diazepam: drug class
|
Benzodiazepine in anxiolytics category
|
|
Diazepam: drug interactions
|
metabolized by P450
|
|
Diazepam: drug other info
|
1. rapid absorption
2. LONG half life (20-100 hrs) 3. metabolized by P450, so susceptible to changes w/ aging & liver disease |
|
Lorazepam: drug class
|
Benzodiazepine in anxiolytics category
|
|
Lorazepam: drug interactions
|
no P450 metabolism --> fewer drug interactions
|
|
Lorazepam: drug other info
|
1. intermediate absorption
2. intermediate half-life (10-24 hrs) 3. metabolized by kidney so no changes w/ aging & liver disease |
|
Oxazepam: drug class
|
Benzodiazepine in anxiolytics category
|
|
Oxazepam: drug interactions
|
no P450 metabolism --> fewer drug interactions
|
|
Oxazepam: drug other info
|
no changes w/ aging & liver disease
|
|
Buspirone: superclass
|
Anxiolytics
|
|
Buspirone: mechanism
|
5-HT1 partial agonist (complex effects post- and pre-synaptically)
|
|
Buspirone: class side effects
|
1. delayed efficacy
2. caution when switching between BDZs and buspirone |
|
Buspirone: Class interactions
|
1. kinetics NOT linear
2. short half-life (2-3 hrs) |
|
Buspirone: class indications
|
1. anxiety disorders
2. symptomatic treatment of anxiety in other conditions |
|
Non-benzodiazepine receptor agonists: superclass
|
Soporifics
|
|
Non-benzodiazepine receptor agonists: mechanism
|
enhance effectiveness of GABA signaling (increased opening frequency of Cl channel)
|
|
Non-benzodiazepine receptor agonists: class indications
|
insomnia
|
|
Zolpidem: drug class
|
Non-benzodiazepine receptor agonists in soporifics category
|
|
Zolpidem: drug other info
|
1. 2.5 hour half life
2. binds to alpha-1 subunit of BDZ receptor ONLY |
|
Zaleplon: drug class
|
Non-benzodiazepine receptor agonists in soporifics category
|
|
Zaleplon: drug other info
|
1. 1 hour half life
2. binds to alpha-1 subunit of BDZ receptor ONLY |
|
Eszopiclone: drug class
|
Non-benzodiazepine receptor agonists in soporifics category
|
|
Eszopiclone: drug indication
|
long-term use for insomnia OK
|
|
Eszopiclone: drug other info
|
1. rapid absorption
2. 6 hour half life (increases in elderly) 3. binds non-specically to alpha-1 and alpha-2 subunits of BDZ |
|
Cholinesterase inhibitors: superclass
|
anti-dementia agents
|
|
Cholinesterase inhibitors: mechanism
|
boost ACh signaling by preventing degradation of ACh
|
|
Cholinesterase inhibitors: class side effects
|
pro-cholinergic effects, I presume
|
|
Cholinesterase inhibitors: class indications
|
mild-to-moderate dementia of the Alzheimer type
|
|
Tacrine: drug class
|
Cholinesterase inhibitors in anti-dementia agents category
|
|
Tacrine: drug side effects
|
1. intolerable SE
2. liver toxicity |
|
Tacrine: drug indications
|
NONE- "historical interest only"
|
|
Donezepil: drug class
|
Cholinesterase inhibitors in anti-dementia agents category
|
|
Donezepil: drug side effects
|
more mild SE than tacrine
|
|
Donezepil: drug interactions
|
P450 2D6 and 3D4 metabolism
|
|
Donezepil: drug other info
|
long half life (70 h)
|
|
Rivastigmine: drug class
|
Cholinesterase inhibitors in anti-dementia agents category
|
|
Rivastigmine: drug interactions
|
no P450 metabolism --> fewer interactions
|
|
Rivastigmine: drug other info
|
1. short functional half life (8-12 hrs)
2. available as patch 3. significant first-pass effect (give w/ food) |
|
Galantamine: drug class
|
Cholinesterase inhibitors in anti-dementia agents category
|
|
Galantamine: drug other info
|
1. liver + kidney metabolism
2. short half life (7 hrs) |
|
Memantine: superclass
|
Anti-dementia agents
|
|
Memantine: mechanism
|
uncompetitive antagonist of NMDA receptor
|
|
Memantine: Class interactions
|
1. VERY LONG half life (60-100 hrs)
2. no P450 interactions |
|
Memantine: class indications
|
moderate-to-severe DAT
|
|
Alprazolam
1. Drug class 2. Indications |
1. Benzodiazepine
2. Anxiety disorders |
|
Asenapine
1. Drug class 2. Indications |
1. Second-generation (atypical)
2. Acute treatment of mania |
|
Atomoxetine
1. Drug class 2. Indications |
1. NRI
2. ADHD, ODD, Conduct disorder |
|
Chloropromazine
1. Drug class 2. Indications 3. Other notes |
1. First-generation (typical)
2. Schizophrenia 3. Low potency |
|
Clomipramine
1. Drug class 2. Indications |
1. TCA
2. Depression, OCD |
|
Clonazepam
1. Drug class 2. Indications |
1. Benzodiazepine
2. Anxiety disorders |
|
Clonidine
1. Drug class 2. Indications |
1. alpha-agonist
2. ADHD, ODD, Conduct disorder |
|
Desipramine
1. Drug class |
1. TCA (secondary)
|
|
Desvenlafaxine
1. Drug class |
1. phenethylamine
|
|
Dextroamphetamine
1. Drug class 2. Indications |
1. stimulant
2. ADHD, ODD, conduct disorder, may be useful in PDD |
|
Donepezil
1. Drug class 2. Indications 3. Unique side effects/interactions 4. Other notes |
1. cholinesterase inhibitor
2. DAT 3. metabolized by P450 2D6 and 3A4 4. 70 hour half-life |
|
Doxepin
1. Drug class |
1. TCA (tertiary)
|
|
Flumazenil
1. Drug class |
benzodiazepine antagonist
|
|
Fluphenazine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. high potency |
|
Guanfacine
1. Drug class 2. Indications |
1. Alpha-agonist
2. ADHD, ODD, conduct disorder |
|
Iloperidone
1. Drug class 2. Indications |
1. second-generation (atypical) antipsychotic
2. schizophrenia |
|
Imipramine
1. Drug class |
TCA (tertiary)
|
|
Isocarboxazid
1. Drug class 2. Other notes |
1. MAO inhibitor
2. irreversible nonselective MAO inhibitor |
|
Loxapine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. mid potency |
|
Lurasidone
1. Drug class 3. Indications |
1. second-generation (atypical) antipsychotic
2. schizophrenia |
|
Mesoridazine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. low potency |
|
Methylphenidate
1. Drug class 2. Indications |
1. stimulant
2. pervasive developmental disorders |
|
Mirtazepine
1. Drug class 2. Indications 3. Unique side effects/interactions 4. Other notes |
1. other antidepressant
2. PTSD 3. less GI side effects than SSRIs; metabolized by P450 2D6 and 3A systems & also cleared by kidney 4. blocks presynaptic alpha-2 receptors --> increased release of NE and 5HT, blocks 5HT2 & 5HT3 receptors |
|
Molindone
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. mid potency |
|
Paliperidone
1. Drug class 2. Indications |
1. second-generation (atypical) antipsychotic
2. schizophrenia |
|
Perphenzine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. mid potency |
|
Pimozide
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. high potency |
|
Thioridazine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. low potency |
|
Thiothexine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. high potency |
|
Trifluoperazine
1. Drug class 2. Indications 3. Other notes |
1. first-generation (typical) antipsychotic (neuroleptic)
2. schizophrenia 3. high potency |
|
Trimipramine
1. Drug class |
1. TCA (tertiary)
|
|
Venlafaxine
1. Drug class 2. Indications 3. Other notes |
1. phenethylamine
2. PTSD 3. similar to tertiary TCA without many of the side effects; blocks 5HT > NE reuptake |
|
Nicotine: Sxs of intoxication/overdose
|
None
|
|
Nicotine: sxs of dependence
|
general DSM-IV pattern of dependence
|
|
Nicotine: sxs of withdrawal
|
Rapid onset after last use:
1. irritability 2. restlessness 3. poor concentration 4. increased appetite 5. depression 6. anxiety 7. poor sleep 8. cravings |
|
Nicotine: treatment for dependence/withdrawal
|
1. nicotine replacement (gums, patches)
2. bupropion 3. varencline |
|
Alcohol: sxs of intoxication/overdose
|
1. agitation
2. nystagmus 3. uncoordinated speech & ambulation 4. impaired cognitive functioning 5. death in extreme cases |
|
Alcohol: sxs of dependence
|
general DSM-IV pattern of dependence, blackouts, benders, drinking of non-beverage alcohol
|
|
Alcohol: sxs of withdrawal
|
1. Acute (4-8 hrs after last use): tremor, diaphoresis, nausea, headache, diarrhea
2. Alcohol hallucinosis (4-24 hrs after last use): auditory and/or visual hallucinations without disorientation 3. Alcohol withdrawal seizures (12-48 hrs after last use): generalized tonic-clonic seizures 4. delirium tremens (24-72 hrs after last use): delirium, tremors, autonomic instability; rare but very dangerous, can be fatal |
|
Alcohol: treatment for dependence/withdrawal
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1. disulfiram
2. naltrexone 3. acamprosate 4. topiramate 5. long-acting benzodiazepines 6. ICU monitoring in severe cases 7. 12-step programs (AA) and social support |
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Opiates: Sxs of intoxication/overdose
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1. small ("pinprick") pupils
2. somnolence 3. uncoordinated gait 4. coma 5. poor respiration 6. death in extreme cases |
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Opiates: sxs of dependence
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general DSM-IV pattern of dependence, with particularly significant tolerance & withdrawal symptoms
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Opiates: sxs of withdrawal
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1. Early (8-12 hrs after last use): restlessness, mydriasis, yawning, lacrimation, rhinorrhea, diaphoresis, poor sleep
2. Late (24-48 hrs after last use): N/V, chills, muscle pain, abdominal cramps, diarrhea, tremor, mild tachycardia, HTN |
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Opiates: treatment for intoxication/overdose
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Naloxone
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Opiates: treatment for dependence/withdrawal
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1. long-acting opiate: methadone, buprenorphine
2. clonidine + benzodiazepine + antiemetic |
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Cocaine: Sxs of intoxication/overdose
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1. tachycardia
2. arrhythmias 3. HTN 4. tremor 5. paranoid psychosis 6. overactivity 7. mood elevation and/or irritability 8. death in some cases |
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Cocaine: sxs of dependence
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general DSM-IV pattern of dependence, except that withdrawal syndrome is relatively mild and non-specific; progression of dependence is very rapid
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Cocaine: sxs of withdrawal
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Relatively mild, with non-specific symptoms:
1. poor concentration 2. disrupted sleep patterns, 3. depression 4. appetite change 5. craving 6. restlessness |
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Amphetamines: sxs of intoxication/overdose
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Similar to cocaine:
1. tachycardia 2. arrhythmias 3. HTN 4. tremor 5. paranoid psychosis 6. overactivity 7. mood elevation and/or irritability 8. death in some cases |
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Amphetamines: sxs of dependence
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Similar to cocaine: general DSM-IV pattern of dependence, except that withdrawal syndrome is relatively mild and non-specific; progression of dependence is very rapid
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Amphetamines: sxs of withdrawal
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Similar to cocaine: Relatively mild, with non-specific symptoms:
1. poor concentration 2. disrupted sleep patterns, 3. depression 4. appetite change 5. craving 6. restlessness |
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Cannabis: sxs of intoxication/overdose
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Rare cases of psychosis
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Cannabis: sxs of dependence
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Mild to nonexistent
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Cannabis: sxs of withdrawal
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Relatively mild, with non-specific sxs:
1. sleep disturbance 2. impaired concentration 3. irritability or anxiety 4. cravings |
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Sedatives/hypnotics: sxs of withdrawal
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Identical to those of alcohol:
1. Acute (4-8 hrs after last use): tremor, diaphoresis, nausea, headache, diarrhea 2. Alcohol hallucinosis (4-24 hrs after last use): auditory and/or visual hallucinations without disorientation 3. Alcohol withdrawal seizures (12-48 hrs after last use): generalized tonic-clonic seizures 4. delirium tremens (24-72 hrs after last use): delirium, tremors, autonomic instability; rare but very dangerous, can be fatal |
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Hallucinogens (LSD, psilocybin, etc): sxs of intoxication/overdose
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1. agitation
2. perceptual distortions 3. frank hallucinations (especially visual) 4. severe anxiety 5. flashbacks (chronic) |
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Hallucinogens (LSD, psilocybin, etc): sxs of dependence
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tolerance develops very quickly; daily use and dependence are unusual
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Hallucinogens (LSD, psilocybin, etc): sxs of withdrawal
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none known
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Phencyclidine (PCP): Sxs of intoxication/overdose
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1. nystagmus
2. disinhibition 3. analgesia 4. flushing 5. diaphoresis 6. disorientation 7. disorganized violent attacks 8. may precipitate chronic psychosis |
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Hydrocarbon inhalants: Sxs of intoxication/overdose
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1. short-lived ataxia
2. euphoria 3. hallucinations 4. chronic use may produce neurological damage |
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Hydrocarbon inhalants: sxs of dependence
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full dependence syndrome is unusual, but users may progress to other substances
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