Peds Psych Medications Frequently Used

Front 1

Benadryl

Back 1

Sleep Problems-early insomnia, #1
Acute Anxiety, Mild Agitation (without delirium), Multiple Acute Somatic Sxs, #1

Diphenhydramine

Hint 1

Sedation>hs dosing, Tolerance ?
Potential AM “hangover;” paradoxical rxn
Anticholinergic fx>cardiac concerns (cap on total dose)

Front 2

Trazodone

Back 2

Sleep Problems-early insomnia, #2

Desyrel

SARI class (serotonin antagonist and reuptake inhibitor)

Hint 2

Potential AM “hangover”
Priapism (rare)
Hypotension potential

Front 3

Melatonin

Back 3

Sleep Problems-early insomnia, #3

Hint 3

OTC
Potential AM “hangover”

Front 4

Celexa

Back 4

Major Depression, #1
Chronic Anxiety, Trauma Sxs/PTSD, Abdominal Pain, #1

Citalopram

SSRI class

Hint 4

Fewest drug-drug interactions
Very mild sedation in some

Front 5

Zoloft

Back 5

Chronic Anxiety, Trauma Sxs/PTSD, Abdominal Pain, #3

Sertraline

SSRI class

Hint 5

Some (few) drug-drug interactions
Greater GI side fx
>SI risk in Depression studies?

Front 6

Propanolol & Clonidine

Back 6

Chronic Anxiety, Trauma Sxs/PTSD, Abdominal Pain, #4

Beta blocker (propanolol)
Adrenergic agonist and a guanidine receptor agonist (Clonidine)

Hint 6

Role acute trauma/somatic sx
Role PTSD
Watch for sedation/HTN on w/d

Front 7

Lexapro

Back 7

Major Depression, #2
Chronic Anxiety, Trauma Sxs/PTSD, Abdominal Pain, #2

Escitalopram

SSRI class

Hint 7

Cousin of above
Fewer drug-drug interactions?
Greater sedation (>hs dosing?)

Front 8

Prozac

Back 8

Major Depression, #3

Fluoxetine

SSRI class

Hint 8

Best data for childhood depression
More drug-drug interactions – rare use with the medically complex

Front 9

Wellbutrin

Back 9

Major Depression, #4

Buproprion

Non-tricyclic antidepressant

Hint 9

Seizure risk higher
Role for ADHD/substance/smoking

Front 10

Seroquel

Back 10

Acute Anxiety, Mild Agitation (without delirium), Multiple Acute Somatic Sxs, #2
Sleep Problems-early insomnia, #4

Quetiapine

Atypical antipsychotic

Hint 10

Divided doses-tid-qid
Sedation (excessive)>”hangover”)
Weight gain esp in long term?
Lower EPS potential/TD risk

Front 11

Risperdal

Back 11

Hyperactive/Agitated Delirium (hypothesized high dopaminergic state), #1
Hypoactive/Mixed Delirium (hypothesized cholinergic/dopamine dysregulation; low/normal dopamine level), #1
Acute Anxiety, Mild Agitation (without delirium), Multiple Acute Somatic Sxs, #3

Risperidone

Atypical antipsychotic

Hint 11

Potential sedation/Divided doses?
Weight gain esp in long term?
Mod EPS potential/TD risk vs Haldol
Liquid/ODT (M tabs)

Front 12

Haldol

Back 12

Hyperactive/Agitated Delirium (hypothesized high dopaminergic state), #2

Haloperidal

Typical antipsychotic

Hint 12

Greater EPS potential/TD.risk vs newer agents but may work best; Close attention to QTc prolongation, esp with IV form -- EKG, follow QTc, replete K, Mg, Ca

(EPS = Extrapyramidal symptoms, including parkinsonism, akathisia, dystonia, and tardive dyskinesia)

Front 13

Zyprexa

Back 13

Hyperactive/Agitated Delirium (hypothesized high dopaminergic state), #3

Olanzapine

Atypical antipsychotic

Hint 13

Sedation (excessive)>”hangover”
Watch weight gain esp in long term
Lower EPS potential/TD risk?
ODT (Zydis)

Front 14

Thorazine

Back 14

Hyperactive/Agitated Delirium (hypothesized high dopaminergic state), #4

Chlorpromazine

Typical antipsychotic

Hint 14

Lower EPS potential/TD risk?
Anticholinergic; watch use of Benadryl
May use IM; Avoid IV due to skin necrosis and cardiovascular collapse

Front 15

Ritalin

Back 15

Hypoactive/Mixed Delirium (hypothesized cholinergic/dopamine dysregulation; low/normal dopamine level), #2

Methylphenidate

Psychostimulant

Hint 15

Potential agitation

Front 16

Abilify

Back 16

Hypoactive/Mixed Delirium (hypothesized cholinergic/dopamine dysregulation; low/normal dopamine level), #3

Aripiprazole

Atypical antipsychotic

Hint 16

Watch weight gain esp in long term
Lower EPS potential/TD risk?
ODT (Disc melts)