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91 Cards in this Set

  • Front
  • Back
Lithium
Bipolar
Valproic Acid
Depakote
-Bipolar (rapid cyclers, mixed episodes)
Carbamazepine
Tegretol
-Bipolar (rapid cyclers, mixed episodes)
Lamotrigine
Lamictal
-maintenance of Bipolar II
Atypical Antipsychotics
Bipolar
Tacrine
Cognex
-Alzheimers
-anti-AchE (help ^ACH)
-not used b/c of liver toxicity
-SE:^LFTs, salivation, sweating, lacrimation (SLUD)
-intx:1A2,2D6
Donepezil
Aricept
-Alzheimers (mild-severe)
-anti-AchE (help ^Ach)
-SE: insomina
-inhibit CYP2D6,3A4
Rivastigmine
Exelon
-Alzheimers (mild-mod.sev.)
-anti-AchE (help ^Ach)
-food delays abs.
-SE:dizziness, HA
-no CYP intx.
Galantamine
Razadyne
-Alzheimers
-dual action:
1)anti-AchE
2)stim N rec. to ^Ach prod.
-it you stop tx, must restart titration
-SE:agitation, anorexia, sleep probs.
-intx: 2D6, 3A4
-food delays abs.
-has ER form
Estrogen
-Alzheimers
-prevention??
NSAIDS
-Alzheimers
-?dec. inflammation that causes plaques
-not used (GI risks)
Vitamin E
-Alzheimers
-anti-oxidant
-delays deterioration
Ginkgo Biloba
-Alzheimers
-anti-oxidant
-unproved, ok to try
Huperzine A
-Alzheimers
-anti-oxidant, neuroprotection
-don't know efficacy
Statins
-Alzheimers
-anti-lipid
-cholesterol is factor in plaque formation
Memantine
Namenda
-Alzheimers (vascular)
-NMDA antag.
-blocks glutamate
-SE:agitation,confusion, dizziness,constipation,HA
-can use w/Anti-AchE
Haloperidol
Atypical Anti-psych
Benzos
Delirium (from Alz.)
Levodopa/Carbidopa
Sinemet
-Parkinsons
-Dop precursor/dopa-decarboxylase inhibitor
-dose:
Lev:300-1000mg/day in 3-8 divided doses
Carb:75-100 mg/day
-SE: hallucin./confusion, anorexia, nausea, orthostatic hypotension, dyskinesias
-start low, go slow
-issues: wearing off, on-off phenomena, peak dose dyskinesias, slow onset of response
-CR form (dose:same but in 2-4 divided doses)
Bromocriptine
Parlodel
-Parkinsons
-Dopamine Ag.
-older
-SE:orthostatic hypotension, constipation, pleuropulmonary fibrosis (BAD-use other drug!)
Pergolide
Permax
-Parkinsons
-Dopamine Ag.
-older
-SE:orthostatic hypotension, mental changes, dyskinesias
Ropinirole
Requip
-Parkinsons, Restless legs
-Dopamine Ag.
-newer
-SE: sleep attacks!,insomnia, constipation, dizziness, HA
Pramipexole
Mirapex
-Parkinsons
-Dopamine Ag.
-newer
-SE: sleep attacks!,insomnia, constipation, dizziness, HA
Tolcapone
Tasmar
-Parkinsons
-COMT inhibitor (block deg. of dopamine and levodopa)
-liver failure! (Bad-use entacapone)
-monitor LFTs
-must be taken w/ levo/carb.
Entacapone
Comtan
-Parkinsons
-COMT inhibitor (block deg. or dopamine and levodopa)
-must be taken w/ levo/carb.
-works peripherally
-^"on" time, dec. "off" time
-SE: diarrhea, dyskinesias
Levodopa/Carbidopa/Entacapone
Stalevo
-Parkinsons
-combined mechanisms
Benztropine
-Parkinsons
-Anticholinergic
-early PD, for tremor
-avoid in elderly
-SE: dry mouth, constipation, urinary retention,confusion
Amantadine
Symmetrel
-Parkinsons
-MOA?
-caution in elderly (^^confusion)
SE:confusion, convulsions, GI, livedo reticularis (leg spots)
-adjust for renal dys.
Selegiline
Eldepryl
-Parkinsons
-MAO-B inhibitor
-doesn't cause HT crisis
-?neuroprotective- likely not
Apomorphine
Apokyn
-Parkinsons
-D1/D2 Ag.
-SQ inj. (mL, NOT mg)
-for "off" periods w/ sev. motor fluctuations
-SE: **N**/V, low BP, fainting, hallucination, sleepy
-must pretreat w/antiemetic
(ONLY Tigan)
-
Trimethobenzamide
Tigan
-Parkinsons
-antiemetic
-used before Apomorphine to control nausea
-started 3 days before initial dose of Apomorphine, continued 2mo.+
Biperiden
Akineton
-Parkinsons
-Anticholinergic
-SE: anti-cholinergic
Estazolam
Prosom
-Sleep (DFA,DMS,EMA)
-Benzo
-longer onset, moderate duration (7-9hrs.)
-SE: sedation, psychomotor retartdation, falls, anterograde amnesia, rebound insomnia
Temazepam
Restoril
-Sleep (DMS,EMA)
-Benzo
-longer onset, moderate duration (7-9hrs.)
-SE: sedation, psychomotor retartdation, falls, anterograde amnesia, rebound insomnia
Flurazepam
Dalmane
-sleep: not used though
-Benzo
-super long t1/2 (100hrs.)
-rapid onset, long duration
Quazepam
Doral
-sleep: not used though
-Benzo
-super long t1/2 (100hrs.)
-rapid onset, long duration
Triazolam
Halicon
-Sleep:DFA (not used much)
-Benzo
-fast onset, short duration
-SE: bizzard behavior, daytime anxiety, rebound insomnia, anterograde amnesia
Zolpidem
Ambien
-sleep:
IR:DFA
CR:DMS,EMA
-Benzo-rec. ag.
-little effect on sleep stages
-tk on empty stomach
-no tol/rebound insom./w/d
-safe w/ preg.- others are not
Eszopiclone
Lunesta
-sleep (Chronic insomnia)
-Benzo-rec. ag.
-effective up to 6 mo.
Ramelton
Rozerem
-sleep: DFA
-Melatonin rec.ag.(MT1,MT2)
-not controlled (good for pt. w/ abuse)
-can be used for long time
-active met. (caution w/liver)
-intx:fluvoxamine, 1A2
Antidepressants (Sleep)
-Sleep
1)TCAs
SE:antichol., CV
2)Trazodone
SE:priapism
3)Mirtazapine (Remron)
SE:EDS,wt.gain
-not for the elderly
Antihistamines (Sleep)
-Sleep
1)Diphenhydramine
-not as effective as BZDs
-SE:sedation, antichol., CV, glaucoma
-avoid in late preg.and elderly
2)Doxylamine- not avail. anymore
Valerian Root
-sleep
-^GABA
-intx: barbiturates, benzos, ethanol, opioid analgesics
CNS Stimulants
-Narcolepsy (EDS)
-CIIs
1)Methylphenidate
2)Dextroamphetamine
3)Methamphetamine'

SE:^BP,^HR, CNS effects
Modafinil
Provigil
-Narcolepsy (EDS)
-CIV
-induces 2C19, 3A4(OC)
Antidepressants (Narcolepsy)
-Narcolepsy (Cataplexy)
1)SSRI (fluoxetine, venlafaxine)
2)TCA (protriptyline, imipramine, clomipramine)
3)MAOI (selegiline)

SE:anticholinergic
Sodium oxybate
Xyrem
-Narcolepsy (Cataplexy)
-date rape drug
-CIII, ONLY for narc., otherwise illegal
-potent
-intx:alcohol, CNS dep.
Dopamine Agonists (RLS)
-Restless legs
-1st line: Requip
-long half lives, flexible dosing
SE: sleep attacks, edema, nausea, drowsiness
Gabapentin
Neurontin
-Restless legs
-usefull in painful RLS w/ neuropathy
-no intx.
Hypnotics (RLS)
-Restless legs
1)clonazepam*
-long half-life- hangover
2)temazepam
3)zolpidem
4)eszopiclone

-disad:tolerance, confusion, ^snoring
Levodopa/Carbidopa (RLS)
Sinemet
-Restless legs
-good for short term
-bad-^augmentation
(sx earlier and req. ^dose)
Opioids (RLS)
-Resless legs
ex)propoxyphene, hydrocodone, oxycodone, etc.
-at bedtime
-good for painful RLS
-SE:tolerance, constipation
Iron supplement
-Restless legs
Melatonin
-Circadian Rhythm Disorder
-caution w/ epilepsy, warfarin
Clonazepam
-REM Behavior Disorder
Antidepressants (Neuropathic pain)
-Neuropathic pain
-inhibit descending NE/5HT opiate receptors
1)SSRI
2)SNRI
3)TCAs
-Amitriptyline
-Clomipramine
-Desipramine
-Nortriptyline

SE: sedation, anti-chol, hypotension, CV, sz., wt. gain
Opioids (Neuropathic Pain)
-Neuropathic pain
-inhibit descending NE/5HT opiate receptors
-2nd line
SE: sedation, constipation
Carbamazepine (Neuropathic Pain)
Tegretol
-Neuropathic Pain
-MOA: in PNS & CNS
PNS-Na channel blocker
CNS-modifies L-type Ca channels
-SE: sleepy, hyponatremia, rash
Oxcarbazepine (Neuropathic Pain)
Trileptal
-Neuropathic Pain
-MOA: PNS & CNS
PNS- Na channel blocker
CNS- modulates N, P type Ca channels
SE: like CBZ, but worse
Lamotrigine (Trigeminal Neuralgia)
Lamictal
-Trigeminal Neuralgia
-blocks Na channels
Topiramate (Neuropathic Pain)
Topamax
-Neuropathic pain
-blocks Na channels
-blocks glutamate
-^GABA
-pts. won't tk: bad SE
SE:cog. eff., slowing, word finding
Gabapentin (Neuropathic pain)
Neuropentin
-Neuropathic Pain
-1st line*
-^GABA
-fast onset (days-wks)
-few SE (sed, dizz)
Pregabalin
-neuropathic pain
-try gabapentin 1st, then switch to pregab. if needed
Mexiletine
-neuropathic pain
-only for pt. who do not respond to other meds
Lidocaine
-neuropathic pain
-patch
-no CNS effect
Capsaicin
-neuropathic pain
-cream
Betaseron
-Multiple Sclerosis-RR
-INF beta 1b
-SC inj./qod
-SE: inj. site rxn, cutaneous necrosis, flu-like, menstrual irreg., abortion pot., CNS (more dep., confusion)
Avonex
-multiple sclerosis -relapsing
-INF beta 1a
-IM inj./wk
SE: flu-like, similar to bateseron
Rebif
-multiple sclerosis
-INF beta 1a
-SC inj.
-SE: flu, HA, inj. site rxn, sz.
Glatiramer
Copaxone-RR
-multiple sclerosis
-SC inj./d
-SE: inj. pain, chest pain (tightness, tk w/ someone 1st time)
Mitoxantone
Novatrone
-multiple sclerosis
-for very progressive, relapsing MS
-IV inf.
-CAN CAUSE CHF!
-SE:alopecia, leukopenia, menstural probs (like a chemo drug)
Beta Blockers
-Glaucoma- 1st line
-ex)"-olol"
1)Betaxolol
2)Carteolol
3)Levobunolol
4)Metipranolol
5)Timolol
-MOA: dec. aq. humor production by ciliary body
-SE:hypotension, syncope, bradycardia, bronchospasm, CNS effects
-caution w/:asthma, HF,DM
Prostaglandin Analogs
-glaucoma-1st line
1)Latanoprost (Zalatan)-frige
2)Brimatoprost (Lumigan)
3)Travoprost (Travitan)
MOA-^trabecular outflow, ^uveoscleral outflow
SE:muscle/joint pain, brown iris, hypertrichosis (^eye lashes), edema of retina
-Caution w/:macular edema, inflammatory conditions
Alpha-2 Adrenergic Agonists
-glaucoma
1)apraclonidine
2)brimondidine (Alphagan)-1st line
MOA:dec. aq. humor production, ^uveoscleral outflow
SE: hypotension, dizziness, fatigue, dry mouth, allergic rxn.
Caution w/: infants, MAOIs, TCAs, CV DM, renal
Carbonic Anhydrase Inhibitors (CAIs)- Topical
-glaucoma
1)brinzolamide (Azopt)
2)dorzolamide (Trusopt)
-MOA:dec. aq. humor production
-SE:local discomfort (stinging, blurred vision, tearing)
-Caution w/:sulfa allergy, renal/hepatic
Carbonic Anhydrase Inhibitors (CAIs)- Systemic
-glaucoma
1)acetazolamide
2)dichlorphenamide
3)methazolamide
MOA: dec. aq. humor production
SE:acidosis (fatigue, wt. loss, depression), metallic taste, GI
Caution w/:TONS!!! (sulfa, sickle-cell....)
Cholinergic Agonists
-glaucoma
1)pilocarpine
2)carbachol
MOA:^aq. humor outflow
SE: miosis, HA, cataracts
Caution: night driving, pulmonary disease
*at high doses, systemic SE
Cholinesterase Inhibitors
-glaucoma
1)Echothiophate
-MOA:^ aq. humor outflow
-SE: like Chol. Ag. but more severe, more systemic
-caution: w/ artificial lens (b/c of cataracts risk)
Non-specific Adrenergic Ag.
-glaucoma
1)epinephrine
2)dipivefrin
-MOA:^outflow
SE:HA, faintness,^BP, ^HR
Caution:CV, aphakia (no lens), CAG
Oxybutynin
Ditropan
-incontinence
-anti-cholinergic
-MOA: inhibits invol. contractions of bladder
-^capacity of bladder (relaxes it)
-delay the initial urge to void
SE:anti-chol, tachycardia, confusion* (HIGH CNS penetration)
-also patch
-CYP3A4 inhibitor
Tolerodine
Detrol
-incontinence
-start w/ low dose in elderly
-avoid w/ 3A4, 2D6 inhibitors
Trospium
Sanctura
-incontinence
-anti-chol
-MOA: inhibits invol. contractions of bladder
-^capacity of bladder (relaxes it)
-delay the initial urge to void
SE:anti-chol, tachycardia, confusion
Solifenacin
VESIcare
-incontinenece
-anti-chol (M3 selective)
-MOA: inhibits invol. contractions of bladder
-^capacity of bladder (relaxes it)
-delay the initial urge to void
SE:anti-chol, tachycardia, confusion
-CYP 3A4 inhibitor
Darifenacin
Enablex
-incontinence
-anti-chol (M3 selective)
-MOA: inhibits invol. contractions of bladder
-^capacity of bladder (relaxes it)
-delay the initial urge to void
SE:anti-chol, tachycardia, confusion
-avoid w/3A4, 2D6 inhibitors
Hyoscyamine
Urispas
-incontinence
-AVOID in elderly
Estrogen
-incontinence
-ring/cream
-poor evidence-but can help atrophic vaginitis
Alpha Blockers
-BPH
1)Terazosin (Hytrin)
2)Doxazosin (Cardura)
3)Alfuzosin (UroXatral)
4)Tamsulosin (Flomax)
MOA-dec. smooth muscle tone leading to dec. urethral resistance
-titrate slow!
-SE:orthostatic hypotension
(GIVE AT BED)
-also used for high BP (except Tamulosin)
-days-wks for benefit
-more common than 5-alpha inh. b/c of cost and quick effect
5-Alpha Reductase Inhibitors
-BPH
1)Finasteride (Proscar)
2)Dutasteride (Avodart)
-MOA:inhibit 5-alpha reductase blocking the conversion of testosterone to active dihydrotestosterone, which interferes w/ prostate enlargement
-SE:sex.dys, breast tenderness/enlargement
-takes 3-6mo.
-dec. PSA
-start low, titrate up
-teratogenic, women avoid exposure
Pseudoephedrine
-incontinence (stress)
-sympathomimetic
-strengthen smooth muscle responsible for opening and closing the bladder's internal sphincter
SE:agitation, insomnia, anxiety, tachycardia
Sildenafil
Viagra
-ED
-phosphdiesterase inhibitors
MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis
SE:HA, flushing, dyspepsia, diarrhea, rhinitis, nausea, blue tinged vision, dizziness, rash
-tk on empty stomach
-30-60 min. onset
-4 hr. duration
-caution w/ nitrates, antihypertensives
Tadalafil
Cialas
-ED
-phosphdiesterase inhibitors
MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis
SE:HA,dyspepsia, back/limb pain, myalgias, rhinitis, flushing
-30 min onset
24-36 hr duration!!!
-caution w/ nitrates, antihypertensives
Vardenafil
Levitra
-ED
-phosphdiesterase inhibitors
MOA: ^cGMP levels producing smooth muscle relaxation leading to ^blood flow to penis
SE:HA,dyspepsia, back/limb pain, myalgias, rhinitis, flushing
-caution w/ nitrates, antihypertensives