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44 Cards in this Set

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Least anticholinergic TCA's
Desipramine
Nortriptyline
TCA with least orthostatic hypotension
Nortriptyline
Tertiary amine preferentially work on which amine
Serotonin (esp clomipramine)
Secondary amine act more on?
NE (es desipramine)
Mechanism of Action for Venlafaxine
SSNRI
Advantage of Venlafaxine
10% greater rate of full reminission
Duloxetine
Like venalafaxine but more balanced effect on seritonin and norepi

Can be given at full dose initially
Uses for Buproprion
Bipolar Depression
ADHD
Smoking Cessation

Slightly higher seizure risk than TCA's
Use for Buspirone
Generalized anxiety disorder
DOC for generalized anxiety disorder
Buspirone
Trazadone
Sedative
Useful in agitated dementia

No real side effect issues
Nefazodone
Like traz but with less sedation and REM sleep supression

May cause liver failure so being removed from the market
Anti-Depressant with less sedative effects than other.

May have serious side effect
Nefazodone

Liver failure
Carbamazepine
Mood stabilizer and broad spectrum anti-convulsant. Also works for neuralgia.

Better than Li for mixed states
Better than Li for Bipolar with mixed episodes or rapid cycling
Carbamazepine
Note as good of a anti-depressant as Li but as good for manic states
Valproate

Rare side effect of fatal hepatotoxicity, hemorrhagic pancreatitis and agranulocytosis in those under two years of age with other anticonvulsants
Don't give this drug to kids under 2 years old, especially if they are on other anticonvulsants
Valproate
First approved mantenance tx for bipolar disorder since lithium
Lamotrigine

may cause rash, Steve-Johnson syndrome

Go low and slow
Indication for ECT
Refractory to TX
Need for rapid correction
Catatonia
Refractory Schizophrenia
Pregnant
Benzodiazapine antagonist
Flumazenil
Flumazenil
Benzo anatagonist
Zolpidem
BZ1 selective

Sedation with little disruption of REM sleep

Good for initial insomnia
Good for initial insomnia
Triazolam
Zolpidem
Benzo's given IV
Lorazepam and Midazolam

Lorazepam more reliable for acute anxiety, aggitation

Midazolam has shorter half-life, better for anesthesia
For actuately agitated patients
Lorazepam IV

can be given with haldol
Rapid Onset Benzo's
Flurazepam, Tempazepam, Quazepam and Triazolam
Good for middle insomnia
Flurazepam

Long half life, some residual sedation
Best for inital insomnia
Triazolam

not associated with amnesia dn behavioral changes
Bezo'w without active metabolites (for elderly or liver compromised)
Lorazepam
Oxazepam
Tempazepam
Best benzo's for routine use
Lorazepam
Chlordiazepoxide
Clonazepam
TX for generalized anxiety disorder
Buspirone (low and slow)

Benzo's TCA's and venalafaxine esp. if previously treated with benzo's
Tx for Panic Disorder
Bezon's acutely, but not monotherapy

Use SSRI or TCA for prophylaxis
Tx for Phobic Disorder
Behavioral Therapy

Benzo for acute
Benzo for public speaking
SSRI's and MAOI's for Generalized Social Phobia
Tx for PTSD
TCA's and MAOI's 1st Line
Clondine, Naltrxone or Propranolol
Lithium and Carbamazepine

No Benzo's
SSRI's are good, but may induce arousal and anxiety
Tx for OCD
SSRI's
Best Benzo for Detox
Clonazepam
Greatest risk for addiction
Alprazolam (Xanax)

Short half-life, rapid onset
Risk for amnesia
Triazolam
Secondary Amines preferentially act on what receptors
NE more than 5_HT

Desipramine, Nortriptyline
Clomipramine preferentially acts on which receptor
Serotonin
Venlafaxine preferential action
SSRI at low dose
More NE action at high dose
Duloxetine preferntial action
5HT, NE equally
Buspirone MOA
Pre and Post synaptic Serotonin partial agonist/antagonist

For GAD
Trazodone Preference
Serotonin anatgonist only