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83 Cards in this Set
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What type of med is this? Any prominent SE or other comments?
Amitriptyline (Elavil) |
tricyclic, tertiary amine (as supposed to secondary amine or tetracyclic compound which has fewer anticholinergic and sedating effects).
HIGHLY anticholinergic, very sedating |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) |
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What type of med is this? Any prominent SE or other comments?
Doxepin (Adapin, Sinequan) |
tricyclic, tertiary amine (as supposed to secondary amine or tetracyclic compound which has fewer anticholinergic and sedating effects).
HIGHLY anticholinergic, very sedating |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) |
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What type of med is this? Any prominent SE or other comments?
Imipramine (Tofranil) |
tricyclic, tertiary amine (as supposed to secondary amine or tetracyclic compound which has fewer anticholinergic and sedating effects).
HIGHLY anticholinergic |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) |
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What type of med is this? Any prominent SE or other comments?
Clomipramine (Anafranil) |
tricyclic, tertiary amine (as supposed to secondary amine or tetracyclic compound which has fewer anticholinergic and sedating effects).
HIGHLY anticholinergic, very sedating. Note: OCD responds specifically to clomipramine, may also be useful in those with depression with marked obsessive features |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) |
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What type of med is this? Any prominent SE or other comments?
Trimipramine (Surmontil) |
tricyclic, tertiary amine (as supposed to secondary amine or tetracyclic compound which has fewer anticholinergic and sedating effects).
HIGHLY anticholinergic, very sedating. |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) |
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What type of med is this? Any prominent SE or other comments?
Desipramine (Norpramin) |
TCA, secondary amine (as supposed to tertiary amine, which is more sedating)
Least anticholinergic, not sedating |
Other secondary amines are: Nortriptyline (pamelor)
Protriptyline (Vivactil) Desipramine is the LEAST anticholinergic and not sedating |
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What type of med is this? Any prominent SE or other comments?
Nortriptyline (Pamelor) |
TCA, secondary amine.
Less anticholinergic |
Other secondary amines are:
Protriptyline (Vivactil) Desipramine is the LEAST anticholinergic and not sedating |
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What type of med is this? Any prominent SE or other comments?
Protriptyline (Vivactil) |
TCA, secondary amine.
Less anticholinergic, not sedating. SE: Psychomotor stimulation |
Other secondary amines are:
Nortriptyline (Pamelor) Desipramine is the LEAST anticholinergic and not sedating |
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What type of med is this? Any prominent SE or other comments?
Amoxapine (Asendin, Asendas) |
Tetracyclic, less antichoinergic
SE: can cause extrapyramidal syndrome and NMS |
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To avoid fatal serotonin syndrome, no SSRI or SSNRI should be combined with a monoamine oxidase inhibitor. An SSRI should be discontinued at least ____ weeks before starting an MAOI.
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5 weeks!
What are the symptoms of serotonin syndrome? |
Serotonin syndrome is characterized by (in order of appearance):
diarrhea, restlessness, extreme agitation, hyperreflexia, autonomic instability, myoclonus, seizures, hyperthermia, rigidity, delirium, coma, death. |
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What type of med is this? Any prominent SE or other comments?
Fluoxetine (Prozac) |
SSRI, used in treatment of OCD
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Other SSRIs include: Sertraline, paroxetine, fluvoxamine, citalopram, escitalopram.
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What type of med is this? Any prominent SE or other comments?
Sertraline (Zoloft) |
SSRI, causes diarrhea more commonly than other SSRIs, used in the treatment of OCD
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Other SSRIs include: Fluoxetine, paroxetine, fluvoxamine, citalopram, escitalopram.
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What type of med is this? Any prominent SE or other comments?
Paroxetine (Paxil) |
SSRI, mildly anticholinergic, used in treatment of OCD
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Anticholinergic:
- dry mouth - blurry vision - urinary retention - constipation - sedation - orthostatic hypotension (alpha adrenergic blockade) - tachycardia - prolongation of QT interval - weight gain (antihistamine-1 effect) Other SSRIs include: Fluoxetine, Sertraline, fluvoxamine, citalopram, escitalopram |
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What type of med is this? Any prominent SE or other comments?
Fluvoxamine (Luvox) |
SSRI, N/V common, used in OCD treatment
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Other SSRIs include: Fluoxetine, sertraline, praoxetine, citalopram, escitalopram
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What type of med is this? Any prominent SE or other comments?
Citalopram (Celexa) |
SSRI, possibly fewer sexual side effects than other SSRIs and SSNRIs
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Other SSRIs include: Fluoxetine, sertraline, praoxetine, fluvoxamine, escitalopram
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What type of med is this? Any prominent SE or other comments?
Escitalopram (Lexapro) |
SSRI
Nearly all SSRIs and SSNRIs have SE: agitation, akathisia, anxiety, panic, insomnia, diarrhea, GI distress, HA, sexual dysfunction, delayed ejaculation or impotence or anorgasmia |
Other SSRIs include: Fluoxetine, sertraline, praoxetine, fluvoxamine, citalopram
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What type of med is this? Any prominent SE or other comments?
Venlafaxine (Effexor) |
SSNRIs, used to treat GAD and social anxiety.
SE: anxiety, may increase blood pressure at higher doses, HA, insomnia, sweating |
Other SSNRIs: duloxetine (cymbalta)
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What type of med is this? Any prominent SE or other comments?
Duloxetine (Cymbalta) |
SSNRI, also used for treatment of GAD and painful diabetic neuropathy
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Other SSNRI: venlafaxine (effexor)
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What type of med is this? Any prominent SE or other comments?
phenelzine (Nardil) |
MAOI
SE: orthostatic hypotension, somnolence, weight gain Other: all cheese, fermented or aged foods, wine and liver should be avoided. Should not be coadministered with SSRIs. |
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What type of med is this? Any prominent SE or other comments?
isocarboxazid (marplan) |
MAOI
SE: orthostatic hypotension, somnolence, weight gain Other: all cheese, fermented or aged foods, wine and liver should be avoided. Should not be coadministered with SSRIs. |
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What type of med is this? Any prominent SE or other comments?
Selegiline (Eldepryl/ Emsam) |
MAOI
SE: orthostatic hypotension, somnolence, weight gain, irritation at patch site Other: all cheese, fermented or aged foods, wine and liver should be avoided. Should not be coadministered with SSRIs. |
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What type of med is this? Any prominent SE or other comments?
Tranlycypromine (parnate) |
MAOI
SE: orthostatic hypotension, somnolence, weight gain Other: all cheese, fermented or aged foods, wine and liver should be avoided. Should not be coadministered with SSRIs. |
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What type of med is this? Any prominent SE or other comments?
Nefazodone (Serzone) |
Misc. antidepressant med.
Mech of action: Serootnin-2 antagonist and serotonin reuptake inhibitor. SE: sedation, hepatotoxicity Note: Less sexual dysfunction with this drug than with SSRIs and SSNRIs |
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What type of med is this? Any prominent SE or other comments?
Trazodone (Desyrel) |
Misc. antidepressant med.
Mech of action: Serootnin-2 antagonist and serotonin reuptake inhibitor. SE: Priapism (prolonged erection may lead to impotence), orthostatic hypotension, sedation Notes: can be used in low doses to manage sleep probs but should be avoided with MAOIs |
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What type of med is this? Any prominent SE or other comments?
Mirtazapine (Remeron) |
Misc. antidepressant med.
MOA: Noradrenergic and specific serotonin antagonist SE: Weight gain, sedation. Note: NO interference with sexual function, no N or diarrhea |
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What type of med is this? Any prominent SE or other comments?
Buproprion (Wellbutrin) |
Misc. antidepressant med.
Mech of action: NE and dopamine reuptake inhibitor SE: GI (N/ anorexia), seizures at high doses, less sexual dysfunction Note: also used for smoking cessation, CI in pts with eating disorder or seizure disorder |
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What type of med is this? Any prominent SE or other comments?
Lithium |
Mood stabilizer
Mech of action: inhibits adenylate cyclase enzme SE: N, tremor, hypohtyroidism, cardiac dysrhythmias, diarrhea, diabetes insipidus (thirst, urination, weight gain, acne) |
At toxic levels, significant alterations in consciousness, seizures, coma, and death may occur.
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What type of med is this? Any prominent SE or other comments?
Valproic acid, valproate (Depakene) |
Mood stabilizer
Mech of action: opens chloride channels, unknown SE: thrombocytopenia, pancreatitis, weight gain, hair loss, GI distress, cognitive dulling, NEURAL TUBE DEFECTS IN PREGNANCY What other mood stabilizer has the exact same profile? |
divalproex sodium (depakote) has the exact same profile as valproic acid, valproate (depakene)
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What type of med is this? Any prominent SE or other comments?
Divalproex sodium (Depakote) |
Mood stabilizer
Mech of action: Opens chloride channels, unknown SE: thrombocytopenia, pancreatitis, weight gain, hair loss, GI distress, cognitive dulling, NEURAL TUBE DEFECTS IN PREGNANCY What other mood stabilizer has the exact same profile? |
Valproic acid, valproate (depakene) has the same exact profile as divalproex sodium (depakote)
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What type of med is this? Any prominent SE or other comments?
Carbamazepine (tegretol) |
Mood stabilizer
mech of action: inhibits kindling, inhibits repetitive firing of action potentials by inactivating sodium channels SE: N/V, slurred speech, dizziness, drowsiness, low WBC count, high liver function tests, cognitive slowing CI: in preggers as can cause craniofacial defects in newborn |
Other: Potent inducer of P450 system
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What type of med is this? Any prominent SE or other comments?
Lamotrigine (Lamictal) |
Mood stabilizers
SE: leukopenia, rash, hepatic failure, N/V, diarrhea, somnolence, dizziness |
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What type of med is this? Any prominent SE or other comments?
Gabapentin (Neurontin) |
Mood stabilizer
SE: Somnolence, dizziness, ataxia, fatigue, leukopenia, weight gain Other: no drug-drug interactions bu rash can be fatal |
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What type of med is this? Any prominent SE or other comments?
Topiramate (Topomax) |
Mood stabilizer
SE: Psychomotor slowing, memory probs, fatigue Other: MANY drug-drug interactions |
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What type of med is this? Any prominent SE or other comments?
Chlorpromazine (thorazine) |
Low potency first generation antipsychotic med
Note: Sedation and orthostatic hypotension are very common SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
half life of Chlorpromazine (thorazine) is 24hrs (8-55 hr range is listed in casefiles)
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What type of med is this? Any prominent SE or other comments?
Haloperidol (haldol) |
High potency first generation antipsychotic
Note: extrapyramidal syndrome very common, available in long acting intramuscular depot SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
half life of haloperidol (haldol) is 24 hrs (8-55 range)
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What type of med is this? Any prominent SE or other comments?
Thioridazine (Mellaril) |
Low potency first generation antipsychotic med
Note: higher incidence of cardiac disturbances than others, and retinitis pigmentosa SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
half life of haloperidol (haldol) is 24 hrs (8-55 range)
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What type of med is this? Any prominent SE or other comments?
Mesoridazine (serentil) |
Low potency first generation antipsychotic med
note: cardiac arrhythmias (torsades de pointes) higher risk SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
half life 30 hrs (8-55 hr range for first gen antipsychotic agents listed in casefiles)
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What type of med is this? Any prominent SE or other comments?
Molindone (lidone, moban) |
medium potency first generation antipsychotic med
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
12 hr half life
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What type of med is this? Any prominent SE or other comments?
fluphenazine (prolixin) |
high potency first generation antipsychotic agent
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
18 hr half life
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What type of med is this? Any prominent SE or other comments?
Trifluoperazine (Stelazine) |
high potency first generation antipsychotic agent
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
18 hr half life
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What type of med is this? Any prominent SE or other comments?
Thiothixene (Navene) |
high potency first generation antipsychotic agent
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
34 hour half life
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What type of med is this? Any prominent SE or other comments?
Perphenazine (Etrafon, Trilafon) |
high potency first generation antipsychotic agent
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
12 hour half life
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What type of med is this? Any prominent SE or other comments?
Loxapine (Loxitane) |
medium potency first generation antipsychotic agent
SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
8 hr half life
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What type of med is this? Any prominent SE or other comments?
pimozide (orap) |
high potency first generation antipsychotic
Mech of action: block central dopamine receptors. Are effective in reducing positive symptoms of schizophrenia. SE: -CNS effects: extrapyramidal symptoms, tardive dyskinesias, sedation, neuroleptic malignant syndrome - anticholinergic effects - cardiovascular effects (esp alpha adrenergic blockade --> orthostatic hypotension), cardiac rhythm disturbances - endocrine effects: decreasing dopamine in pituitary glands leads to increased prolactin levels that can cause gynecomastia and galactorrhea and sexual dysfunction - weight gain |
55 hr half life
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What type of med is this? Any prominent SE or other comments?
Clozapine (Clozaril) |
second generation antipsychotic agent
Action site: serotonin-dopamine antagonist SE: Agranulocytosis, anticholinergic side effects, weight gain, sedation neuroleptic malignant syndrome |
Note: complete blood count and diff counts required weekly or for the first 6 months and biweekly thereafter
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What type of med is this? Any prominent SE or other comments?
Risperidone (Risperdal) |
second generation antipsychotic agent
Action site: serotonin-dopamine antagonist SE: extrapyramidal withfrawal syndrome in high doses, postural hypotension, increased prolactin; weight gain, sedation, decreased concentration |
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What type of med is this? Any prominent SE or other comments?
Olanzapine (Zyprexa) |
second generation antipsychotic agent
Action site: serotonin-dopamine antagonist SE: Increased prolactin, orthostatic hypotension, anticholinergic side effects, weight gain, somnolence |
Get alanine amino transferase levels as drug affects the liver
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What type of med is this? Any prominent SE or other comments?
Quetiapine (Seroquel) |
second generation antipsychotic agent
Action site: serotonin-dopamine antagonist SE: orthostatic hypotension, somnolence, transient increase in weight |
Do a slit lamp eye examination at baseline and every 6 months for those at risk for developing cataracts
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What type of med is this? Any prominent SE or other comments?
Ziprasidone (Geodon, Zeldox) |
second generation antipsychotic agent
Action site: serotonin-dopamine antagonist SE: Dose-related QT interval prolongation, psotural hypotension, sedation |
Need to get baseline potassium and magnesium measurements
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What type of med is this? Any prominent SE or other comments?
Aripiprazole (Abilify) |
Secnod generation antipsychotic agent
Mech of action: partial agonist at doapmine and srotonin - 1A receptors and antagonist at postsynaptic serotonin 2A receptors SE: headache, nausea, anxiety, insomnia, somnolence |
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What type of med is this? Any prominent SE or other comments?
Diazepam (Valium) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Lorazepam (Ativan) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Clonazepam (Klonopin) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Alprazolam (Xanax) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Chlordiazepoxide (Librium) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Oxazepam (Serax) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Temazepam (Restoril) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Midazolam (Versed) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Triazolam (Halcion) |
benzodiazepine
mech of action: bind to GABA receptors. Are effective in anxiety and sleep disorders and in reducing ancity and agitation in other disorders like acute psychosis. Metabolized by liver. SE: sedation, behavioral disinhibition (esp in young or elderly), psychomotor impairment, cognitive impairment, confusion and ataxia Note: are addictive and after prolonged use, withdrawal can cause seizures and death |
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What type of med is this? Any prominent SE or other comments?
Buspirone (BuSpar) |
other anxiolytic/sedative-hypnotic
Indicated in generalized anxiety SE: HA, GI distress, dizziness Other: Less useful in patients who have used benzodiazepines; should not be used with MAOIs |
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What type of med is this? Any prominent SE or other comments?
Zolpidem (Ambien) |
other anxiolytic/sedative-hypnotic
Indicated for insomnia disorder SE: HA, drowsiness, dizziness, nausea, diarrhea Other: increased effect with alcohol or selective serotonin reuptake inhibitors |
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What type of med is this? Any prominent SE or other comments?
Zaleplon (Sonata) |
other anxiolytic/sedative-hypnotic
Indicated for insomnia SE: HA, peripheral edema, amnesia, dizziness, rash, nausea, tremor |
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What type of med is this? Any prominent SE or other comments?
Remeleton (Rozerem) |
other anxiolytic/sedative-hypnotic
Indicated: for insomnia SE: HA, galactorrhea |
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What type of med is this? Any prominent SE or other comments?
Eszopiclone (Lunesta) |
other anxiolytic/sedative-hypnotic
Indicated for insomnia SE: anxiety, decease in sexual desire, dry mouth, unpleasant taste Other: stopping drug suddenly can cause anxiety, unusual dreams, stomach and muscle cramps, nausea, vomiting, sweating and shakiness |
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What type of med is this? Any prominent SE or other comments?
Dextroamphetamine and amphetamine (Adderall) |
Stimulant
Indicated for ADHD SE: nervousness, restlessness, difficulty falling asleep or staying asleep Other: might slow children's growth or weight gain, can be addictive |
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What type of med is this? Any prominent SE or other comments?
Modafinil (Provigil, Alertex, Modavigil) |
Stimulant
Inidcated for: Narcolepsy, excessive daytime sleepiness SE: Dizziness, insomnia, diarrhea Other: increases the release of monoamines and elevates hypothalamic histamine levels |
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What type of med is this? Any prominent SE or other comments?
Dextroamphetamine (Dexedrine) |
Stimulant
Indication: ADHD, narcolepsy SE: Nervousness, restlessness, difficulty falling asleep or staying asleep Other: can be addictive |
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What type of med is this? Any prominent SE or other comments?
Methylphenidate (Ritalin, Concerta) |
Stimulant
Indicated for: ADHD, narcolepsy |
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Choice of drug to treat extrapyramidal symptoms produced by neuroleptics is
A. alprazolam B. benzotropine C. fluoxetine D. naloxone |
B. benzotropine
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Extrapyramidal side effects:
- Parkinsonism - masklike face, cogwheel rigidity, pill-rolling tremor - akathisia - restlessness and agitation - dystonia - sustained contraction of muscles of neck, tongue, eyes, diaphragm Occurs with high potency traditional antipsychotics, is reversible, can occur within days of starting med, can be life threatening (ex. dystonia of the diaphragm --> asphyxiation!) FA183 |
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Hyperprolactinemia occurs with what two of the following?
A. high-potency traditional antipsychotics B. low-potency traditional antipsychotics C. olanzapine D. risperidone |
A. high-potency traditional antipsychotics
C. olanzapine FA183 |
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___________ is characterized by choreoathetoid muscle movements, usually of mouth and tongue. Occurs after many years of antipsychotic use (esp high potency typical antipsychotics) and can be irreversible.
A. extrapyramidal side effects B. tardive dyskinesia C. neuroleptic malignant syndrome |
B. tardive dyskinesia
FA183 |
EPS is Parkinsonism (masklike face, cogwheel rigidity, pill rolling tremor), akathisia, dystonia (sustained contraction of muscles of neck, tongue, eyes diaphragm)
NMS: fever, tachy, HTN, tremor, elevated CPK, "lead pipe" rigidity. Can be caused by all antipsychotics after short or long time. Medical emergency with 20% mortality rate. |
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______________ consists of fever, tachycardia, HTN, tremor, elevated CPK, "lead pipe" rigidity. Can be caused by all antipsychotics after short or long time (increased with high-potency traditional antipsychotics). Is a medical emergency with 20% mortality rate.
A. extrapyramidal side effects B. tardive dyskinesia C. neuroleptic malignant syndrome |
C. neuroleptic malignant syndrome
FA183 |
EPS is Parkinsonism (masklike face, cogwheel rigidity, pill rolling tremor), akathisia, dystonia (sustained contraction of muscles of neck, tongue, eyes diaphragm)
Tardive dyskinesia: choreoathetoid muscle movements, usually of mouth and tongue. Occurs after years of antipsychotic use (esp high potency typical antipsychotics) and can be irreversible. |
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Which of the following are INDUCERS of CYP450 group? (CYP450 commonly metabolizes psychiatric drugs so knowing these is v. important!)
A. barbiturates B. carbamazepine C. duloxetine D. fluoxetine E. fluvoxamine F. paroxetine G. sertraline H. smoking I. St. John's wort |
A. barbiturates
B. carbamazepine H. smoking I. St. John's wort FA 184 |
Important CYP450 inhibitors include:
D. fluoxetine E. fluvoxamine F. paroxetine G. sertraline |
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Which of the following, is FALSE?
A. all antidepressants have similar response rates in treating major depression but differ in safety and side effect profiles. B. about 70% of patients with major depression will respond to antidepressant medication. About 30% of this is placebo response. C. most antidepressants have a withdrawal phenomenon, characterized by dizziness, HA, nausea, insomnia and malaise. May need to be tapered. |
All of those are TRUE.
trick question |
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This has the longest half-life with active metabolites; therefore, no need to taper. IS safe in pregnancy, approved for use in children. More common sleep changes and anxiety.
A. Citalopram (Celexa) B. Escitalopram (Lexapro) C. Fluoxetine (Prozac) D. Fluvoxamine (Luvox) E. Paroxetine (Paxil) F. Sertraline (Zoloft) |
C. Fluoxetine (Prozac)
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Highest risk for GI distrubances of the listed meds.
A. Citalopram (Celexa) B. Escitalopram (Lexapro) C. Fluoxetine (Prozac) D. Fluvoxamine (Luvox) E. Paroxetine (Paxil) F. Sertraline (Zoloft) |
F. Sertraline (Zoloft)
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Short half-life leading to withdrawal phenomena if not taken consistently.
A. Citalopram (Celexa) B. Escitalopram (Lexapro) C. Fluoxetine (Prozac) D. Fluvoxamine (Luvox) E. Paroxetine (Paxil) F. Sertraline (Zoloft) |
E. Paroxetine (Paxil)
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This is currently approved only for use in obsessive-compulsive disorder (OCD).
A. Citalopram (Celexa) B. Escitalopram (Lexapro) C. Fluoxetine (Prozac) D. Fluvoxamine (Luvox) E. Paroxetine (Paxil) F. Sertraline (Zoloft) |
D. Fluvoxamine (Luvox)
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Side effects of SSRIs mostly resolve within a few weeks and include... (8)
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- sexual dysfunction (25-30%)
- GI disturbance - insomnia - headache - anorexia, weightloss - restlessness - seizures - serotonin syndrome FA187 |
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True or False:
Venlafaxine (Effexor) can increase blood pressure so do not use in patients with untreated or labile BP. |
TRUE
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Which of the two following are serotonin-NE euptake inhibitors (SNRIs)?
A. Bupropion (Wellbutrin) B. Duloxetine (Cymbalta) C. Nefazodone (Serzone) D. Trazodone (Desyrel) E. Venlafaxine (Effexor) |
B. Duloxetine (Cymbalta)
E. Venlafaxine (Effexor) |
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Which of the following can lower seizure threshold so use with caution in patients with epilepsy and eating disorders?
A. Bupropion (Wellbutrin) B. Duloxetine (Cymbalta) C. Nefazodone (Serzone) D. Trazodone (Desyrel) E. Venlafaxine (Effexor) |
A. Bupropion (Wellbutrin)
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Which ar eserotonin receptor antagonists and agonists?
A. Bupropion (Wellbutrin) B. Duloxetine (Cymbalta) C. Nefazodone (Serzone) D. Trazodone (Desyrel) E. Venlafaxine (Effexor) |
C. Nefazodone (Serzone)
D. Trazodone (Desyrel) Useful in treatment of refractory major depression, major depression w/ anxiety, and insomnia. Do not have sexual side effects of SSRIs and do not affect REM sleep. SE of nausea, dizziness, orthostatic hypotension, cardiac arrhythmias, sedation, priapism. |
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