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59 Cards in this Set
- Front
- Back
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Prozac, Sarafem
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fluoxetin, SSRI (dysphoric disorder)
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Celexa
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citalopram, SSRI
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Lexapro
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escitaloporam oxalate, SSRI
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Zoloft
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sertraline, SSRI
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Paxil
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paroxetine, SSRI
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Luvox
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fluvoxamine, SSRI
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Pexeva
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paroxetine mesylate, SSRI
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SSRI side effects
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headache
anxiety insomnia transcient nausea vomiting diarrhea sedation sexual dysfunction diastolic HTN increased perspiration |
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SSRI drug interactions
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MAOI's, St John's Wart, TCA, amphetamines, NSAIDS
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Effexor
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venlafaxine, SNRI
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Serzone
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Nefazodone, SNRI
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Cymbalta
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duloxetine, SNRI, can elevate liver enzymes
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norpramin
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desipramine, SNRI
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pristiq
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desvenlafaxine, SNRI
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SNRI side effects
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headache
anxiety insomnia transcient nausea vomiting diarrhea sedation sexual dysfunction diastolic HTN increased perspiration plus high BP |
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what is serotonin syndrome and symptoms of serotonin syndrome
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overactivity of serotonin or impairment of serotonin metabolism
-agitation, diarrhea, tachycardia, hallucinations, increased body temp, loss of coordination, nausea, overactive reflexes, rapid change in BP, vomiting, coma |
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how is serotonin syndrome treated?
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24 hour observation, benzodiazepines (valium, ativan) to decrease agitation, seizure like movements and muscle stiffness, periactin-blocks serotonin production, IV fluids
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Wellbutrin, Zyban
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Bupropion, NDRI
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side effects of NDRI
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agitation/anxiety
insomnia appetite suppression psychosis |
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Remeron
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mirtazapine
alpha 2 antagonist- increases norepin/noradrenergic and serotonin |
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side effects of alpha 2 antagonists
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sedation
dizziness weight gain dry mouth constipation change in urinary functioning |
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Desyrel
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trazodone
serotonin 2 antagonist reuptake inhibitor |
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side effects of SARI
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SEDATION
weight gain nausea, vomiting CONSTIPATION dizziness fatigue in-coordination tremor |
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how do tricyclic antidepressants work?
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inhibit reuptake of serotonin and norepine
-more serious side effects -takes 7-8 days to take effect |
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Elavil
therapeutic concentration |
amitriptyline, TCA
93-140 |
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anafranil
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clomipramine, TCA (OCD, anxiety
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sinequan
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doxepin, TCA
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Trofranil
therapeutic concentration |
imipramine, TCA
175-350 |
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surmontil
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trimipramine, TCA
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asendin
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amoxapine, TCA
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norpramin
therapeutic concentration |
desipramine, TCA
> or = 116 |
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aventyl, pamelor
therapeutic concentration |
nortriptyline, TCA
58-148 |
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vivactil
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protryptyline, TCA
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ludiomil
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maprotiline, TCA
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what are the side effects of TCA's?
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CV (due to norepine)
must have EKG before starting sedation orthostatic hypotension anticholinergic--drying up (urinar retention, dry mouth, bowel hypomotility, dry mucosa) |
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TCA drug interactions
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-clonidine (catapres)- high BP
-carbamazepine (tegretol)- lower TCA levels, higher tegretol levels--toxicity -cimetidine (tagamet)- reduce breakdown of some TCA, increasing side effects |
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signs of TCA toxicity
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drowsiness
confusion slurred speech ataxia dry mucosa tachycardia urinary retention myclonus (twitching) hyperreflexia hypertension COMA conduction delays SVT hypotension RESPIRATORY DISTRESS PVC VT seizures PULMONARY EDEMA high AVB |
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how do MAOI's work?
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inhibit MAO (enzyme that breaks down serotonin, norep-increasing avaliability)
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nardil
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phenelzine, MAOI
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parnate
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tranylcypromine, MAOI
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marplan
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isocarboxazid, MAOI
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Emsam
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selegiline, MAOI, avoid exposure of heat to external patch
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side effects of MAOI's
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dizziness
headache insomnia dry mouth blurred vision constipation nausea peripheral edema urinary hesitancy muscle weakness forgetfulness weight gain sexual dysfunction |
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What foods should be avoided by those taking MAOI's?
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protein powder, miso soup, tofu, beer, banana peels, cheese, wine, protein/wine extracts, sauerkraut, smoked fish, brewer's yeast, liver, smoked/cured/aged/processed meat, salami, sausage, steak, pickled herring, shirmp paste, fava beans, whiskey, liqueurs, bean curd, ginseng
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What foods are cautions for MAOI's?
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avocados, caffeine, chocolate, dairy products, nuts, raspberries, soy sauce, spinach
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lithium citrate
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lithium citrate, antimanic-mood stabilizer
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therapeutic blood levels of lithium, peak absorption, elimination half life
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therapeutic range: 0.8-1.4 mEq/L
peak abs-1.5-4.5 half life- 24-72 |
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side effects of lithium
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weight gain, thirst, metallic taste, increased urination, fine head and hand tremor, drowsiness, mild diarrhea
-must be consistant with salt intake |
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how is lithium dosed?
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initially: 600-900 mg/dat
increase: 1200-1800 mg/TID adjust dose according to clinical response and trough at 12 hours after episode 0.6-1.0 mmol/L if no response after 14 days, D/C |
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what shoud be monitored if on lithium?
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creatinine concentration, thyroid hormones, CBC, kidney function
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signs of lithium toxicity
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delirium with disorientation, fluctating LOC, hallucinations, extrapyramidal syndromes, corticospinal dysfunction and weakness, increased tone, hyperreflexia, extensor plantar response, severe diarrhea
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depakote, peak abs, half life, therapeutic serum level
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valproic acid, antimanic, anticonvulsant
peak abs- 1-6 half life- 10-12 therapeuti serum levels- 50-120 ug/ml |
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tegretol, side effects, peak absorbtion, elimination half life, therapeutic serum levels
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carbamazepine, antimanic, anticonvulsant
-side effects: dizziness, drowsiness, tremor, visual disturbances, nausea, vomiting, weight gain, alopecia, aplastic anemia, agranulocytosis, give with food -peak absorption 4-5, half life 10-25, therapeutic serum level 4-12 ug/ml |
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lamictal, side effects
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lamotrigine, antimanic, anticonvulsants
-side effects: skin rash (benign or life threatening- Steven johnson syndrome), sedation, blurred or double vision, dizziness, n/v/gi distress |
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topamax
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topiramate, antimanic, anticonvulsant
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trileptal
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oxcarbazepine, antimanic, anticonvulsant
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neurontin
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gabapentin, antimanic, anticonsulsants
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eskalith, lithobid
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lithium carbonate, antimanic
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how do anticonvulsants work as mood stabilizers?
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reduce repetitive firing of action potentials in the nerves, used if no response to lithium
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