Psych Meds Mu

Front 1

SSRI's class ADR's

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Sexual side effects
anorexia, weight loss, weight gain,
-bruxism
-suicidal ideation and behavior
-Serotonin syndrome
-Discontinuation syndrome
-increase risk of UGI bleeding

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Fluoxteine- MOA

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Increase the amount of serotonin available in the synapse
-SSRI

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Clinical indications for Fluoxetine

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MDD
OCD
Panic disorder
bulimia
PMDD

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Fluoxetine interactions

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Potent inhibitor of CYP2D6 (B-blocker)

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Clinical indications for Sertraline

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-MDD
-OCD
-panic disorder
-PTSD
-social anxiety disorder
-PMDD
(SSRI)

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#1 ADR of Sertraline

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nausea

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INdications for Paroxetine

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mdd
gad
ocd
ptsd
social anxiety disorder
pmdd

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paroxetine interactions

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strong inhibitor of CYP2D6

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ADR's of Parozetine

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anticholingeric effects (xerostomia, constipation, sedation)

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Indications for Citalopram

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treatment of depression and off lable us

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indcations of Escitalopram

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MDD
GAD

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only approved for treatment of OCD

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Fluvoxamine

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name the 2 SNRI's

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Venlafaxine
Duloxetine

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indications for Bupropion

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-treatment of depression
-adjunct in smoking cessation

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ADR's of Buproprion

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-orginally associated with seizures in anorexia and bulimia patients, they are contraindicated

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common ADR's of Trazadone

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Sedation
postural hypotension
hepatotoxicity

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ADR's of Mirtazapine

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Sedation-more sedation a *lower doses
-*increase in appetite, weight gain

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When should baseline ECG's be done for TCA's

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>40 yrs
< 40 yrs screen by history, if negative don't need one

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tertiary amine TCA's

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imipramine
amitrityline

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secondary amine TCA's

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Desipramine
nortriptyline

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interactions of Imipramine

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moderate inhibitor of CYP2D6

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ADR's of Imipramine

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orthostatic hypotension
sedation
anticholingeric effects

Front 23

clinical indications for amitriptyline

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-treatment of depression
-analgesic for certain neuropathies and prophylaxis against migraine headaches

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Indications of Desipramine

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-depression
-peripheral neuropathies (unlabeled)

Front 25

good drug to start on for a TCA

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Nortriptyline

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indications for nortriptyline

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depression
peripheral neuropathies (unlabeled)

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MAO- name one

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Phenelzine

Front 28

contraindications to MAOI's

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unctontrolled HTN
pheo
concurrent use of sympathomimetics
food with a high content of tyramine

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clinical indications for MAOI's

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"atypical depression" (depression with hyperphagia or hypersomnia)

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ADR's of MAOIs

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**dizziness due to hypotensive effects

Front 31

common classes of meds for anxiety

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ssri's
buspirone
tca's
benzos
maoi's
combo therapy

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clinical indciations for buspirone

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GAD

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Benzo's to treat anxiety

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Alprazolam
Lorazepam
Diazepam
Midazolam

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3 phases of general treatment strategies

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1. acute phase focuses on symptoms containment/patient safety
2.Continuation phase- goal to reach full remission of symptoms and resotration of functioning
3. maintenance phase aims to sustain remision and lasts >1yr after the resolution of symptoms

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1st line pharmacologic therapy for patients with severe manic or mixed episodes

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-lithum or valproate
-antipsychotic agent

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what is the dosing for LI

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0.6-1.3meq/L

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interactions of Lithium

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Diuretics can lead to lithium toxicity

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ADR's of lithium

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hypo or hyperthyroidsm

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disturbances in the perception of reality, evidenced by hallucinations, delusions, or thought disorganization

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psychosis

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false sensory perceptions occurring in any of the five snesory modalities

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hallucinations

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false beliefs that are firmly held despite obvious evidence to the contrary

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delusions

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pyschotic disorders

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schizophrenia
bipolar mania
major depression with psychotic features
-Alzheimer's disease
-delirium

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positive symptoms

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-hallucinations
-delusions
-thought disorganization
(active psychosis)
(responds to antipsychotic medication)

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Negative symptoms

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-withdrawal
-anhedonia
-loss of motivation
(correlate with functional impairment)
-responds well to antipsychotics meds, and psychosocial interventions better

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low potency conventional anti psychotics

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thioridazine
mesoridazine

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exhibits a strong alpha-adrenergic blocking effect and depresses the release of hypophyseal/hormones

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Chloropromazine

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Interactions of Chlorpromazine

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-strong inhibitor of CYP2D6

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clinical indications for chlorpromazine

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control of mania
treatment of schizophrenia
treatment of intractable hiccups

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INdications of Haloperidol

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-schizophrenia
-Tourette's

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Adverse drug reactions for haloperidol

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postural hypotension
EPS
NMS
increase prolaction

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ADR's of Clozapine

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Agranulocytosis

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indications for clozapine

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treatment-refaractory szhizoprenia

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Olanzapine indications

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schizophrenia
bipolor

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Quetiapine ADR's

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weight gain/DM 10-20 lbs

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Risperidone ADR's

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weight gain/DM

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Ziprasidone indications

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schizophrenia
acute manic episodes

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Aripiprazole indications

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schizophrenia
acute manic episodes

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what to monitor for atpycial antipsychotics

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BMI
fasting lipid profile
fasting blood glucose