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73 Cards in this Set
- Front
- Back
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Fluoxetine
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SSRI
Longest half life so don't need taper Safe in preg and children Can elevate levels neuroleptics |
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Sertraline
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SSRI
Highest risk for GI probs (S=Stomach) Few drug interactions |
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Paroxetine
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SSRI
Highly protein bound (drug interactions) Short half life=withdrawal sx More anticholinergic effects |
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Fluvoxamine
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SSRI
Good for OCD too Lots drug interactions N/V |
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Citalopram
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SSRI
Fewest drug interactions |
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Escitalopram
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SSRI
Levo-enantiomer of citalopram with fewer SEs More expensive than citalopram |
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Side effects SSRIs
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Sex dysfunciton (anorgasmia, dec libido, delayed ejaculation) (can augment with buproprion, sildenafil, or switch antidepressant)
Anorexia HA, GI Restless (Less SEs than TCA/MAOI b/c don't act on histamine adrenergic or muscarinic receptors) |
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Venlafaxine
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SNRI
Depression, GAD, ADHD Can increase BP, otherwise SEs like SSRIs Desvenlafaxine is the active metabolite and is expensive |
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Duloxetine
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SNRI
Depression + NEUROPATHIC PAIN or fibromyalgia More dry mouth constipation (NE effects) but otherwise similar to SSRI (liver effects if bad liver) |
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Buproprion
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NDRI
Lack of sexual SEs as compared to SSRI Lowers seizure threshold and can precipitate psychosis CI in epilepsy, active eating ds, or on MAOI |
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Trazodone
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SARI/Serotonin receptor antagonist and agonist
Refractory dep + insomnia Not much sexual SEs Sedation + priapism |
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Nefazadone
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SARI/Serotonin receptor antagonist and agonist
Refractory dep + insomnia Not much sexual SEs Sedation + priapism |
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Mirtazepine
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Alpha adrenergic antagonist
Refractory dep SE: sedation, weight gain No sex SEs, few interactions Good for elderly |
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Treat TCA overdose
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IV sodium bicarbonate
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Amitriptyline
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TCA - 3*
Good for dep, migraines, chronic pain, insomnia |
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Imipramine
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TCA - 3*
Good for enuresis and panic disorder IM form too |
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Clomipramine
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TCA - 3*
Most serotonin spec. Good for OCD |
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Doxepin
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TCA - 3*
Good for chronic pain |
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Nortriptyline
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TCA - 2*
Least orthostatic hypotension, Treat chronic pain |
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Desipramine
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TCA - 2*
Least activating/sedating/anticholinergic |
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Tertiary vs Secondary TCAs
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3* are highly anticholinergic (more sedating, more lethal)
ACID=amitriptyline, clomipramine, imipramine, doxepin 2* are metabolites of 3* and are less anticholinergic Nortryptiline, Desipramine |
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Amoxapine
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Tetracyclic antidep
Metabolite of antipsychotic loxapine, may have EPS like typical antipsychiotics |
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Maprotiline
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Tetracyclic antidep
Seizure, arrhythmia, fatal OD |
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Major complications of TCA
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Cardiotox, Convulsions, Coma
Anti-HAM Histamine: sedation Adrenergic: CV SEs like orthostatic hypo, arrhythmia, widen QRS/QT/PR intervals, DON'T give to people with recent MI or Cardio probs Muscarinic: drymouth, constipation urinary retention, blurred vision, tachycardia, exacerbate glaucoma |
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Phenelzine
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MAOI
Refractory dep/anx |
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Tranylcypromine
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MAOI
Refractory dep/anx |
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Isocarboxazid
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MAOI
Refractory dep/anx |
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OCD
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SSRI (high dose) and TCA (clomipramine)
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Panic disorder
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SSRI, TCA (imipramine), MAOI
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Eating disorder
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SSRI (high dose), TCA, MAOI
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Dysthymia
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SSRI
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Social phobia
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All 3
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GAD
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SSRI, SNRI (venlafaxine) TCA
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IBS
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SSRI, TCA
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Enuresis
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TCA (imipramine)
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Neuropathic pain
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TCA (amitriptyline, nortriptyline) duloxetine
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Migraine
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TCA (amitriptyline) SSRI
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PMDD
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SSRI
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Depressive phase of manic depression
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SSRI
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Insomnia
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Mirtazepine, TCA (amitriptyline)
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Donazepil
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Cholinesterase inhibitor
Alzheimers |
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Tacrine
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Cholinesterase inhibitor
Alzheimers |
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Rivastigmine
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Cholinesterase inhibitor
Alzheimers |
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Galantamine
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Cholinesterase inhibitor
Alzheimers |
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Memantine
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NMDA antagonist
Alzheimers |
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Chlorpromazine
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Low potency typical antipsychotic
SE: bluish discoloration, orthostatic hypotens, photosensitive Treat: intractable hiccups & N/V |
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Thioridazine
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Low potency typical antipsychotic
SE: retinitis pigmentosa |
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Loxapine
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Mid potency typical antipsychotic
Higher risk seizures metabolite is antidep |
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Thiothixine
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Mid potency typical antipsychotic
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Trifluoperazine
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Mid potency typical antipsychotic
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Perphenazine
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Mid potency typical antipsychotic
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Decanoate form available
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Haloperidol and fluphenazine
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Haloperidol
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High potency typical antipsychotic
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Fluphenazine
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High potency typical antipsychotic
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Pimozide
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High potency typical antipsychotic
Associated with heart block and other heart problems |
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Treat EPS
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Decrease dose of offending antipsychotic, add benztopine or diphenhydromine
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Mesolimbic DA pathway
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+ symptoms of schizophrenia
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Mesocortical DA pathway
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- symptoms of schizophrenia
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Clozapine
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Atypical antipsychotic
More efficacious and reduce suicide risk Agranulocytosis, seizures, tachycardia, hypersal |
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Risperidone
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Atypical antipsychotic
Increase prolactin, orthostatic hypo Long acting injectible |
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Quetiapine
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Atypical antipsychotic
Sedation, orthostatic hypo |
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Olanzapine
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Atypical antipsychotic
Weight gain |
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Ziprasidone
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Atypical antipsychotic
Less weight gain |
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Aripiprazole
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Atypical antipsychotic
Unique in partial D2 agonism More activating (akathesia), less sedation and weight gain |
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Paliperidone
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Atypical antipsychotic
Metabolite of risperidone, injectible form |
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Asenepine
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Atypical antipsychotic
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Iloperidone
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Atypical antipsychotic
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Lithium
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Acute mania, prevent relapse, augment antidep/psych and abstienece from EtOH, treat aggression and impulsivity, cyclothymia
Check ECG, creatinine, thyroid function, CBC, and pregnancy test Diabetes insipidues, fine/course tremor, weight gain, sedation, hypothyroid, benign leukoctosis, EBSTEIN's abnormality (teratogen) |
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Lamotrigine
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Good for biopolar depression
Steven-Johnsons |
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Pregabalin
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GAD, fibromyalgia
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Carbamazepine
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Mixed episodes and rapid cycling bipolar
Need CBC and LFTs Teratogen, Steven-Johnsons |
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Benzodiazepine OD treatment
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Flumazenil
Don't give too quick or get withdrawal |
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Long acting benzos
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Diazepam, Clonazepam
anx, panic attacks |
