Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
118 Cards in this Set
- Front
- Back
|
What is the only SSRI that is PC D? Why?
|
paroxetine hydrochloride, pulmonary HTN, others are C
|
|
|
What CYP for fluoxetine and paroxetine? What DI to watch out for?
|
2D6, 1c antiarrhythmics
|
|
|
What is only SSRI hepatically excreted?
|
fluoxetine
|
|
|
What brand name of fluoxetine if used for PMDD (premenstrual dysphoric disorder)?
|
serefem
|
|
|
What AE SSRI and warfarin?
|
highly protein bound
|
|
|
What SSRI causes weight gain?
|
paroxetine (pudgy)
|
|
|
What SSRI causes weight loss?
|
fluoxetine (L for loss)
|
|
|
What other AD makes you lose weight?
|
bupropion
|
|
|
What is SE of sertraline?
|
diarrhea
|
|
|
What SSRI does not come as a oral solution?
|
fluvoxamine
|
|
|
What is a CI for Zoloft solution?
|
disulfram, because has alcohol in it
|
|
|
What SSRI has ODT?
|
citalopram
|
|
|
What SSRI has once weekly dosing?
|
fluoxetine, 90mg
|
|
|
What is max dose for bupropion?
|
SR is 400mg/day, 450mg/day for others
SR can't be given withing 8hrs of each other (BID dosing) |
|
|
What is only SSRI for kids? What age?
|
fluoxetine, 8 years or older
|
|
|
What is fluoxetine metabolite?
|
norfluoxetine
|
|
|
Which has longer t1/2 fluoxetine or norfluoxetine?
|
norfluoxetine
|
|
|
What cyps for bupropion?
|
2D6 inhibitor, 2B6 metabolizes
|
|
|
What is sertraline metabolite?
|
n-desmethylsertraline
|
|
|
What are the secondary TCAs?
|
amoxapine, desipramine (Norpramin), nortriptyline (Pamelor), protriptyline (Vivactil)
|
|
|
What are the tertiary TCAs?
|
amitriptyline, clomipramine (Anafranil), doxepin (Sinequan), imipramine (Tofranil), trimipramine (Surmontil)
|
|
|
What is the SNRI that is indicated only for obesity?
|
Meridia (Sibutramine)
|
|
|
How long for antidepressant effect with AD drugs?
|
see improvement at 2 weeks, 4-6 weeks for max effect
|
|
|
What is TCA with least sedation? Why?
|
desipramine (Norpramin), least H1 receptor affinity
|
|
|
What is TCA with greatest NE effects?
|
desipramine (Norpramin)
|
|
|
What is the only topical TCA?
|
doxepin (Sinequan)
|
|
|
Which TCA is used for fibromyalgia?
|
amitriptyline
|
|
|
Which TCA is used for COPD?
|
protriptyline (Vivactil)
|
|
|
What TCA is better to use in elderly? Why?
|
desipramine (Norpramin), less anticholinergic, in glaucoma don't have to worry about ocular pressure
|
|
|
Which TCA has the highest chance of decreasing seizure?
|
clomipramine (Anafranil)
|
|
|
Which SNRI is a 2D6 inhibitor?
|
duloxetine
|
|
|
Which SNRI is used in fibromyalgia?
|
duloxetine
|
|
|
What is Nefazodone (Serzone) BBW?
|
hepatic failure
|
|
|
What is Trazodone BBW?
|
suicide
|
|
|
What trazodone AE and what causes them?
|
dizziness form anti alpha 1
sedations from antihistmine priapism more in men |
|
|
What is a nefazodone (Serzone) AE?
|
more priapism effect in women
|
|
|
What triazolopyridine has the longest t1/2?
|
nefazodone (Serzone)
|
|
|
How long is acute tx for depression?
|
3 months
|
|
|
How long is continuation tx for depression?
|
4-9 months
|
|
|
What is criteria for indefinite tx of depression?
|
anyone with 3 episodes or more
anyone > 50 years old with 2 episodes anyone > 60 years old with 1 episode |
|
|
Which AD have worst withdrawal?
|
paroxetine and venlafaxine
|
|
|
What is another drug that SSRIs interact with?
|
triazoloBDZ
|
|
|
What is the main AE for bupropion?
|
seizures/tics
if on something for seizures and stable can give |
|
|
What effect does trazodone have on digoxin?
|
increase concentration
|
|
|
What drugs are used for serotonin syndrome?
|
cyproheptadine (Periactin), methysergide, propranolol, dantrolene (Dantrium) (for hyperthermia)
|
|
|
What is required when taking methysergide for migraine?
|
6 month drug holiday
|
|
|
What is main use for trazodone?
|
help them sleep
|
|
|
What is only MAOI with a patch?
|
selegiline (Eldepryl)
|
|
|
What foods should be avoided in MAOI?
|
chees and wine, high in tyramine
|
|
|
What was the first MAOI used?
|
Iproniazid
|
|
|
How do you manage MAOI htn crisis?
|
acidify urine with vit C and use IV BB
|
|
|
What does MAO A metabolize?
|
5-ht, epi, ne, mor in intestine
|
|
|
What does MAO B metabolize?
|
DA
|
|
|
What effect does MAOI have on heart?
|
suppress s/s of angina, watch for MI
|
|
|
Which MAOIs are hydrazine derivatives?
|
isocarboxazid (Marplan), phenelzine (Nardil)
|
|
|
How long do you wait after taking fluoxetine before starting MAOI (vice versa)?
|
5 weeks
2 week if go from MAOI to fluoxetine |
|
|
Which MAOI regains normal MAO the fastest?
|
tranylcypromine (Parnate)
|
|
|
What is active ingredient in St. Johns wort?
|
hypericum
|
|
|
What can you take to make Adderall absorb more?
|
antacid
|
|
|
What methylphenidate dosage form is a patch?
|
Daytrana
|
|
|
What methylphenidate is 30% IR and 70% ER?
|
Metadate CD
|
|
|
What methylphenidate is the OROS dosage form, and how is it released?
|
Concerta, first part is released in 1 hour, the rest lasts 5-9 hours
|
|
|
What methylphenidate is available as a solution and chewable tablet?
|
Methylin
|
|
|
What methylphenidate is available as SODAS (spheroidal oral drug absorption) form and 50/50 ratio of IR/ER?
|
Ritalin LA
|
|
|
What is the max dose for methylphenidate?
|
72mg for Concerta
60mg for the rest |
|
|
Which isomer of methylphenidate is more active, D or L?
|
D isomer
|
|
|
What is metabolite of methylphenidate?
|
ritalinic acid or PPA
|
|
|
Which form of methylphenidate do you poop the tablet?
|
Concerta
|
|
|
How long do you wear the patch and where do you put it for Daytrana?
|
Wear patch for 9hrs on hip, lasts for 12 hours, put on 2hrs before you want effect, alternate hip
|
|
|
What methylphenidate should no be given if there is a GI obstruction?
|
Concerta
|
|
|
What are the main things you worry about with stimulants?
|
glaucoma, tics, HTN, wt loss, insomnia, MAOIs
|
|
|
What methylphenidate is wax matrix SR tablet?
|
Ritalin SR
|
|
|
What is one drug that should not be given with stimulants?
|
clonidine
|
|
|
What methylphenidate is hydrophilic polymer ER tab?
|
Methylin ER
|
|
|
Which stimulants are IR tablet?
|
Ritalin, Methylin, Focalin (dexmethylphenidate), Dexedrine (dextroamphetamine), Adderall
|
|
|
What methylphenidate is wax matrix ER tablet?
|
Metadate ER
|
|
|
What stimulant is SR beads?
|
Dexedrine Spansules (dextroamphetamine)
|
|
|
Which methylphenidate is eurand diffucaps technology?
|
Metadate CD
|
|
|
Which stimulant is microtrol IR and controlled release beads, 50/50 ratio IR/ER?
|
Adderall XR
|
|
|
Why isn't atomoxetine (Strattera) addictive?
|
doesn't work in nucleus accumbens
|
|
|
What is MOA of atomoxetine (Strattera)?
|
selective NE reuptake inhibitor
|
|
|
What is atomoxetine (Strattera) BBW?
|
suicide
|
|
|
How many symptoms do you have to have to be diagnosed with ADHD?
|
6 for 6 months, have to diagnose before 7 months
|
|
|
What are the 2 sections of ADHD?
|
attention and hyperactivity
|
|
|
Where does ADHD have to be diagnosed?
|
2 different locations; home, school, physicians office
|
|
|
What is MOA of triptans?
|
5-HT1B and 5-HT1D receptor agonists
|
|
|
Which triptan is not renally dosed because it is only 10% renally excreted?
|
Frovatriptan (Frova)
|
|
|
Which triptan has the longest t1/2?
|
frovatriptan (Frova)
|
|
|
Which triptans are ODT?
|
zolmitriptan (Zomig) and rizatriptan (Maxalt)
|
|
|
Which triptans have nasal spray?
|
zolmitriptan (Zomig) and sumatriptan (Imitrex)
|
|
|
What is the triptan with SQ injection?
|
sumatriptan (Imitrex)
|
|
|
What vitamin can be given for migraine prophylaxis?
|
B2 (riboflavin) and Mg also
|
|
|
What herbals can be given for migraine?
|
feverfew and bilberry
|
|
|
Which triptan is used for cluster HA?
|
sumatriptan (Imitrex) injection
|
|
|
When can you repeat triptans?
|
naratriptan (Amerge) 4 hours, sumatriptan (Imitrex) 1 hour, all others are 2 hours
|
|
|
Which triptan's t1/2 increases in the elderly?
|
eletriptan (Relpax)
|
|
|
What triptan is CI for severe renal impairment (CrCl <15)?
|
naratriptan (Amerge)
|
|
|
What triptans are CI for severe hepatic impairment?
|
naratriptan (Amerge), sumatriptan (Imitrex), eletriptan (Relpax)
|
|
|
What triptans are CI for cerebrovascular or peripheral vascular syndromes?
|
naratriptan (Amerge) and sumatriptan (Imitrex)
|
|
|
What triptans are CI for peripheral vascular disease?
|
frovatriptan (Frova) and eletriptan (Relpax)
|
|
|
Can you give SSRI with triptan?
|
can, but watch out for serotonin syndrome
|
|
|
What is fluoxetine/olanzapine?
|
Symbyax, SSRI and atypical antipsychotic, for depression
|
|
|
Which triptan is 3A4?
|
eletriptan (Relpax)
|
|
|
Which SSRIs are 3A4?
|
fluoxetine and fluvoxamine
|
|
|
Which SSRI is 1A2?
|
fluvoxamine
|
|
|
What is sumatriptan/naproxen?
|
Treximet
|
|
|
What is Midrin?
|
isometheptene, APAP, dichloralphenazone
C4 control |
|
|
What does isometheptene do?
|
vasoconstrictor, works on alpha beta
|
|
|
What SSRI have the highest sexual dysfunction?
|
fluoxetine and paroxetine
|
|
|
Which triptan causes somnolence?
|
rizatriptan (Maxalt)
|
|
|
What triptan is the most plasma protein bound?
|
eletriptan (Relpax)
|
|
|
What receptor does sumatriptan (Imitrex) bind?
|
5-HT1
|
|
|
What triptans bind to 5HT1b,d, and f?
|
almotriptan (Axert) and eletriptan (Relpax)
|
|
|
What triptans bind to 5HT1b and 5HT1d?
|
frovatriptan (Frova), zolmitriptan (Zomig), and rizatriptan (Maxalt)
|
|
|
What triptan binds to 5-HT1d only?
|
naratriptan (Amerge)
|
|
|
Does frovatriptan (Frova) bind to BDZ receptor sites?
|
no
|
|
|
Which SSRI is excreted the most in breast milk?
|
fluoxetine
|
|
|
Which SSRI is excreted the least in breast milk?
|
sertraline
|
