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67 Cards in this Set
- Front
- Back
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Complex partial seizures Drug therapy New Onset
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Monotherapy: Carbamazepine is Drug of Choice
Phenytoin, valproic acid, gabapentin, lamotrigine, topiramate, phenobarb |
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Absence Seizures Drug therapy
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Ethosuximide: Drug of choice
If both absence and generalized:valproic acid |
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Tonic clonic seizures drugs of choice
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Phenytoin, carbamazepine, topiramate, valproic acid
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Second-line
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Lamotrigine, phenobarb, primidone
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Drug for women that may have children to take if on anticonvulsants
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1 mg of Folic acid per day
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Phenobarb Side effects
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Drosiness,, folate deficiency, hepatic failure, teratogenic
Decreases effective ness of birth control pills |
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Phenytoin Indications
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All seizures except absence and febrile
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Phenytoin Side effects
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N/V, Osteomalacia, peripheral nuropathy, hepatic failure, teratogenic
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Phenytoin counseling
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Do not break, crush, chew
May alter your gums. Brush and floss daily |
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Carbamazapine Indications
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Most widely used anticonvulsant
DOC for complex partial Effective in most generalized seizures Ineffective in absence and febrile Carbamazepine is metabolized to its effetive drug |
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Carbamazepine Side effects
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N/V, neutropenia, reversible rash
SIADH (Hyponatremia and water retention), osteomalacia, folate deficiency Direct hepatotoxicity, Aplastic anemia Teratogenic Do not use with MAOIs |
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Valproic acid Indications
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DOC for absence seizures along with ethosuximide
All types of generalized and partial seizures Not used <2 years old |
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Valproic acid side effects
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Fatal hepatotoxicity
GI upset Avoid use in pregnancy Teratogenic |
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Gabapentin Indications
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Partial seizures: used most often for peripheral neuropathies
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Topiramate counseling
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Drink plenty of water to avoid renal caliculi (Kidney stones)
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Status epilepticus Drug of choice
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Benzodiazepenes: Lorazepam preferred over diazepam
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Bipolar Terapies
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Lithium, Divalproex sodium, carbamazepine
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Lithium Brand
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Lithobid, Eskalith generic
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Divalproex sodium Brand
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Depakote generic
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Carbamazepine Brand
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Tegretol generic
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Lithium contraindications
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Renal disease, Cardiovascular disease
Use in caution with thyroid disease, sodium depletion, diuretics |
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Lithium monitoring
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Thyroid panel - may cause hypothyroidism
SCr/BUN - Renally eliminated CBC w/diff-may cause leukocytosis Electrolytes-hyponatremia=lithium toxicity |
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Depakote indication
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first line in treating acute manic episodes, off label use for prophylaxis
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Depakote contraindications
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hepatic sysfunction, pregnancy, <2 years old
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Depakote monitoring
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Valproic acid levels
LFTs every month for 6 then every 6 months |
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Carbamazepine Indication
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Second-line for acute and prophylactic bipolar treament
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Clozapin/Clozaril drug class
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Atypical Antipsychotic
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Risperdal drug class
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Atypical Antipsychotics
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Zyprexa generic
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Olanzapine brand
Atypical antipsychotic |
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Seroquel generic
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Quetiapine brand
Atypical antipsychotic |
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Ziprasidone brand
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Geodon Generic
Atypical antipsychotic |
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Abilify generic
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Aripiprazole brand
Atypical antipsychotic |
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TCAs MOA
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Increase the synaptic concentration of 5-HT and/or norepinephirne in the CNS
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TCA Adverse effects
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Orthostatic hypotension, tachy, sedation, anitcholinergic, weight gain, sexual dysfunction
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TCA contraindications
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MAOI, pregnany, lactation, glaucoma
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Amitriptyline brand
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Elavil generic
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Nortriptyline brand
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Pamelor generic
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Imipramine brand
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tofranil generic
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Doxepin Brand
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Sinequan generic
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Clomipramine brand
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Anafranil generic
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Desipramine brand
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Norpramin generic
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Doxepin drug class
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TCA
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MAOIs MOA
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Increase synaptic concentration of NE,5-HT, and DA by inhibiting enzyme MAO
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MAOI adverse effects
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ortho hypotension
Weight gain Sexual dysfunction anticholinergics effects |
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MAOI contraindications
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Renal or hepatic dysfunction
CVD Not within 5 weeks of fluoxetine or 2 weeks of other SSRIs |
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MAOI drug food interactions
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Tyramine containing foods: red wine, aged cheese, and marmite
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Phenelzine brand
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Nardil Generic
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Phenelzine drug class
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MAOI
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Tranylcypromine brand
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Parnate generic
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Tranylcypromine drug class
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MAOI
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SSRI MOA
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Inhibit reuptake of 5-HT, Taper on disconinuation except fluoxetine
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SSRI Adverse effects
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GI, nervousness, insomnia, HA, fatigue, sexual dysfuntion
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Lexapro generic
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Escitalopram brand
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Fluvoxamine brand
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Luvox generic
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Fluvoaxamine drug class
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SSRI
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Venlafaxine brand
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Effexor generic
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Effexor MOA
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Inhibits reuptake of 5-HT and NE
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Effexor indication
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Generalized anxiety disorder and major depression
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Effexor Adverse effects
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GI, anxiety, insomnia
Elevation in BP Same as SSRIs |
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Cymbalta generic
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Duloxetine brand
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Cymbalta indications
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Major depression and diabetic peripheral neurpathic pain
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Nefazodone brand
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Serzone generic
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Nefazodone MOA
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inhibits 5-HT and NE uptake
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Mirtazapine brand
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Remeron Generic
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Remeron MOA
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Increases 5-HT and NE in synapses
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Benzodiazepine MOA
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potentiate actions of GABA by increasing influx of chloride into neurons, reducing neruonal firing
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Benzo Adverse effects
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Sedation, dizziness
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