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35 Cards in this Set

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SSRI
Serotonin Reuptake Inhibitors
SSRI Adverse Effects
Rash skin abnormalities. Drugs bind to receptors for neurotransmitters caues headaches, dizziness, sedation, insomnia, restlessness, tremor, and gastrointestinal dysfuncion and decreased libdo, weight loss. Serotonin Syndrome
SSRI Serotonin Syndrome
increased level of Serotonin characterized by fever, agitation, confusion, tremors, and cardiovascualr abnormalities, which may progress to coma and death.
SSRI Interactions
highly plasma protein bound metabolized by the cytochrome P450 (liver)
Cytochrome P450
cytochrome mixed funcion oxidase system
SSRI Contraindications
Should not be used with MAOI's or within 2 weeks of terminating treatment of MAOI. can cause manic episode or exacerbate exisitng mania
Fluxoetine (generic)
Prozac, Sarafen (brand name)
Fluxoetine dosage
usual dosage 20/mg day administerd in the morning Maximum adult dose 80mg/day
Fluxoetine notes
Store at Room temp
Very long Half life (2 days 1st dose)can stay in plasma for as much as two months

lower incidence of adverse effects

94% of drug is plasma protien bound

longer duration in the elderly
fluvoxamine (fluvoaxmine maleate) (generic)
Luvox (brand name)
fluvoxamine dosage
50 mg qd hs increasing 100-300mg pediatric dose 25mg max pediatric dose 200mg/day
fluvoxmine special notes
store at room temp sensitive to humidity

has shortest half life of all SSRI's no active metbolites are formed less protein bound

sedation is more common

anorexia and weight loss less of a concern

approved for obsessive-compulsive disorder (OCD)
metabolite
A metabolite is any substance produced or used during metabolism (digestion). In drug use, the term usually refers to the end product that remains after metabolism.
OCD
obsessive-compulisve disorder
SSRI Mechanism of action
inhibit the membrane protein pumps that transport released serotonin 5HT
Paroxetine hydrochloride(generic)
Paxil (Brand name)
Paroxetine hydrochloide dosage
immediate release tablets or oral suspension 20mg/day increasing 10mg/day increments to a maximum dose of 50mg/day
paroxetine mesylate (generic)
Asimia (brand name)
Paroxetine mesylate dosage
20-50 mg /day(adult) 20-40mg daily (geriatric dose)
paroxetine mesylate special notes
therapy of OCD panic disorder and depression

mesylate form is more completly absobed effects more predictable

half life prolonged in geriatric patients
sertaline hydrochloride (generic)
Zoloft (brand name)
Sertaline hydrochloride dosage
25mg/day increasing to 50mg/day after one week. Max dose 200mg/day
Sertaline hydrocloride special notes
very little sedation does not interfere with motor skills

food increase bioavailablity of the durg. take with meals
venlafaxine hydrocloride
effexor effexxor XR
venlafaxine hydrocloride special notes
treates melancholia, not a pure ssri

no contraindications in geriatric patients

35% protein bound

half-life prolonged in paites with liver disease
citalopram
celxa
citalopram dosage
20 mg daily dose increase to 40mg max dose 80mg
citalopram notes
highly selective SSRI
very low receptor binding
decreased adverse effects

dosage reduced for elderly and paitens with reduced hepatic function

antifungal agents may decrease cilaopram clearance
escitalopram
lexapro
escitalopram dosage
10mg once daily
escitalopram notes
highly selective ssri
100 fold more potent than citalopram
very low receptor binding
decreased adverse effects
56% protein bound

half-life double din patents with reduced liver function
SRA
Serotonin Receptor Agonists

used for migraine headaches
SRA mechanism of action
SRA act as a direct agnist at the serotonin receptor mimic effects of serotonin
Sumatriptan succinate
Imitrex
sumatriptan succinate dose
50-110mg per dose max dose 200mg store between 2 and 30℃