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61 Cards in this Set
- Front
- Back
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amitriptyine
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elavil
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nortriptyline
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pamelor
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imipramine
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tofranil
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desipramine
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norpramin
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clomipramine
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anafranil
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TCA MOA
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NE and 5HT reuptake inhibitor
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TCA side effects
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cardiovascular
anticholinergics sedation weight gain sexual dysfunction |
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Olanzapine
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zyprexa
sedation weight gain orthostatic hypotension anticholinergics |
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risperidone
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risperdal
prolactin elevation orthostatis sexual dysfunction |
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quetiapine
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seroquel
sedation hypotension HA weight gain lenticular formation |
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ziprasidone
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geoden
mild sedation minimal weight gain QTc prolongation |
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Clozapine
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Clozaril
Agranulocytosis seizures sedation hypotension salivation weight gain |
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aripiprazole
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abilify
anxiety HA nausea constipation |
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phenelzine
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nardil
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tranylcypromine
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parnate
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MOA MAOI
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irreversible inhibition of MAO A and MAO B to raise 5HT DA NE
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MAOI side effects
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hypotension
dizziness weight gain insomnia cardiac effects constipation sexual disfunction |
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Tyramine- absolute contraindications
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aged cheese
aged meats tap beer sauerkraut soy sauce banana peel marmite |
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tyramine- moderate contraindications
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red/white wine
canned or bottled beer |
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drug interactions of tyramine
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merperidine- agitation, seizure, coma
SSRI, TCA, stimulants, levodopa- hypertensive crisis |
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selegiline
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emsam
MAO A and dose-dependent MAO B. food contstrictions start at 9 mg |
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citalopram
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celexa
only 5HT inhibitor |
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escitalopram
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lexapro
s-entatiomer of citalopram |
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fluoxetine
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prozac, sarafem
long t1/2 active metabolite 2D6, 3A4, 2C inhibition |
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fluvoxamine
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luvox
1A2, 3A4, 2C inhibitor |
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paroxetine
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paxil
anticholinergic short t1/2 2D6 inhibition |
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sertraline
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zoloft
active metabolite |
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SSRI side effects
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nausea
diarrhea sedation insomnia anxiety HA sexual side effects night mares night sweats serotonin syndrome |
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venlafaxine
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-effexor
-SNRI (NE >150 mg) -active metabolite -N/D -HA -hypertension -sexual dysfunction -nervousness -insomnia -XR reduces SE |
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duloxetine
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-cymbalta
-5HT, NE reuptake inhibitor -metabolized by 2d6, 1A2 -Nausea -insomnia -headache -sexual dysfunction |
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Bupropion
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-wellbutrin
-NDRI -contraindications: sz, bulemia, zyban -GI upset -restlessness -insomnia -sz -HA -NO SEXUAL SE |
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nefazodone
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-serzone
-SRI (S2 antagonist, NE at higher dose) -3A4 inhibitor -only generic due to liver failure -dry mouth -nausea -dizziness -constipation -sedation -liver failure -NO SEXUAL SIDE EFFECTS |
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Mirtazapine
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-remeron
-alpha 2, 5HT3, 2A, 2C antagonist -increases NE and 5HT -weight gain -sedation -dry mouth -constipation -NO SEXUAL SIDE EFFECTS |
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Trazodone
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-heterocyclic antidepressant
-increases 5HT -H1 blocker -used for insomnia |
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SJW
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-hypericum
-SSRI -COC interaction |
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Lithium- MOA, what for
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-classic mania
-effects anion exchanged and sodium transport -normalizes transmission of 5HT, HE, DA |
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Lithium- pk
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-t1/2 =24 hours
-renal! -effects in 5-10 days |
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Lithium levels
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-manic: 0.9-1.4
-maintenace: 0.45-0.6 -blood levels every week until stable |
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Lithium- monitor
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-na
-ecg -bun, Scr -thyroid -preg -wbc -urinalysis/ kidney function |
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lithium- short term side effects
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-GI upset
-tremor -poly liquids -fatigue |
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lithium- chronic side effects
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-tremor
-poly liquids -wbc -acne -weight gain -hypothyroid |
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lithium- teratogenicity
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cardiovascular congenital effects
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Lithium toxicity
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-mild-severe (1.5-2.5)
-hold dose and care for them |
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lithium- advantages
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-control mania without drugged effect
-normalize mood -prophalactic -relapses are shorter and less severe -blood monitoring gives accurate titration -low cost |
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lithium- disadvantages
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-narrow window
-patient compliance for watching for toxiticy -lag period before TM works -prophylatic effect is 6 mo to a year -expense of blood draws -makes rapid cyclers worse |
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VPA (BP)
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-rapid cyclers and mixed episode
-3-5 days -enhance GABA activity by effecting Na channels -hepatic metabolism (glucuronidation, oxidation) -50-120 mcg/ml -cbc -lft -GI distress -sedation -weight gain -alopecia -thrombocytopenia -inc. LFT -pancreatitis -hepatotoxicity |
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carbamazapine (BP)
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-rapid cyclers and mixed episode
-inhibits transmission at Na channel -hepatic 3A4 metabolism -1-2 weeks for effect -8-12 mg/l -get level 12 hr post 5 day dose -cbc -electrolytes -LFTS -sedation -ataxia -nausea -rash -hyponatremia -aplastic anemia -thrombocytopenia |
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lamotrigine (BP)
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-BPII
-delay time of occurence of mood episodes -inhibits VG Na channels -titrate to avoid rash -interacts with VPA, CBZ |
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Anticonvulsants (BP)
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topiramate
oxcarbamazine gabapentin tiagabine |
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atypical antipsychotics (BP)
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-all work
-dose high -refractory-this and AED |
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carbamazapine
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-tegretol
-partial, tonic-clonic -metabolized by 3A4 -autoinduction -CNS SE -SIADH -leukopenia -aplastic anemia -hepatitis -rash -4-12 mg/ml -induces cyp, udp |
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phenytion
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-dilantin
-partial, tonic-clonic -excessive binding -2c9, 2C19 metabolized -CNS SE -rash -gingical hyperplasia -hirstriusm, coarse facial features -osteoporosis -cyp, ugd inducer -interactions with antacids and enteral feedings -10-20 mg/ml (1-2 unbound) |
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VPA
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-depakote
-all seizures -saturable binding -glucuronidation, minor cyp -CNS SE -platelet effects -parkinsonism -hepatotoxicity -pancreatitis -weight gain -menstrual cycle abnormalities -50-100 mg/ml -inhibits cyp and ugd -can be induced |
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pb
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-partial, tonic-clonic
-20% renal, 50% cyp -long t1/2 -sedation, decreased cog function -megaloblastic anemia -osteomalacia -rash -excites kids -induces cyp, ugt -15-20 mg/ml |
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gabapentin
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-neurontin
-partial -saturable binding -renal -no interaction -weight gain -CNS -edema |
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pregabalin
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-lyrica
-renal -no interactions -weight gain -euphoria -cns |
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lamotrigine
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-lamictal
-all seizures -gluc, t1/2-24, 15, 60 -no induction, inhibition -not as much CNS -ha -insomnia -rash- go slow! -4-20 mg/ml |
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topirimate
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-topamax
-all seizures -low binding -renal -inhibits 2C9, induces 3A4 -CNS -kidney stones -weight loss |
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zonisamide
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-zonegran
-partial, absence, myoclonic -63 hours -no induction or inhibition -3A4 -CNS -kidney stones -rash -Scr -sulfa allergy |
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levetiracetum
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-keppra
-partial, absence, myoclonic -unbound -renal, non-cyp -no interactions -10-50 mg/ml -sedation -behavior -weight neutral |
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oxcarbamazine
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-trileptal
-partial -no autoinduction -inhibit 2C19 -induce 3A4, UGT -CNS SE -abdominal pain -tremor -hyponatremia |
