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43 Cards in this Set
- Front
- Back
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Phenelzine
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nonspecific MAOA inhibitors, irreversible
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tranylcypromine
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nonspecific MAO inhibitor, irreversible
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selegiline
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transdermal MAO inhibitor, nonspecific
at low doses, specific for MAO B for Parkinson's fewer food restricitions, but still drug interactions |
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clomipramine
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TCA
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fluoxetine/Prozac
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SSRI
active metabolite, long t1/2 interacts with P450 2D6 - TCAs no 1st order kinetics |
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sertraline/Zoloft
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SSRI
less interaction with P450 |
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Citalopram/Celexa
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SSRI
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Paroxetine/Paxil
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SSRI
no 1st order PK P450 2D6 - interaxn with TCAs |
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Fluvoxamine/Luvox
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SSRI
OCD and antidepressant strongly inhibits P4501A2 -> inc levels of theophylline |
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Side effects of TCA
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anticholinergic effects
alpha1 blockade - orthostasis anti-histamine (sedation, weight gain, drowsiness) cardiac toxicity |
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Side effects of SSRIs
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GI - nausea, vomiting, diarrhea
sexual dysfunction initial increase in anxiety |
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Trazodone
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5HT2 antagonist
for depression and insomnia potentially irreversible priapism |
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Nefazodone
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5HT2 antagonist
for depression weak 5HT and NE reuptake inhibition strongly inhibits P4503A4 - inc carbamazepine and OC rare side fx of liver failure |
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Buproprion
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antidepressant and smoking cessation
mech unclear seizure risk, esp anorexia and bulemia |
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Venlafaxine
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SNRI - Effexor
blocks 5HT> NE reuptake (like 3 amine without side fx) |
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Duloxetine
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SNRI - Cymbalta
blocks 5HT>NE (like 3 amine without side fx) |
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Mirtazapine
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antidepressant - Remeron
blocks a2 adrenergic receptors -> inc NE and 5HT release blocks 5HT2 and 5HT3 receptors less GI side fx than SSRIs P450 met, cleared by kidney |
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Imipramine
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TCA
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Lithium
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Mood stabilizer
monitor blood levels - toxicity close the therapeutic levels cleared by kidney - inc plasma levels with HCTZ, ACEis, NSAIDs; dec with theophylline |
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Side effects of Li
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pregnancy - Ebstein's anomaly
tremor concentrating defect - polyuria, polydipsia nausea, vomiting, diarrhea rare neuro side fx thyroid, parathyroid CV, dermatological weight gain and fluid retention |
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Valproate
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Mood stabilizer - anticonvulsant
highly bound to albumin - aspirin inc levels CBZ and phenytoin induce met Valproate inc CBZ GI, tremor, sedation contraind for very young children - liver toxicity Inc androgens - PCOS |
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Lamotrigine
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Mood stabilizer - anticonvulsant
autoinduces Stevens Johnson syndrome - rash more effective for depressed phase |
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Carbamazepine
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Mood stabilizer - anticonvulsant
autoinduces induces met of valproate and antipsychotics, OC dec estrogen GI, sedation, blurred vision, ataxia, clumsiness, dizziness |
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haloperidol
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typical antipsychotic
high potency |
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fluphenazine
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typical antipsychotic
high potency |
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chlorpromazine
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typical antipsychotic
low potency |
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clozapine
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atypical antipsychotic
low risk of long term movement disorders other potentially fatal side effects - agranulocytosis, sedation, seizures low D2 binding - can be used in psychotic Parkinson's |
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risperidone
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atypical antipsychotic
low dose low EPS total active moeity consta - depot with slow release |
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olanzapine
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atypical antipsychotic
young, smoking male has dec plasma levels marked weight gain and dec glucose tolerance |
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quetiapine
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atypical antipsychotic
weight gain second to olanzapine |
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ziprasidone
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atypical antipsychotic
inc QT interval less problems with weight gain |
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aripiprazole
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atypical antipsychotic
partial agonist at D2R antagonist at 5HT2 less problems with weight gain and movement disorders |
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lorazepam
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benzodiazepine
glucuronized and excreted by kidney little effect of liver disease or aging shorter t1/2 |
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diazepam
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benzodiazepine
complex P450 met, susceptible to liver disease/aging longer t1/2 |
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chlordiazepoxide
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benzodiazepine
intermediate onset, slow distribution t1/2 |
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zolpidem
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non benzodiazepine
binds alpha1 omega GABA receptor soporific only extended release (Ambien CR) |
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zaleplon
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non benzodiazepine
binds alpha1 omega GABA receptor soporific only |
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eszopiclone
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nonselective GABA receptor binder
anxiolytic and muscle relaxant rapidly absorbedm met by liver |
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buspirone
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partial 5HT 1a receptor agonist
mech unknown, but not cross reactive with benzos anxiolytic delayed efficacy 3-4 wks, chronic use only nonlinear kinetics |
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donepezil
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AChE inhibitor - Aricept
6-12 mo stabilization period results in 1-2 wks large VOD, 1st order linear PK met 2D6 3D4 |
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rivastigmine
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AChE inhibitor
plasma t1/2 1-2hrs, fxnal t1/2 10-12hrs sig 1st pass effect food enhances bioavailability |
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Galantamine
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AChE inhibitor
inactivated by both liver and kidney |
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memantine
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Alzheimer's disease
uncompetitive antagonist of NMDA receptor prevents excitotoxicity for moderate-severe dementia |
