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48 Cards in this Set
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- Back
Chlorpromazine
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Class = Antipsychotic
Trade name = Thorazine Indications: Psychosis, N/V, Sedation preop,Intractable hiccups, Tetanus adjunct, Porphyria MOA= unknown Antagonizes D2 Not used much due to TD and cardiovascular and sedation effects |
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Haloperidol
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Haloperidol
Class = Antipsychotic Trade name = Haldol Indications: Psychosis, Tourette's, Acute agitation MOA= unknown Selectively Antagonizes D2 Side effects: extrapyrimidal |
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Clozapine
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Clozapine
Class = 2nd gen, Atypical Antipsychotic Trade name = Indications: Resistant Schizophrenia MOA= unknown Selectively Antagonizes D1, D4, 5HT and others Used only by qualified psychiatrists Adverse side effects: Antichoinergic, Orthostatic hypotension, Sedation, weight gain, lipid abnormalities |
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Risperidone
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Risperidone
Class = Atypical Antipsychotic Trade name = Risperidol Indications: Schizophrenia, Bipolar-mixed MOA= unknown Antagonizes D2, 5HT and others * Not approved for dementia related psychosis - Start low and go slow Severe Side effects: Neuroleptic malignant syndrome, orthostatic hypotension, TD, Prolactin elevation |
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Clonidine
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Clonidine
Class = Antihypertensive Indicatons = HTN OFF LABEL: Neuropathic pain, opioid detox, anaesthetic uses, ADHD Adjunct MOA= Stimulates Alpha-2 adrenergic receptors, centrally acting anihypertensive ADRs: dry mouth, hypotension, sedation |
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Disulfiram
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disulfiram
Class = ALDH agonist Trade name = Antabuse Indications: Alcohol dependence MOA= Inhibits acetaldehyde dehydrogenase ADR: Hepatotoxin |
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Varenicline
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Class = N-acetylcholine R partial agonist
Trade name = Chantix Indications: Smoking cessation MOA= Agonizes and blocks alpha-2 and beta-2 nicotinic receptors ADR: SI, depression, agitation |
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Lithium
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Class = mood stabilizer
Trade name = Indications = bipolar, acute mania, schizoaffective * Must have regular monitoring MOA= unknown alters neuronal Na+ transport ADR: GI upset, tremor, polyuria; drug interactions (ACE inhibitors, NSAIDs, diuretics) |
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Quetiapine
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Class = Atypical antipsychotic
Trade name = Seroquel Indications = Schizophrenia, bipolar-mixed MOA= unknown Antagonizes D2, 5-HT and others * Avoid abrupt w/d ADR= none severe, orthostatic hypotension, sedation, lipids |
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Alprazolam
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Class = Benzodiazepine
Trade name = Xanax Indications = Anxiety, panic d/o MOA= unknown Binds to benzo receptors, enhances GABA effect * Avoid abrupt w/d ADR: CNS depressive effects |
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Temazepam
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Class = Benzodiazepine
Trade name = Restoril Indications = ST Insomnia MOA= unknown ADR: CNS depressive effects Binds to benzo receptors, enhances GABA effect * Avoid abrupt w/d |
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Clonazepam
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Class = Benzodiazepine
Trade name = Klonopin Indications = Sz, Panic d/o, anxiety, leg movement neuralgia MOA= unknown Binds to benzo receptors, enhances GABA effect D/C caqrefully: w/d and rebound anxiety ADR: CNS depressive effects |
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Valproic acid
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Indications = Sz (complex partial, simple and complex-abscence) ,
Bi polar , migraine prophylaxis, Schizophrenia w/ strong affective component trade name = valproate class = Anti-seizure drug/ mood stabilizer MOA = Unknown ADR = Teratogen, Pancreatitis * watch hepatotoxicity |
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Carbamazepine
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class = Anti-seizure drug/ mood stabilizer
Indications = Sz, Trigeminal neuralgia, Bipolar trade name = Tegretol MOA = Reduces post-tetanic potentiation, decrease Sz spread. In trigeminal neuralgia and bipoloar exact MOA is unknown ADR= Heme(agranulocytosis, aplastic anemia HLA-B 1502 allele (asians) dangerous skin rxn |
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Lamotrigine
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Class= anitconvulsant,
mania/bipolar, alt to 1st line (lithium, valproate) Indications = Bipolar maintenance 1st line for Partial Sz, atypical absence, myoclonic, atonic Lennox-Gastaut Sz General tonic-clonic Sz trade name = Lamictal MOA = Unknown * Suicidality ADR: *serious rash, withdrawal Sz, hepatic, angio edema |
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Aripiprazole
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Indications = Schizophrenia,
bipolar mixed, adjunct - major dressive d/o trade name = Abilify class = 3rd gen antipsychotic, DA system stabilizer MOA = Exact unknown, partially antagonizes D2, 5-HT1A antagonizes 5-HT2A NOT APPROVED for Dementia related psychosis (caridac) start low and go slow ADR= minimal side effect profile, Orthostatic hypotension |
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Ziprasidone
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Indications = Schizophrenia, bipolar mixed, Schiz-associated agitation
trade name = Geodon class = Exact unknown, Antagonizes D2, 5-HT and others MOA = Exact unknown NOT APPROVED for Dementia related psychosis ADR= minimal side effect profile, QT interval prolongation, neuroleptic malignant sydrome, TD, Orthostatic hypotension |
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Paroxetine
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Indication = Major Depression, Panic d/o, Anxiety (social, general), PMS dysphoric d/o
Trade name = Paxil Class = SSRI MOA = Selectively Inhibits Seratonin Reuptake Beware Seratonin Syndrome Don't mix MAOI's BBW-SI in youth ADR= Sex-dysfxn, GI upset, sedation, constipation |
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Zolpidem
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Class = Hypnotic
Indication = ST insomnia Trade name = Ambien MOA = Interacts w/ GABA-Benzo complex ADR= psychiatric/behavior changes may occur unpredictably, withdrawal effects, abuse potention, Rapid onset CNS effects |
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Seratonin Syndrome
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A predictable consequence of serotonergic CNS activity - posioning.
Increased HR, shivering, sweating, dilated pupils, myoclonus, hyper-reflexes, high BP, Hyperthermia, hypervigilance, and agitation. Caused by: antidepressants, opioids, CNS stimulants, triptans, psychedelics, herbs and others. Tx: DC causative drugs, start benzodiazepine, supportive therapies and time, 24 hrs. |
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Type B drug reaction
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Idiosyncratic drug reactions that are not dose dependent; creating an immunogenic reaction and cellular damage.
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Neuroleptic malignant syndrome
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Life threatening!
adverse rxn to antipsychotics. Muscle rigidity, fever, autonomic instability, cognitive changes, delerium F ever E ncephalopathy V itals unstable E levated enzymes (CPK) R igidity of muscles D/C any DA type drugs, Benzo's can help. |
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MAOI's
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Monoamine Oxidase Inhibitors
Antidepressants-Atypical antidepressants Last line of defense <-- potentially lethal dietary & drug interactions. Newer (seligeline, moclobemide) are safer-reversable binding. |
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SSRI's
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Selective Seratonin Reuptake Inhibitors
Antidepressants, anxiety, personality d/o, premature ejaculation. Have little affinity for NE or DA transporters Common ADR= Sex-dysfxn, GI upset Drugs in this class include (trade names in parentheses): citalopram (Celexa, Cipramil, Dalsan, Recital, Emocal, Sepram, Seropram, Citox) dapoxetine (no trade name yet; not yet approved by the FDA) escitalopram (Lexapro, Cipralex, Esertia) fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin (EUR), Fluox (NZ), Depress (UZB), Lovan (AUS)) fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox) paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Rexetin, Xetanor, Paroxat) sertraline (Zoloft, Lustral, Serlain) zimelidine (Zelmid, Normud) |
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Tricyclic or TCA's
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Antidepressants - Major depression, lower dose for insomnia and chronic pain relief.
Thought to inhibit reuptake of NE and 5-HT. Side effects are anticholinergic in nature (dry mouth, sedation) Generally replaced by SSRI and SNRI. |
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Triptans
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Migraine and cluster head aches.
Bind 5-HT receptors in cranial vessels causing constriction and inhibiting inflammatory neuropeptide release. Triptans include: sumatriptan (Imitrex) -Selective serotonin receptor agonist rizatriptan naratriptan zolmitriptan eletriptan (Relpax) almotriptan frovatriptan |
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Acetaminophen
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Indication: mild pain, fever
Class: analgesic MOA: analgesic=unknown antipyretic via the hypothalamic heat regulation center Caution with alcohol intake. |
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Ibuprofen
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Indication: mild-moderate, OA, RA, anti-inflammatory
Class: NSAID MOA: unknown cycloxygenase and lipoxygenase-reduces prostaglandin synthesis *GI problems, take w/ food |
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Hydrocodone/homatropine
hydrocodone/ibuprofen |
Indication: mild pain, fever
Class: Narcotic combo's MOA: analgesic= bind various opioid receptors |
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acetaminophen-butalbutol-caffeine
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Indication: Tension Head Ache
Trade name: Fioricet Class: analgesic-antipyretic-barbituate combo MOA: analgesic=unknown sedation= butalbutol cerebral vasoconstriction |
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Propranolol
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Class: Beta-blocker
Indication: HTN, angina, Post-MI, Migraine HA, Essential tremor ... Trade name: Inderal MOA: Non selectively antagozes Beta1 and Beta2 adrenergic receptors ADRs= Cardiac failure, CHF, Avoid abrupt W/D-->MI |
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Dihydroergotamine
DHE 45 |
Indication: HA migraine and cluster
Class: Migraine MOA: constricts cranial and peripheral blood vessels (ergot) |
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Sumatriptan
(imitrex) |
Indication: Migraine HA - acute
Class: Migraine MOA: activates 5-HT1 receptors producing vasoconstriction. |
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Gabapentin
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Indication: Partial Sz, post-herpetic neuralgia, Neuropathic pain.
Trade name: neurontin Class: Neurologic anti-convulsant MOA: exact=unknown |
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Nortriptyline
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Indication: Depression
Class: Tricyclic antidepressant MOA: unknown. Inhibits NE and 5-HT uptake |
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Amiodipine
(norvasc) |
Indication: HTN, CAD
Class: Calcium Channel Blocker, Dihydropyridines MOA: CCB for vascular smooth muscle and myocardium |
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Butorphanol
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Indication: Moderate to severe pain
Class: Narcotics MOA: Binds to opioid receptors producing both agonist (Mu) and antagonist (Kappa) effects |
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Donepezil
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Donepezil
Trade name: aricept Indication: Mild-severe Alzheimer's dementia Class: Alzheimers med- ACh EsteraseInhibitor MOA: Reversibly binds and inactivates acetylcholinesterase |
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Memantine
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Indication: Mod-Severe Alzheimer's
Class: Alzheimer's, NMDARA MOA: Binds N-methyl-D-Aspartate receptor agonist |
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Haloperidol
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Haloperidol
Trade name=Haldol Indication: Psychosis, Tourette's, Acute agitation Class: 1st Gen. antipsychotics MOA: exact=unknown Selectively antagonizes D2 receptors Not approved for dementia related psychosis. Don't use if parkinson's dz ADR=Extrapyrimidal Sx, Tardive dyskinesia |
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Clozapine
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Indication: Resistant Schizophrenia
Class: 2nd Gen. Atypical antipsychotic MOA: exact=unknown Selectively antagonizes D1, D4, 5-HT receptors *Must have psychiatrist order and administer |
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Olanzapine
(Zyprexa) |
Olanzapine
Indication: Schizophrenia, Bipolar-mixed Class: 2nd Gen. Atypical antipsychotic, Mania/Bipolar MOA: exact=unknown Selectively antagonizes DA, 5-HT receptors * Not for dementia related psychosis |
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Risperidone
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Class = Atypical Antipsychotic
Trade name = Risperidol Indications: Schizophrenia, Bipolar-mixed MOA= unknown Antagonizes D2, 5HT and others * Not approved for dementia related psychosis - Start low and go slow Severe Side effects: Neuroleptic malignant syndrome, orthostatic hypotension, TD, Prolactin elevation |
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Nortriptyline
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Nortriptyline
Indication: Depression Class: Tricyclic antidepressant MOA: exact=unknown Selectively inhibits NE and 5-HT receptors. * Suicidality ADR= Orthostatic hypotension |
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Antipsychotic Side Effects
Generally speaking |
weight gain,
hypotension, impotence, agranulocytosis, tardive dyskinesia, tardive akathisia (inner restlessness), tardive psychoses, tardive dysphrenia (worsening Sx) |
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Anticonvulsant Side Effects
Generally speaking |
All- teraogenic to some extent
Withdrawal effects Phenytoin - nystagmus Carbamazepine - Derm rxn, ataxia, drug interaction-enzymes Lamotrigine - dizziness, nausea, HA Gabapentin - sedation, dizziness Ethosuximide - GI distress, N/V Valproate - GI distress, N/V |
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Benzodiazepine Side Effects
Generally speaking |
Sedative effect (may be paradoxical in kids)
Tolerance effect Dependance effect |
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Antidepressant Side Effects
Generally speaking |
TCAs, SSRI, SNRI all have to some extent sedation and anticholinergic effects (dry mouth, constipation, urinary retention).
weight gain, diabetes impotence |