Adult Mental Health Meds Flashcards
(40 cards)
SSRIs
Fluoxetine (Prozac) long half-life, good for adolescents and those that may miss a dose, very activating, take in am
Sertaline
Citalopram QTC prolongation, weight nuetral, max dose 40mg, 20mg if >60yo
Escitalopram weight neutral
Paroxetine heavy weight gain very sedating, avoid use in obesity, HTN, DM
Fluvazamine seldom used bc dosed 2x/day poor se profile, used in OCD when pt does not respond to any other med
SSRIs & SNRI for PTSD
Fluoxetine, Paroxetine and Sertaline [Venlafaxine (SNRI)]
SNRIs great for depression and anxiety
Venlafaxine and Desvenlafaxine
monitor HR and BP in both meds
SNRIs
Venlafaxine used in ADHD & depression
Dsevenlafaxine
Duloxetine - helps w/ depression, chronic anxiety, fibromyalgia, and diabetic neuropathy. Smoking will reduce bioavailibility of drug by 33%
Levomilnacipra
Milnacipran
Atypical Antidepressants
Bupropion (Wellbutrin) may use in ADHD, nicotine addiction, do not give in pt has anxiety, do not give in eating disorders, don’t give in seizure disorders or renal or GI issues
Mirtazapine low doses cause sedation, helps pt w/ decrease appetite gain weight and also helps with insomnia in low doses
Serotonin Antagonist Reuptake Inhibitors (SARI)/Antidepressant
Trazadone
Nefazodone
Serotonin Partial Antagonisht Reuptake Inhibitor/SSRI
Vilazodone treats depression and anxity
BZDs
Lorazepam short half-life more addicting
Clonazepam Long Acting
Chlordiazepoxide Long Acting
Oxezepam
Alprazolam shorter half-life more addicting
Diazepam: used for severe alcohol withdrawal and seizures, long acting
Temazepam Long Acting
Midazolam & Triazolam ultra short acting
Anxiolytics
Buspirone (Buspar) takes 4-6 wks to take effect, must take regularly do not take as PRN
Other meds for somatic features:
Propranolol
Atenolol
Clonidine also helps w/ ADHD
Stimulants
Amphetamine/dextropamphetamine (Adderall)
Dexmethylphendiate (Focalin)
Dextroamphetamine
Methyphenidate (Ritalin)
Lisdexamfetamine dimesylate (less addicting)
Non Stimulant ADHD Meds
Guanfacine
Clonidine
Atomoxetine –> may increase SI
Antidepressants such as desipramine, venlafaxine, and buproprion
Typical Antipyschotics/FGA
Impacts positive symptoms
Haloperiodol
Loxapine
thiordazine
thiothixene
fluphenazine
mesodazine
trifluoperzine
chlorpromazine
perphenazine
SGA
Impacts negative and positive symptoms w/ less EPS
Clozapine: used to reduce pyschotic symptoms and episodes resistant to 1st line atipyschotics
Ziprasidone
Risperidone
Quetiapine
Aripiprazole
Iloperiodne
Asenapine
Lurasidone
Mood Stabilizer
Valproic Acid
Divalproex Sodium
Lithium Carbonate
Lamotrigine
Carbamazepine
Oxcarbazepine
MAOIs
High overdoese potential
Interacts negatively w/ tyramine found in many foods causes HTN crisis, do not combine MAOIs w SSRI or TCA w/in 14 days of each other
Phenelzine
Tranycypromine Sulfate
Selegiline Transdermal
Meds that may cause depression
BB, steroids, interferons, isotretinon (Accutane), some retroviral drugs, cancer drugs, BZDs, progresterone
May induce mania
Steroids, disulfiram, Isoniazid, antidepressants w/ bipolar disorder
False + Drug Screens
Amphetamines: stimulant, wellbutrin, fluozetine, trazodone, ranitidine, nefazone, nasal decongestants, pseuoephedrine
Alcohol: Valium
BZDs: Sertaline
Cocaine: amoxicillin, other abx, and NSAIDS
Heroine or morphine: quinolones, rifampin, codeine, poppy seeds
Meth or PCP: cough syrup/nyquil
What meds are great for depression and chronic pain?
SNRIs and TCAs
Tx w/ antidepressants
Initial improvement w/in 1-2wks
max improvement w/in 4-12 weeks
if zero response @ max dose w/in 4-8 wks, switch to a different antidepressan w/in same or different class
When remission is reached continue tx for 4-9 mo
Serotonin Syndrome
Life threatening event/ medical emergency
Autonomic instability, restlessness, agitation, myoclonus, hyperreflexia, hyperthermia, diaphoresis, tremors, chills, diarrhea, ataxia, HA, insomnia
TX: stop all offending meds, use IV fluids and muscle relaxants, o2, HTN meds, in severe cases serotonin blockers
Course for mild 24-72hrs, mid-severe days - weeks
Nonpharm interventions for Mood Disorders
ECT, transcranial magnetic stimulation, vagal nerve stimulation, Phototherapy (do not use w/ bipolar disorder may cause manic episode)
Which Personality Disorder is common w/ BPD
1/3 OF BPD pts have Cluster B personality type which includes borderline, narcissistic, antisocial and histrionic
1st line Pharm for BPD
Mood stabilizer for entire life. Lithium is great choice for pts w/ significant SI bc it reduces SI b 13 fold, must get labs w/ lithium use
Meds for bipolar depression
seroquel, Symbyax (combo of olanzapine and fluoxetine/ great for bipolar depression for an eight week period), lurasidone
