All Drugs Flashcards
Paroxetine
SSRI - see class
BAD:
SEDATING
SEXUAL DYSFUNCTION
DISCONTINUATION
Sertraline
SSRI - see class
BAD:
SEVERE GI DRUG INTERACTIONS
SEXUAL DYSFUNCTION
DISCONTINUATION
Fluoxetine (Prozac)
SSRI - see class
GOOD:
minimal discontinuation
good for non-compliance
BAD:
ACTIVATION
Citalopram
SSRI - see class
BAD:
DOSE DEPENDANT LONG QT
SEXUAL DYSFUNCTION
DISCONTINUATION
Escitalopram
SSRI - see class
GOOD:
better acutely and for remission than Citalopram
BAD:
LONG QT
SEXUAL DYSFUNCTION
Fluvoxamine
SSRI - see class
BAD:
GI UPSET
WEAKNESS
SEXUAL DYSFUNCTION
Amitriptyline
Tertiary TCA - see class
GOOD:
very effective
BAD:
LETHAL IN OD
V HIGH SEs
Doxepin
Tertiary TCA - see class
GOOD:
very effective
BAD:
LETHAL IN OD
V HIGH SEs
Clomipramine
Tertiary TCA - see class
GOOD:
very effective
BAD:
LETHAL IN OD
V HIGH SEs
Desipramine
Secondary TCA - see class
GOOD:
very effective
BAD:
LETHAL IN OD
HIGH SEs
Nortriptyline
Secondary TCA - see class
GOOD:
very effective
BAD:
LETHAL IN OD
HIGH SEs
Venlafaxine
SNRI - see class
GOOD: in elderly as fast renal clearance
BAD: BP RAISE DISCONTINUATION SEXUAL LONG QT
Duloxetine
SNRI - see class
GOOD:
less increase in BP than Venlaflaxine
BAD:
BP STILL RISES
DRUG-DRUG INTERACTIONS
Mirtazapine
Novel - see class
GOOD:
augmentation with SSRI
BAD:
CHOLESTEROL INCREASE
VERY SEDATING
WEIGHT GAIN
Buproprion
Novel - see class
GOOD: augmentation with SSRI no weight gain no sexual dysfunction no sedation
BAD:
SEIZURE RISK
ANXIETY !!
Lithium
Mood Stabiliser
GOOD:
long term prophylaxis of mania and depression, especially bipolar
ONLY MEDICATION THAT REDUCES RISK OF SUICIDE
BAD: TOXICITY!!! GI THYROID TERATOGENIC
NEED TO DO: U&E TSH PREG TEST CREATININE
TARGET LEVEL 0.6-1.2
> 2.5 = SEVERE TOXICITY
Fluphenazine
High Potency Typical Antipsychotic - see class
BAD:
EXTRAPYRAMIDAL SIDE EFFECTS
Haloperidol
High Potency Typical Antipsychotic - see class
BAD: EXTRAPYRAMIDAL SIDE EFFECTS
Pimozide
High Potency Typical Antipsychotic - see class
BAD:
EXTRAPYRAMIDAL SIDE EFFECTS
Chlorpromazine
Low Potency Typical Antipsychotic - see class
BAD:
CARDIOTOXIC
SEDATION
HYPOTENSION
Thioridazine
Low Potency Typical Antipsychotic - see class
BAD:
CARDIOTOXIC
SEDATION
HYPOTENSION
Risperidone
Atypical Antipsychotic - see class
BAD:
HYPERPROLACTINAEMIA
WEIGHT GAIN
SEDATION
Olanzapine
Atypical Antipsychotic - see class
BAD: WEIGHT GAIN +++
LFTs
Quetiapine
Atypical Antipsychotic - see class
BAD:
LFTs
ORTHOSTATIC HYPOTENSION
Aripiprazole
Atypical Antipsychotic - see class
GOOD:
MINIMAL SEs
Clozapine
Atypical Antipsychotic - see class
GOOD:
IT WORKS! _ RESERVED FOR TREATMENT RESISTANT PATIENTS
BAD:
LOADS OF SEs - AGRANULOCYTOSIS
SEIZURES
Valproic Acid (DEPAKOTE)
Anticonvulsant - see class
GOOD: COMORBID SUBSTANCE ABUSE RAPID CYCLERS BETTER TOLERATED THAN LITHIUM AS EFFECTIVE AS LITHIUM FOR DEPRESSION
BAD: NOT AS EFFECTIVE AS LITHIUM FOR MANIA THROMBOCYTOPAENIA PLATELET DYSFUNCTION TERATOGENIC
NEED TO DO:
LFTs
FBC
PREG TEST
TARGET LEVEL: 50-125
Carbamazepine (Tegretol)
Anticonvulsant - see class
GOOD:
1st line for acute mania and mania psychosis
RAPID CYCLERS
MIXED PATIENTS
BAD: RASH+++
AV CONDUCTION DELAY
DRUG-DRUG
NEED TO DO:
LFTs
FBC
ECG
TARGET LEVEL: 4-12
Lamotrigine (Lamictal)
Anticonvulsant - see class
GOOD:
also for chronic/neuropathic pain
BAD:
RARE BUT VERY SEVERE SKIN REACTIONS - TOXIC EPIDERMAL NECROSIS, STEVEN’S JOHNSON SYNDROME - THEREFORE WITHDRAW IMMEDIATELY IF ANY SIGN OF A RASH
NEED TO DO:
LFTs
Chlordiazepoxide
Benzodiazepine
GOOD:
for withdrawal state
BAD:
ADDICTIVE +++!!!
Thiamine
Treatment for Wernicke’s Encephalopathy and Korsakoff Psychosis
Naloxone
Specific opiate antagonist, used for the treatment of opioid toxicity, reverses resp. depression etc
