Antidepressants, Antipsychotics, & Anticonvulsants

Question 1

Amitriptyline HCl

Elavil

Answer 1

Indication(s): Depression

MOA: inhibits the membrane pump mechanism responsible for the re-uptake of norepinephrine & serotonin at the presynaptic nerve terminals.

Question 2

Aripiprazole

Abilify

Answer 2

Indication(s): Schizophrenia, bipolar disorder

MOA: Exact MOA is unknown, but may be due to a combination of partial agonist activity at dopamine D2 & Serotonin 5-HT1A receptors & antagonist activity at 5-HT2A receptors. metabolized by CYP3A4 & CYP2D6 enzymes to dehydro-aripipazole following oral administration.

Question 3

Bupropion XL

Wellbutrin, Zyban

Answer 3

Indication(s): Depression, Seasonal Affective Disorder

MOA: weak inhibitor of neuronal uptake of norepinephrine, serotonin & dopamine, and does not inhibit monoamine oxidase.

Question 4

Citalopram Hydrobromide

Celexa

Answer 4

Indication: Depression

MOA: Blocks the neuronal uptake of serotonin. but not of norepinephrine or dopamine, into human platelets in the CNS. Metabolized by CYP3A4 & CYP2C19

Question 5

Donepezil HCl

Aricept

Answer 5

Indication: Alzheimer’s Disease

MOA: reversible acetylcholinesterase inhibitor that works centrally to increase the amount of acetylchoine available at cholinergic synapses.

Question 6

Duloxetine

Cymbalta

Answer 6

Indication: Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), neuropathic pain

MOA:
potent inhibitor or neuronal serotonin & norepinephrine & a slight inhibitor of dopamine reuptake. It’s MOA is thought to be due to a potentiation of serotonergic & noradrenergic activity in the CNS

Question 7

Escitalopram

Lexapro

Answer 7

Indication: Depression
MOA: the pure s-enantiomer of citalopram. Highly selective serotonin reuptake inhibitor which blocks the neuronal reuptake of serotonin, but not of norepinephrine or dopamine, into human platelets in the CNS

Question 8

Fluoxetine HCl

Prozac, Sarafem

Answer 8

Indication: Depression, Obsessive-Compulsive Disorder (OCD), bulimia nervosa, panic disorder

MOA: Blocks the neuronal uptake of serotonin but not of norepinephrine, into human platelets in the CNS .

Question 9

Gabapentin

Neurontin

Answer 9

Indication: Seizures, postherpetic neuralgia

MOA: Exact MOA is unknown; has antiseizure activity in rats & mice. Excretion occurs by the renal route as unchanged drug.

Question 10

Lamotrigine

Lamictal, Lamictal XR

Answer 10

Indication: Seizures, bipolar disorder

MOA: Exact MOA unknown; It has weak (or zero) effects on serotonin, adrenergic, dopamine, histamine, opioid, muscarinic, GABA, or adenosine A1 or A2 receptors. It’s MOA may be due to an inhibition of voltage sensitive Na+ channels resulting in a stabalization of neuronal membranes & modulation of presynaptic transmitter release of excitatory amino acids (glutamate & aspartate).

Question 11

Memantine HCl

Namenda

Answer 11

Indication: Alzheimer’s Disease

MOA: Persistent activation of CNS N-methyl-D-aspartate (NMDA) receptors by the excitatory amino acid glutamate has been hypothesized to contribute to the sympomatology of Alzheimer’s disease. Memantine is thought to exert its therapeutic effect through its action as a low to moderate affintiy uncompetitive (open-channel) NMDA receptor antagonist. It binds preferentially tot he NMDA receptor operated cation channels. It shows little to no affinity fo GABA, benzodiazepine, dopamine, adrenergic, histamine, & glycine receptors or for voltage dependent Ca2+, Na+ or K+ channels. It does show antagonist effects at the 5HT3 receptor & a slight inhibition of nicotinic acetylcholine receptors. Excretion od unchanged drug occurs in the urine by active tubular secretion.

Question 12

Olanzapine

Zyprexa

Answer 12

Indication: Psychotic disorders, bipolar disorder

MOA: Is thought to be due to selective antagonism of dopmaine & serotonin 5HT2 receptors in the CNS. Is also an inhibitor of serotonin 5HT 2a & 2c, muscarinic M1-5, histamine H1, & adrenergic alpha-1 receptors. First pass metabolism cecreases the amount that reaches systemic circulation by 40%

Question 13

Paroxetine HCl

Paxil, Paxil XR, Pexeva

Answer 13

Indication: Depression, Obsessive-Compulsive Disorder (OCD), panic disorder

MOA: Highly selective inhibitor of neuronal serotonin uptake. It weakly inhibits Norepinephrine & dopamine neuronal reuptake. Steady state concentrations are achieve in abotu 10 days. ~95% bound ot plasma proteins & is a substrate for P-450 hepatic isoenzyme CYP2D6. Metabolized in the liver & excreted in teh urine (64%) & in the feces (36%)

Question 14

Pregabalin

Lyrica

Answer 14

Indication: Neuropathic pain, seizures, fibromyalgia

MOA: may be realted to it’s high binding affinity to alpha(2)-delta site in CNS tissues. Well absorbed after oral administration/ eliminated by renal excretion. Does not bind to plasma proteins.

Question 15

Quetiapine

Seroquel

Answer 15

Indication: Schizophrenia, bipolar disorder

MOA: multiple neurotransmitter antagonist with activity at serotonin 5HT1a, & 5HT2, dopamine1 & Dopamine2, Histamine1 & adrenergic alpha-2 & alpha-2 receptors. The MOA of quetiapine is thought to be due to its action at hte Dopamine2 & serotonin 5HT2 receptors.

Question 16

Sertraline HCl

Zoloft

Answer 16

Indication(s): Depression, Obsessive-Compulsive Disorder (OCD), panic disorder,Premenstrual Dysphoric Disorder (PMDD), social anxiety disorder

MOA:
Inhibition of neuronal uptake of serotonin (5HT). Excretion occurs both through urine & feces. Highly bound to plasma proteins (98%) & is a substate for P-450 hepatic isozyme CYP3A3/4

Question 17

Trazadone HCl
(Desyrel)

Answer 17

Indication: Depression

MOA: Inhibits serotonin uptake by brain synaptospmes therefore increasing hte behavioral effects of the serotonin precursor, 5-hydroxytryptophan. Trazodone is extensively metabolized by the liver.

Question 18

Venlafaxine XR

Effexor XR

Answer 18

Indicaiton: Depression

MOA: Serotonin-norepinephrine reuptake inhibitor (SNRI)

Question 19

Amitriptyline HCl

Elavil

Answer 19

Consultation:
May cause drowsiness
Avoid alcohol
Store in cool, dry place away from sunlight & children; if dose is missed, skip it & return to normal dosing schedule

Question 20

Amitriptyline HCl

Elavil

Answer 20

Adverse Reactions: Tachycardia, dry mouth, blurred vision, nausea, vomiting, dizziness, weakness, headache, constipation, urinary retention, drowsiness, and weight gain

Question 21

Aripiprazole

Abilify

Answer 21

Adverse Effects:
Headache, insomnia, asthenia, nausea, vomitting, constipation, weight gain, anxiety, lightheadedness, drowsiness & blurred vision. Tardive dyskinesia is a rare possibility.

Question 22

Aripiprazole

Abilify

Answer 22

Consultation:
Use caution when performing tasks that require mental alertness. Avoid alcohol while taking this medication. Use appropriate precautions against heat exposure & dehydration. Store tablets in cool, dry place away from sunlight & children. Store oral solution in the refrigerator & use within 6 months of opening the bottle. if a dose is missed, skip it & return to normal dosing schedule.

Question 23

Bupropion XL

Wellbutrin, Zyban

Answer 23

Adverse reactions:

DIzziness, constipation, weight loss, dry mouth, insomnia, sweating, agitation, and tremor

Question 24

Bupropion XL

Wellbutrin, Zyban

Answer 24

Consultation:
Swallow tablets whole/ do not crush or chew; do not double doses; Do not take OTC medications without first consulting a physician or pharmacist. Refrain form consuming alcohol. Store in a cool dry place away form sunlight. Contact a physician if side effects become severe or bothersome or if a seizure occurs. Weight loss or gain may be temporary. Pay close attention to any changes in mood, behaviors, thoguhts or feelings; antidepressants may increase thoughts of suicide or actions. Continued therapy of up to 2 weeks may be needed to show noticeable improvement.

Question 25

Citalopram Hydrobromide

Celexa

Answer 25

Adverse Reactions: Nausea, dry mouth, somnolence, insomnia, diarrhea, ejaculation disorder & impotence.

Question 26

Citalopram Hydrobromide

Celexa

Answer 26

Consultaion: May impair cognitive & motor performance; use caution when operating machinery or when mental alertness is required. Up to 2 weeks may be needed before therapeutic effects are seen. Do not abruptly discontinue medication. Avoid alcohol while taking this medication. Store in a cool dry place, way form sunlight & children. If dose is missed, skip it & return to normal dosing schedule. Pay close attention to any changes in mood behaviors, thoughts or feelings; antidepressants may increase suicidal thoughts or actions.

Question 27

Donepezil HCl

Aricept

Answer 27

Adverse Effects: Nausea, diarrhea, insomnia, vomitting, muscle cramps, fatigue, and anorexia

Question 28

Donepezil HCl

Aricept

Answer 28

Consultation: May be taken with or without food. Take in the evening, just prior to retiring. Store in a cool, dry place away from sunlight or children. if a dose is missed, skip it & return to normal dosing schedule- do not double dose!!

Question 29

Duloxetine

Cymbalta

Answer 29

Adverse Effects: nausea, dry mouth, constipation, insomnia, dizziness, diarrhea, decreased appetite, fatigue, drowsiness, sweating, vomitting, blurred vision, erectile dysfunction

Question 30

Duloxetine

Cymbalta

Answer 30

Consultation: Therapeutic effects may take as long as 4 weeks to appear. May cause drowsiness- use caution while operating machinery or when mental alertness is required. Avoid alcohol while taking this medication. Consult with physician or pharmacist before taking any nonprescription medications. do not abruptly dicontinue medication. Stor ein a cool, dry place away form sunlight & children. if dose is missed skip it & return to normal dosing schedule. Pay close attention to any changes in mood behaviors, thoughts or feelings. Antidepressants may increase suicidal thoughts or actions.

Question 31

Escitalopram

Lexapro

Answer 31

Adverse Effects:

Nausea, somnolence, insomnia, diarrhea, ejaculation disorder, increased sweating, dizziness, and impotence

Question 32

Escitalopram

Lexapro

Answer 32

Consultation: May impair cognitive & motor performance- use caution while operating machinery or when mental alertness is required. avoid alcohol while taking htis medication. Consult with your physicain or pharmacist before taking nonprescription medications. Do not abrubtly discontinue medications. Store in a cool dry place, away from sunlight & children. If a dose is missed, skip it & return to normal dosing schedule. Pay close attention to any sudden changes in mood behavior, thoughts or feelings. Antidepressants may increase suicidal thoughts or actions. COntinues therapy for up to 2 weeks may be needed to show noticeable improvement.

Question 33

Fluoxetine HCl

Prozac, Sarafem

Answer 33

Adverse Effects:
nausea, insomnia, anorexia, headache, nervousness, drowsiness, tremor, diarrhea, sweating, asthenia, decreased libido, abnormal ejaculation, and fatigue.

Question 34

Fluoxetine HCl

Prozac, Sarafem

Answer 34

Consultation: Pay close attention to any changes, especially sudden changes in mood behaviors, thoughts, or feelings. Antidepressants may increase suicidal thoughts or actions. May cause drowsiness- use caution while operating machinery or when mental alertness is required. Avoid alcohol while taking this medication. Notifiy a physician if rash or hives develop. Store in a cool, dry place away from sunlight & children. Contact a physician if the above side effects are severe or persistent. If a dose is missed, skip it & return to normal dosing schedule.

Question 35

Gabapentin

Neurontin

Answer 35

Adverse Effects:

Somnolence, dizziness, ataxia, fatigue, nystagmus, tremor, diplopia, rhinitis, and blurred vision.

Question 36

Gabapentin

Neurontin

Answer 36

Consultation: May cause drowsiness. use caution while operating machinery or when mental alertness is required. Avoid alcohol while taking this medication. Do not abruptly discontinue therapy, dose should be tapered over a one week period. May be taken without regard to meals. Store in a cool dry place, away from sunlight & children. Contact a physician if the above side effects are severe or persistent. if a dose is missed, take it as soon as possible; do NOT double dose!

Question 37

Lamotrigine

Lamictal, Lamictal XR

Answer 37

Adverse Effects: dizziness, ataxia, somnolence, headache, diplopia, blurred vision, nausea, vomitting & rash

Question 38

Lamotrigine

Lamictal, Lamictal XR

Answer 38

Consultation: Patients should promptly report any signs of hypersensitivity (fever, lymphadenopathy) or rash to a physician. Do not increase or change dosage without specific instructions from a physician. May cause drowsiness. Use caution while operating machinery or when mental alertness is required. Patients should inform their physician if they become pregnant, or intend to breast feed an infant during therapy. If a dose is missed, take it as soon as possible, but do not double the next dose. Contact a physician if the above side effects are severe or persistent. Chewable tablets may be chewed or dispersed in a teaspoonful of water or diluted fruit juice.

Question 39

Memantine HCl

Namenda

Answer 39

Adverse Effects: dizziness, headache, confusion, hypertension, pain, fatigue, vomiting, coughing, hallucination, & somnolence.

Question 40

Memantine HCl

Namenda

Answer 40

Consultation: May be taken with or without food. Store in a cool, dry place away from sunlight or children. Contact a physician is the above side effects are severe or persistent. If a dose is missed, skip it & return to normal dosing schedule. Do not double doses.

Question 41

Olanzapine

Zyprexa

Answer 41

Adverse effects: Somnolence, agitation, insomnia, nervousness, hostility, dizziness, rhinitis, anxiety, constipation, dry mouth, weight gain, joint pain, fever, postural hypotension, cought, akathesia & amblyopia, abdominal pain, back pain, chest pain, tachycardia, hypertonia, and tremor.

Question 42

Olanzapine

Zyprexa

Answer 42

Consultation: Use caution when rising from prone position, especially during initial dose-trial period. ZYDIS tablets must be used immediately after opening foil sachet. Do not push tablets through foil. May cause drowsiness- use caution when performing activities that require alertness. May be taken without regards to meals. Do not change dosage except on the orders of your physician. Store in a cool, dry place away form sunlight & children. Contacta physician is the above side effects are severe or persistent. If a dose is missed, skip it & return to normal dosing schedule.

Question 43

Paroxetine HCl

Paxil, Paxil XR, Pexeva

Answer 43

Adverse Effects: Occuring in more that 20% of patients include nausea & somnolence; those occuring in more than 10% of patients include headache, asthenis, sexual dysfunction, constipation, dizziness, adn insomnia, & sweating or diarrhea.

Question 44

Paroxetine HCl

Paxil, Paxil XR, Pexeva

Answer 44

Consultation: May cause drowsiness- use caution when perfomring activities that require alertness. Avoid alcohol while taking this medication. COntact a physician if you develop leg, foot or hand swelling or have excessive thirst. Therapy may take up to 2 weeks to see improvement. Do not take any prescription or non-prescription drugs without consulting your physician or pharmacist. Do not abruptly discontinue medication. Do not take sooner than every 24 hours. Store in a cool, dry place away form sunlight or children. Shake suspension well before use. Controlled release tablets should not be chewed or crushed, & should be swallowed whole. Pay close attention to any sudden changes in mood behavior, thoughts, r feelings. Antidepressants may increase suicidal thoughts or actions.

Question 45

Pregabalin

Lyrica

Answer 45

Adverse effects: Dizziness, somnolence & dry mouth are the most common side effects and are dose related. Other adverse effects include ataxia, confusion, asthenia, abnormal thinking, blurred vision, incoordination, weight gain & peripheral edema.

Question 46

Pregabalin

Lyrica

Answer 46

Consultation: May cause drowsiness. Use caution while operating machinery or when mental alertness is required. Avoid alcohol while taking this medication. Do not abruptly discontinue therapy, dose should be tapered over a 1 week period. May be taken without regard to meals. Store ina cool, dry place away form sunlight or children. The oral solution must be used within 45 days of opening the stock container. Contact a physician if the above side effects are severe or persistent. Report unexplained muscle pain, tenderness or weakness, especially if accompanied by fever or malaise. If a dose is missed, take it as soon as possible. Do not double dose.

Question 47

Quetiapine

Seroquel

Answer 47

Adverse Effects: Somnolence, dizziness, constipation, postural hypotension, dry mouth, & dyspepsia.

Question 48

Quetiapine

Seroquel

Answer 48

Consultation: Use caution when rising from a prone position, especially during initial dose-titration period. May cause drowsiness- use caution when performing activities that require alertness. May be taken without regards to meals. Seroquel XR should be swallowed whole, not chewed, divided or crushed. Do not change dosage except on the orders of your physician. Store in a cool, dry place away from sunlight and children. Contact a physician if the above side effects are severe or persistent. If a dose is missed, skip it & return to normal dosing schedule.

Question 49

Sertraline HCl

Zoloft

Answer 49

Adverse Effects: Nausea, diarrhea, dypepsia, dizziness, insomnia, sweating, dry mouth, or male sexual dysfunction (ejaculatory delay)

Question 50

Sertraline HCl

Zoloft

Answer 50

Consultation: Continued therapy may be needed to show noticeable improvement; do not stop therapy before consulting with a physician. Sertaline oral concentraion must be diluted prior to use. Place the proper dose in 4oz. of water, ginger ale, lemon/lime soda, or orange juice ONLY. Do not mix in any other beverage. Take immediately after mixing & do not premix doses. Avoid alcohol while taking this medication. Use caution while performing tasks that require mental alertness. Consult with your physician or pharmacist before takign nonprescription medication. Store in a cool, dry place away from sunlight and children. Contact a physician if the above side effects are severe or persistent. If a dose is missed, skip it & return to normal dosing schedule. Pay close attention to any changes, especially sudden changes in mood behaviors, thoughts or feeligns. Antidepressants may increase suicidal thoughts or actions.

Question 51

Trazadone HCl
(Desyrel)

Answer 51

Adverse Effects: Drowsiness, dry mouth, hpotension, dizziness, confusion, fatigue, headache, PRIPISM, nausea, vomiting

Question 52

Trazadone HCl
(Desyrel)

Answer 52

Consultation: Take with food to enhance absorption. May cause drowsiness. Use care when operating machinery or when mental alertness is required. Avoid alcohol while taking this medication. Patients with prolonged or inappropriate penile erection should discontinue use immediately & consult a physician. Contact a physician if above side affects are severe or persistent. If a dose is missed, skip it & return to normal dosign schedule.

Question 53

Venlafaxine XR

Effexor XR

Answer 53

Adverse Effects: Nausea, dry mouth , anorexia, constipation, drowsiness, insomnia, dizziness, nervousness, abnormal ejaculation, sweating, impotence, decreased libido & yawning

Question 54

Venlafaxine XR

Effexor XR

Answer 54

Consultation: Avoid alcohol. Potential for interaction if taken with other RX or OTC drugs. Store in a cool dry place away form sunlight & children. Swallo capsule whole- do not chew, crush, dissolve or divide. Pay close attention to changes in mood behavior, thoughts or feelings. Antideporessants may increase suicidal thoughts or actions. Continues therapy for up to 2 weeks may be needed to show noticeable improvement.