Antidepressants, Antipsychotics, & Anticonvulsants Flashcards
To recognize Certain Antidepressants, Antipsychotics, & Anticonvulsants and their indication of use
Amitriptyline HCl
Elavil
Indication(s): Depression
MOA: inhibits the membrane pump mechanism responsible for the re-uptake of norepinephrine & serotonin at the presynaptic nerve terminals.
Aripiprazole
Abilify
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.
Bupropion XL
Wellbutrin, Zyban
Indication(s): Depression, Seasonal Affective Disorder
MOA: weak inhibitor of neuronal uptake of norepinephrine, serotonin & dopamine, and does not inhibit monoamine oxidase.
Citalopram Hydrobromide
Celexa
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
Donepezil HCl
Aricept
Indication: Alzheimer’s Disease
MOA: reversible acetylcholinesterase inhibitor that works centrally to increase the amount of acetylchoine available at cholinergic synapses.
Duloxetine
Cymbalta
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
Escitalopram
Lexapro
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
Fluoxetine HCl
Prozac, Sarafem
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 .
Gabapentin
Neurontin
Indication: Seizures, postherpetic neuralgia
MOA: Exact MOA is unknown; has antiseizure activity in rats & mice. Excretion occurs by the renal route as unchanged drug.
Lamotrigine
Lamictal, Lamictal XR
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).
Memantine HCl
Namenda
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.
Olanzapine
Zyprexa
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%
Paroxetine HCl
Paxil, Paxil XR, Pexeva
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%)
Pregabalin
Lyrica
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.
Quetiapine
Seroquel
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.
Sertraline HCl
Zoloft
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
Trazadone HCl (Desyrel)
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.
Venlafaxine XR
Effexor XR
Indicaiton: Depression
MOA: Serotonin-norepinephrine reuptake inhibitor (SNRI)
Amitriptyline HCl
Elavil
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
Amitriptyline HCl
Elavil
Adverse Reactions: Tachycardia, dry mouth, blurred vision, nausea, vomiting, dizziness, weakness, headache, constipation, urinary retention, drowsiness, and weight gain
Aripiprazole
Abilify
Adverse Effects:
Headache, insomnia, asthenia, nausea, vomitting, constipation, weight gain, anxiety, lightheadedness, drowsiness & blurred vision. Tardive dyskinesia is a rare possibility.
Aripiprazole
Abilify
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.
Bupropion XL
Wellbutrin, Zyban
Adverse reactions:
DIzziness, constipation, weight loss, dry mouth, insomnia, sweating, agitation, and tremor
Bupropion XL
Wellbutrin, Zyban
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.
Citalopram Hydrobromide
Celexa
Adverse Reactions: Nausea, dry mouth, somnolence, insomnia, diarrhea, ejaculation disorder & impotence.
Citalopram Hydrobromide
Celexa
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.
Donepezil HCl
Aricept
Adverse Effects: Nausea, diarrhea, insomnia, vomitting, muscle cramps, fatigue, and anorexia
Donepezil HCl
Aricept
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!!
Duloxetine
Cymbalta
Adverse Effects: nausea, dry mouth, constipation, insomnia, dizziness, diarrhea, decreased appetite, fatigue, drowsiness, sweating, vomitting, blurred vision, erectile dysfunction
Duloxetine
Cymbalta
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.
Escitalopram
Lexapro
Adverse Effects:
Nausea, somnolence, insomnia, diarrhea, ejaculation disorder, increased sweating, dizziness, and impotence
Escitalopram
Lexapro
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.
Fluoxetine HCl
Prozac, Sarafem
Adverse Effects:
nausea, insomnia, anorexia, headache, nervousness, drowsiness, tremor, diarrhea, sweating, asthenia, decreased libido, abnormal ejaculation, and fatigue.
Fluoxetine HCl
Prozac, Sarafem
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.
Gabapentin
Neurontin
Adverse Effects:
Somnolence, dizziness, ataxia, fatigue, nystagmus, tremor, diplopia, rhinitis, and blurred vision.
Gabapentin
Neurontin
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!
Lamotrigine
Lamictal, Lamictal XR
Adverse Effects: dizziness, ataxia, somnolence, headache, diplopia, blurred vision, nausea, vomitting & rash
Lamotrigine
Lamictal, Lamictal XR
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.
Memantine HCl
Namenda
Adverse Effects: dizziness, headache, confusion, hypertension, pain, fatigue, vomiting, coughing, hallucination, & somnolence.
Memantine HCl
Namenda
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.
Olanzapine
Zyprexa
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.
Olanzapine
Zyprexa
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.
Paroxetine HCl
Paxil, Paxil XR, Pexeva
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.
Paroxetine HCl
Paxil, Paxil XR, Pexeva
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.
Pregabalin
Lyrica
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.
Pregabalin
Lyrica
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.
Quetiapine
Seroquel
Adverse Effects: Somnolence, dizziness, constipation, postural hypotension, dry mouth, & dyspepsia.
Quetiapine
Seroquel
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.
Sertraline HCl
Zoloft
Adverse Effects: Nausea, diarrhea, dypepsia, dizziness, insomnia, sweating, dry mouth, or male sexual dysfunction (ejaculatory delay)
Sertraline HCl
Zoloft
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.
Trazadone HCl (Desyrel)
Adverse Effects: Drowsiness, dry mouth, hpotension, dizziness, confusion, fatigue, headache, PRIPISM, nausea, vomiting
Trazadone HCl (Desyrel)
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.
Venlafaxine XR
Effexor XR
Adverse Effects: Nausea, dry mouth , anorexia, constipation, drowsiness, insomnia, dizziness, nervousness, abnormal ejaculation, sweating, impotence, decreased libido & yawning
Venlafaxine XR
Effexor XR
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.
