Antidepression, Antipsychotic & anxiolytics

Question 1

Fluoxetine (Prozac)

SSRI (serotonin reuptake inhibitors)

Answer 1

Antidepressants
-Treat: OCD, Bulimia, depression, Panic disorder, premenstrual dysphoric disorder (women have trouble functioning at home, at work, and in relationships during this time.)

• Block the reuptake of serotonin in the nerve terminal of the CNS enhancing its transmission at the serotonergic synapse.
• Serotonin is increased in nerve cells due to blockage of nerve fibers

CNS: nervousness, somnolence (sleepy, drowsy), anxiety, headache, fatigue, emotional lability (rapid, often exaggerated changes in mood).
CV: palpitation, hot flashes, prolonged QT interval.
EENT: nasal congestion, pharyngitis, sinusitis.
GI: N/D/V, dry mouth, anorexia, dyspepsia, constipation, abdominal pain, taste perversion (a distortion of the sense of taste-Dysgeusia)
-GU: sexual dysfunction, decreased libido, micturition disorder (act of urination).
Metabolic: weight loss, hyponatremia.
Musculoskeletal: muscle pain.
Respiratory: URI, cough
Skin: rash, pruritus, diaphoresis.
Other: flulike syndrome, chills.

Question 2

Venlafaxine (Effexor)
SSNRIs
(serotonin Norepinephrine Reuptake Inhibitors

Answer 2

Antidepressants
Treat PDST, Panic disorder, depression, Generalized and social anxiety disorder.

Serotonin and norepinephrine are increased in nerve because the blockage from nerve fibers.

CNS: asthenia, headache, somnolence, dizziness, nervousness, abnormal dream, agitation, weakness.
CV: HTN, tachycardia, vasodilation, palpitations, chest pain.
EENT: blurred vision, mydriasis (dilation of the pupil)
GI: N/V/D, constipation, dry mouth, anorexia, flatulence.
GU: erectile dysfunction, impaired urination
Metabolic: weight gain, weight loss, increased appetite
Skin: diaphoresis, ecchymosis, rash.
Other: suicidal behavior.

Question 3

Trazodone (Desyrel)
Tablets
Triazolopyridine derivatives

Answer 3

Antidepressants
Treat major depression, reactive depression, and anxiety.

*Effect one or two of the three neurotransmitters: serotonin, norepinephrine, and dopamine.

CNS: drowsiness, dizziness, nervousness, confusion, hostility, nightmare, disorientation, incoordination.
CV: orthostatic hypotension, tachycardia, HTN, shortness of breath, ECG changes, edema, palpitations.
EENT: blurred vision, red or itchy eyes, tinnitus, nasal congestion.
GI: dry mouth, dysgeusia, constipation, N/V, anorexia, diarrhea.
GU: urine retention, hematuria, increase libido.
Hematologic: anemia
Metabolic: weight gain or loss
Musculoskeletal: aches, pains.
Skin: rash, urticaria, diaphoresis.

Question 4

Fluphenazine (Prolixin)

*SSRIs
Phenothiazines

Answer 4

Antidepressants
-Management of symptoms of psychosis including schizophrenia.

*Blocks dopamine receptors in the brain, and control psychotic symptoms.

CNS: nervousness, somnolence, anxiety, insomnia, headache, drowsiness, tremor, dizziness, asthenia, abnormal thinking, fatigue, fever, emotional lability.
CV: Palpitation, hot flashes, prolonged QT interval, EPS, tachycardia, impaired thermoregulation.
EENT: nasal congestion, pharyngitis, sinusitis.
GI: nausea, diarrhea, dry mouth, anorexia, dyspepsia, constipation, abdominal pain, vomiting, flatulence, increase appetite, taste perversion.
GU: sexual dysfunction, decreased libido, micturition disorder.
Metabolic: weight loss, hyponatremia.
Musculoskeletal: muscle pain.
Respiratory: URI, cough
Skin: rash, pruritus, diaphoresis.

Question 5

Haloperidol (Haldol)
(ha-loe-PER-i-dole)
Butyrophenone derivatives
(Nonphenothiazines)

Answer 5

Antipsychotics

• treat acute and chronic psychoses
• Treatment in children with severe behavior problems, and are combative.
• Treatment of Tourette’s and dementia in older adults.
• Alters the effect of dopamine on CNS
• Mechanism for antipsychotic effects are unknown

CNS: severe extrapyramidal reactions, dystonia, tardive dyskinesia, NMS, seizure, sedation, drowsiness, lethargy, headache, depression, euphoria, parkinsonian-like syndrome.
CV: tachycardia, hypotension, HTN
EENT: Blurred vision, cataracts, retinopathy.
GI: dry mouth, anorexia, constipation, diarrhea, nausea, vomiting, dyspepsia.
GU: urine retention, menstrual irregularities, priapism.
Hematologic: leukopenia, leukocytosis.
Hepatic: jaundice
Metabolic: hyperglycemia, hypoglycemia, hyponatremia.
Skin: rash, diaphoresis.

Question 6

Aripiprazole (Abilify)
air-eh-PIP-rah-zole

Quinolinone derivatives

Answer 6

Antipsychotics

Manage symptoms of psychosis, including schizophrenia

*interferes with binding of dopamine to dopamine (D2) and serotonin (5-HT2)

CNS: headache, anxiety, insomnia, light-headedness, NMS, seizures, depression, hostility, manic behavior, confusion, thinking abnormalities, impaired concentration.
CV: peripheral edema, chest pain, HTN, tachycardia, orthostatic hypotension, bradycardia.
EENT: blurred vision, conjunctivitis, photophobia, ear pain, increased salivation, nasopharyngitis.
GI: N/V/D, constipation, anorexia, dry mouth dyspepsia.
GU: urinary incontinence, decreased libido, erectile dysfunction.
Hematologic: ecchymosis, anemia, neutropenia.
Metabolic: weight gain, weight loss, hyperglycemia.
Musculoskeletal: neck pain, neck stiffness, muscle cramps, extremity pain.
Respiratory: dyspnea, pneumonia, cough
Skin: rash, dry skin, pruritus, sweating, ulcer.
Other: flulike syndrome, suicidal ideation ad behaviors.

Question 7

Lorazepam 
(Ativan)
1mg table
PO every 4hrs
Through Gtube
Class: Benzodiazepines

Answer 7

Anxiolytics

• CNS: drowsiness, sedation, amnesia, insomnia, dizziness, weakness
• CV: hypotension
• EENT: visual disturbances, nasal congestion
• GI: Ab discomfort, nausea
• Respiratory: respiratory failure and depression