Antipsychotics/Antidepressants/Antiseizure Flashcards by Jayson Welker

Celexa

Citalopram

SSRI

MOA - block the reuptake of serotonin back into the presynaptic neuron

ADR - hypokalemia, hypomagnesemia, bradycardia, QTc elongation can lead to Torsades de pointe, risk of GI bleeding, sexual dysfunction

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Lexapro

Escitalopram

SSRI

MOA - block the reuptake of serotonin back into the presynaptic neuron

ADR - diarrhea, nausea, QTc prolongation (less), risk of GI bleeding, sexual dysfunction

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Prozac

Fluoxetine

SSRI

MOA - block the reuptake of serotonin back into the presynaptic neuron

ADR - most activating/insomnia, hypoglycemia, very long half-life, risk of GI bleeding, sexual dysfunction

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Zoloft

Sertraline

SSRI

MOA - block the reuptake of serotonin back into the presynaptic neuron

ADR - Activating/insomnia, hypoglycemia, WORST GI PROBLEMS (nausea, diarrhea, vomiting), risk of GI bleeding, sexual dysfunction

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Paxil

Paroxetine

SSRI

MOA - block the reuptake of serotonin back into the presynaptic neuron

ADR - MOST SEDATING, MOST ANTI-ACH EFFECTS (SPSS), sexual dysfunction, risk of GI bleeding, QTc prolongation

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Cymbalta

Duloxetine

SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - activation, nausea, headache (take at night), dry mouth, sexual dysfunction, avoid in hepatic dysfunction

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Effexor

Venlafaxine

SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - hypertension, headache (take at night), nausea, activation, dizziness, sexual dysfunction, dry mouth

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Pristiq

Desvenlafaxine

SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - nausea, headache (take at night), dry mouth, dizziness, activation

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Elavil

Amitriptyline

TCA - the “original” SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - anti-ACh (SPSS), sedation, sexual dysfunction, weight gain, seizures, QTc prolongation, hypotension

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Sinequan

Doxepin

TCA - the “original” SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - anti-ACh (SPSS), sedation, sexual dysfunction, weight gain, seizures, QTc prolongation, hypotension

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Pamelol

Nortriptyline

TCA - the “original” SNRI

MOA - block the reuptake of serotonin and norepinephrine back into the presynaptic neuron

ADR - anti-ACh (SPSS), sedation, sexual dysfunction, weight gain, seizures, QTc prolongation, hypotension

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Wellbutrin/Zyban

Bupropion

Antidepressant

MOA - norepinephrine-dopamine reuptake inhibitor

ADR - activation, headache (take at night), dry mouth, hypertension, risk of seizures

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Remeron

Mirtazapine

Antidepressant

MOA - alpha2-adrenergic antagonist effects stimulate NE and serotonin release, potent antagonist of serotonin and histamine receptors

ADR - sedation, increased appetite, dry mouth

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Abilify

Aripiprazole

2nd Generation Antipsychotic

MOA - Dopamine 2 partial agonist

ADR - activating/agitating, akathisia, dyslipidemia, elevation of fasting triglycerides, insulin resistance, FDA warning for impulse-control issues

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Zyprexa

Olanzapine

2nd Generation Antipsychotic

MOA - combination of DA and serotonin type 2 receptor site antagonism

ADR - WEIGHT GAIN, GREATEST METABOLIC RISK, orthostatic hypotension, hypertriglyceridemia, hypercholesterolemia

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Seroquel

Quetiapine

2nd Generation Antipsychotic

MOA - antagonizes serotonin 5-HT1A and 5-HT2, dopamine D1 and D2, histamine H1, and adrenergic α1 and α2 receptors.

ADR - weight gain, SEDATION, dyslipidemia, insulin resistance, orthostatic hypotension, anti-ACh effects (SPSS)

Risperdal

Risperidone

2nd Generation Antipsychotic

MOA - potent serotonin-5-HT2 antagonist with weaker dopamine-D2 antagonism. Whereas typical antipsychotics are dopamine antagonists, the additional serotonin antagonism increases efficacy for negative symptoms of schizophrenia and reduces the likelihood of extrapyramidal symptoms

ADR - sexual dysfunction, weight gain, dyslipidemia, sedation, hyperprolactinemia (breast enlargement/tenderness), amenorrhea (abnormal absence of menstruation)

Eskalith/Lithobid

Lithium - TWF

Bipolar Disorder Agent/Mood stabilizer

MOA - not known but may work by: 1) inhibiting 2nd messenger enzymes 2) modulating G-proteins 3) interacting with various sites on downstream signal cascade

ADR - nausea (early on), dry mouth, polyuria, tremor, weight gain, hypothyroidism, acne, thinning hair, seizures, delirium, confusion

Nardil

Phenelzine

MAO-I

MOA - inhibit monoamine oxide that breaks down monoamines (DA, NE, serotonin)

ADR - postural hypotension, anti-ACh, SEDATION, sexual dysfunction, hepatic issues, DRUG-DRUG INTERACTIONS (DM-cough suppressant, ALL ANTIDEPRESSANTS, methadone, tramadol, fentanyl, cocaine, amphetamine), DRUG-FOOD INTERACTIONS (cheese, chocolate, beer, wine, smoked meats, pickled or canned foods)

Parnate

Tranylcypromine

MAO-I

MOA - inhibit monoamine oxide that breaks down monoamines (DA, NE, serotonin)

Thorazine

Chlorpromazine

1st Generation Antipsychotic

MOA - DA2 receptor antagonist, depresses release of hypothalamic and hypophyseal hormones

ADR - akathisia, dystonia, tardive dyskinesia, sedation, anti-ACh effects (SPSS), weight gain, sexual dysfunction

Haldol

Haloperidol

1st Generation Antipsychotic

MOA - DA 1 and 2 receptor antagonist, depresses release of hypothalamic and hypophyseal hormones

ADR - akathisia, dystonia, tardive dyskinesia, sedation, anti-ACh effects (SPSS), weight gain, sexual dysfunction

Prolixin

Fluphenazine

1st Generation Antipsychotic

MOA - DA 1 and 2 receptor antagonist, depresses release of hypothalamic and hypophyseal hormones

ADR - akathisia, dystonia, tardive dyskinesia, sedation, anti-ACh effects (SPSS), weight gain, sexual dysfunction

Clozaril

Clozapine

2nd Generation Antipsychotic

MOA - noradrenolytic, anti-ACh, anti-Histaminic and arousal reaction inhibiting effects are significant, affinity for DA4 receptor accounts for striking effects in control of behavioral and psychiatric symptoms with low incidence of EPS;—-; effective for reducing suicidality

ADR - metabolic side effects, severe sialorrhea (hyper salivation), dose related risk of seizures (>600mg/day), Absolute Neutrophil Count (ANC) every week CBC for first 6 months, every 2 weeks CBC for second 6 months, then monthly CBC thereafter

Latuda

Lurasidone - administer with at least 350 calories 2nd Generation Antipsychotic MOA - unknown, suggested: involve mediation of central DA type 2 and serotonin type 2 receptor antagonism ADR - less sedation and akathisia if dosed at night, low risk of weight gain or dyslipidemia, no QTc prolongation,

Geodon

Ziprasidone - given with at least 500 calories 2nd Generation Antipsychotic MOA - moderately inhibits NE and serotonin reuptake ADR - activation, QTc prolongation, lowest risk for weight gain, low risk for dyslipidemia and insulin resistance,

Tegretol

Carbamazepine Anticonvulsant - narrow spectrum (focal onset) MOA - acts presynaptically to block firing of action potentials, which decreases the release of excitatory neurotransmitters, and postsynaptically by blocking high-frequency repetitive discharge initiated at cell bodies. ADR - autoinduction (induces it's own metabolism), GI upset, double vision, sedation (initial)

ONFI

Clobazam Anticonvulsant - like a benzodiazepine but you don't build tolerance MOA - ADR - dizziness

Depakote

Divalproex Sodium Anticonvulsant - broad spectrum (focal and generalized) MOA - ADR - GI upset (TWF), sedation, tremor, weight gain, hair loss (temporary)

Neurontin

Gabapentin Anticonvulsant - narrow spectrum (focal seizures) MOA - its mechanism of action is not known. Gabapentin does not interact with GABA receptors or alter the formation, release, degradation, or reuptake of GABA. ADR - MCD

Vimpat

Lacosamide Anticonvulsant - may be broad spectrum MOA - stabilizes hyperexcitable neuronal membranes and inhibits neuronal firing ADR - headache, dizziness, diplopia, nausea

Lamictal

Lamotrigine Anticonvulsant - focal onset and generalized MOA - inhibits voltage-dependent sodium channels, thereby stabilizing neuronal membranes and reducing the release of excitatory neurotransmitters such as glutamate and aspartate. ADR - skin rash when dosing increased too quickly (enhanced by concurrent VPA therapy, high starting dose, rapid dose escalation), sedation

Trileptal/Oxtellar XR

Oxcarbazepine Anticonvulsant MOA - acts presynaptically to block firing of action potentials, which decreases the release of excitatory neurotransmitters, and postsynaptically by blocking high-frequency repetitive discharge initiated at cell bodies. ADR - HYPONATREMIA, interacts with oral contraceptives, often better tolerated

Dilantin

Phenytoin Anticonvulsant - complex partial seizures, generalized tonic clinic, status epilepticus MOA - Blocks Na+ channels, Ca2+ blockade, NMDA blockade and increases GABA concentration ADR - nystagmus (eye twitching), ataxia (loss of muscle control), diplopia, nausea, vomiting, constipation, hirsutism, gingival hypertrophy

Viibryd

Vilazodone SSRI MOA - block the reuptake of serotonin back into the presynaptic neuron ADR - headaches, diarrhea, nausea

Topamax

Topiramate Anticonvulsant - broad(er) spectrum MOA - blockade of voltage-dependent Na+ and Ca2+ channels, other mechanisms involving glutamate ADR - CNS (dizziness, somnolence, mental slowing confusion), renal stones, hypohidrosis (diminished sweating)

Valproic Acid

Valproate Broad spectrum - focal and generalized onset seizures ADR - GI issues, "heartburn" - TWF, CNS, tremor, temporary hair loss, weight gain, elevated liver function lab tests