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Pass Naplex Now Book II > Anxiety/Depression/Biopolar Disorder - Brand/Generic > Flashcards

Anxiety/Depression/Biopolar Disorder - Brand/Generic Flashcards

1
Q

Librium

  • Indication
A

CHLORdiazepoxide

  • Indication: anxiety and EtOH w/d
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2
Q

Klonopin
Clonapam

  • Indication
A

CLONazepam

  • Indication: panic disorder
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3
Q

Valium

  • Indication
A

Diazepam

  • Indication: anxiety/acute etoh w/d, anti-convulsive
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4
Q

Dalmane

  • Indication
A

FLURazepam

  • Indication: only approved for insomnia
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5
Q

Ativan

  • Indication
A

Lorazepam

  • Indication: anxiety, alleviate N/V, panic attacks
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6
Q

RESToril

  • Indication
A

TEMazepam

  • Indication: insomnia
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7
Q

Prosom

  • Indication
A

ESTazolam

  • Indication: insomnia
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8
Q

Xanax, Xanax XR, Niravan

  • Indication:
A

Alprazolam

  • Indication: anxiety
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9
Q

Serax

  • Indication
A

OXazepam

  • Anxiety, EtOH w/d
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10
Q

Halcion

  • Indication
A

Triazolam

  • Anxiety
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11
Q

BuSpar
Vanspar

  • Dose
  • SEs
A

Buspirone

  • Dose: Start 15mg/d. Max 60mg/day
  • Non sedative anxiolytic agent. Take up to 4 wks to work
  • SEs: Dizziness, drowsiness, HA
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12
Q

SSRI Pt counseling

  • Delay onset of effect
  • Avoid

SSRI MOA

SSRI and Bleeding

  • Cause
  • Which agents has the least

SSRI SEs

SSRI DDI

A 
SSRI Pt counseling
- Delay onset of effect
  1st wk: Improved sleep/appetite
  4th wk: increase energy = suicide 
  6-8 wk: improved mood 
- Avoid:
  EtOH, valerian, St. John's wort, SAMe, Kava kava
SSRI MOA
- MOA Inhibits reuptake of 5-HT at all 5HT receptors, acting as a serotonin agonist 
  5HT1 = depression
  5HT2 = sexual dysfunction
  5HT3 = GI SEs

SSRI and Bleeding

  • SSRIs reduce platelet => incr bleeding risk
  • Least agent: fluvoxamine and citalopram
SSRI SEs
- Activating or sedating
  Fluoxetine = highly activating
  Fluvoxamine = highly sedating
- GI effects
- Sexual dysfunction
- HA
- HypoNa
- Anticholinergic effects

SSRI DDI

  • Fluvoxamine: strong 1A2 Inhibitor
  • Fluoxetine and paroxetine: strong 2D6
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13
Q

Celexa

  • Indication
  • Dose
  • DDI
A

Citalopram

  • SSRI
  • Indication: MDD
  • Dose: 10-60mg/da QD. High dose = QT and torsades . Max 40mg/d. Age > 60, max 20mg
  • DDI: Avoid going over 20mg when combined w/ 2C19 inhibitors omeprazole, cimetidine, PO OC
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14
Q

Lexapro

  • Indication
  • Dose
A

Escitalopram

  • SSRI
  • Indication: MDD and generalized anxiety (GA)
  • Dose: 10-20mg PO QD
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15
Q

Prozac

  • Indication
  • Dose
  • MOAIs
A

Fluoxetin

  • SSRI
  • Prozac MDD, OCD, Bulimia nervosa
  • Prozac ER = MDD: 90mg PO QW
  • Dose: 10-80mg PO QD AM
  • MOAIs: d’c 14d prior to start fluoxetin. To start MOAI, d/c fluoxetin 5wk prior to start MOAI due to long t1/2
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16
Q

Luvox

  • Indication
  • Dose
A

FLUVOXamine

  • SSRI
  • Indication: OCD
  • Dose: 50-300mg/d QHS
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17
Q

Paroxetine

  • Indication
  • Frequency
A

Paxil
- SSRI

  • Indication: MDD, OCD, Panic disorder, social anxiety disorder, PTSD
  • Frequency QAM
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18
Q

Zolof

  • Indication
  • Dose
A

Sertraline

  • SSRI
  • Indication: MDD, OCD, PTSD, Panic disorder
  • Dose: 50-200mg PO QD
  • Food increase BA
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19
Q

Vilazodone

  • Indication
  • Administration
A

Viibryd

  • Indication: MDD in adults
  • Dose: Start 10mg QD with FOODs x 7d, then 20mg with FOOD x 7d. Then MD 40mg QD with FOODs
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20
Q

Effexor

  • MOA
  • Indication
  • Frequency
  • Warning pt
  • SEs
A

Venlafaxine

  • MOA: SNRI
  • Indication: MDD, GAD (XR only)
  • Dose frequency: BID/TID. ER take QD.
  • Warning pt: ghost tablet in stool
  • SEs: Activating/sedating, GI, sexual dysfunction
    • HTN*, HA
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21
Q

Pristiq

Khedezla

A

Desvenlafaxine

  • Major active metabolite of effexor XR => take QD
  • MOA: SNRI
  • Dose: 50-400mg/QD. CrCl
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22
Q

Cymbalta

  • MOA
  • Indication
  • Dose
  • Momitor:
A

Duloxetine

  • MOA: SNRI
  • Indication: depression, GAD, diabetic peripheral neuropathy, fibromyalgia, management of chronic musculoskeletal pain
  • Dose: Initial 30. Usually 60. Max 120mg QD
  • Monitor: BP
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23
Q

Savella

  • MOA
  • Indication
  • Dose
  • SEs
  • Allergy
-----
Fetzima
- MOA
- Indication
- Dose
- SEs
A

MILnacipran

  • MOA: SNRI
  • Indication: fibromyalgia
  • Dose: Start 12.5mg to 50mg BID
  • SEs: HA, SZ, HypoNa, Inc LFTs, GI (constipation),
    • Inc BP & Pulse*
  • Allergy: contains FDC Yellow No.5 (tartrazine)
------
LevoMILnacipran
- MOA: SNRI
- Indication: MDD
- Dose: 40-120mg QD
- SEs: same
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24
Q

Wellbutrin

  • MOA
  • Indication
  • Max dose
  • Counseling ~ dose
  • SE
  • Caution
A

Bupropion

  • MOA: Dopamine and NE agonist
  • Indication: MDD, nicotine w/d
  • Max dose: ~400mg/d
  • Counseling ~ dose: take 2nd dose before 5PM
  • SEs: activation, GI, SZ
  • Caution: bulimia, alcoholics, Sz
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25
Q

Desyrel IR

  • Indication
  • SEs
A

TraZOdone

  • Indication: sleep disorder (IR)
  • Dose: 50mg QHS
  • SEs: GI, sexual dysfunction, anticholinergic effects, orthostatic hypoTN, **priapism
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26
Q

Serzone

  • MOA
  • Indication
  • SEs
A

NEFazodone

  • MOA: Blocks serotonin reuptake (less potent than SSRI) and alpha adrenergic blocker
  • Indication: MDD
  • SEs: similar to Trazodone. No Priapism
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27
Q

REMeron

  • MOA
  • Dose
  • SEs
A

MIRtazapine

  • MOA: Inc NE and serotonin in brain, alpha antagonist, serotonin receptor antagonist
  • Dose: Initial 15mg QHS. Max 40mg. Also come in disintegrating tab
  • SEs: somnolence, appettite incr, weight gain, increase TC and TG. Anticholinergic SEs
28
Q

AmiTIPtyline

  • MOA for all TCA
  • Indications
  • Dose
  • SEs
A

Elavil

  • TCA: Tertiary amines
  • MOA: Block reuptake of NEs and serotonin.
    Also stimulated alpha adrenergic (orthostatic hypoTN), histaminergic (weight gain and sedation), anticholindertic
  • Indications: all TCAs are use for MDD except clomipramine are indicated for MDD
  • Dose: range 50 - 300 mg/day
  • SEs: sedation, anticholinegic, orthostatic hypoTN, tachycardia, arrhythmia
29
Q

Anafranil

  • Indication
  • Class
A

CLOMipramine

  • TCA: Tertiary amines
  • Indication: OCD & MDD
30
Q

Sinequan

  • Indication
  • Class
A

DOXepin

  • TCA: Tertiary amines
  • Indication: MDD and anxiety
31
Q

Tofranil

  • Indication
A

IMipramine

  • TCA: Tertiary amines
  • Indication: MDD, night time bed-wetting episodes
32
Q

Surmontil

  • Class
A

TIMipramine

  • TCA: Tertiary amines
33
Q

Asendin

  • Indication
A

aMOxapine

  • Depression
34
Q

Norpramine

  • Indications:
  • Class
A

DesiPRAMINE

  • TCA: Secondary amines
  • Other indication: ADHD
35
Q

Ludiomil

  • Class
A

MAProtiline

  • TCA: Secondary amines
36
Q

Pamelor

  • Class
A

Nortriptylin

  • TCA: Secondary amines
37
Q

Vivactil

  • Class
A

PROtriptyline

  • TCA: Secondary amines
38
Q

Marplan

  • MOA
  • Indication
  • SEs
  • DDIs
  • Tyramine containing foods:
A

IsocarBOXazid

  • MAOIs: inhibits MAO enzyme causing a decrease in the breakdown of dopamine, serotonin, and NE in the synapse
  • Indication for all MOAI: MDD
  • SEs: MAOI’s
    Map = weight gain
    A = anticholinergic
    O = orthostatic hypotension, hypoTN
    I = insomnia
    s - sexual dysfunction

DDI

  • Dextromethorphan: hyperpyrexia & death
  • Meperidine: sz, fever, death
  • Sympathomimetics: amphetamines, ephedrine, etc
  • TCA’s and SSRI’s: hyperthermia, hyperTN, muscle rigiditiy, delirium, coma
  • Tyramine (tryptophan) release NE => hypertensive crisis (signs = HTN, HA, flushing, palpitation, anxiety, N/V, stiff neck, photophobia)

**Containing foods: smoked aged or pickled meat/fish, aged cheeses, yeast, fava beans, beer, avocado, red wine, caffeine, chocolate, soy sauce, yogurt.

39
Q

Nardil

A

PheNELzine

  • MOAIs
40
Q

Parnate

A

TRANylcypromine

  • MOAIs
41
Q

Emsam

  • MOAIs
  • Indication
  • Forms
  • Direction
A

SeLEGiline

  • MOAIs Type B
  • Indication: MDD
  • Forms: patches in 6, 9, 12 mg/24H
  • Direction: apply to dry intact skin QD.
42
Q

Abilify

  • Indication
  • Dose
A

Aripiprazole

  • Indication: antipsychotic for MDD, bipolar, scz
  • Dose: start 2-5mg/d up to 15mg/d (lower dose than use for schizophrenia)
43
Q

SymBYAX

  • Indication
  • Dose
  • Direction to take
  • SEs
A

Olanzapine/fluoxetine

  • Indication: fast response for depression with bipolar or schizophrenia, treatment resistant depression
  • Dose: 3/25mg, 6/25mg, 6/50mg, 12/25mg, 12/50mg QHS
  • Take QHS due to Olazapine
  • SEs: EPSE, tardive dyskinesia, obesity, dyslipidemia, diabetes
  • Monitor: weight, BP, Glucose, lipid
44
Q

Depakote

  • Indication
  • SEs
A

Divalproex Na

  • Indication: Biopolar disorder
  • SEs: hepatitis, pancreatitis
45
Q

Lamictal

  • Indication
  • SEs
A

Lamotrigine

  • Biopolar disorder
  • SEs: severe hypersensitivity reaction
46
Q

Topamax

A

Topiramate

  • Biopolar disorder
47
Q

Equetro

  • Indication
  • Dose
  • SEs
A

Carbamazepine

  • Biopolar disorder
  • Dose: 100, 200, 300mg
  • SEs: aplastic anemia, agranulocytosis (CBC)
48
Q

Zyprexa

  • Indication
  • Dose
A

Olanzapine

  • Biopolar disorder
  • Dose: start 10mg IM for acute mania
49
Q

Resperdal

A

RISPERidone

  • Biopolar disorder
50
Q

Geodone

A

ZIPrasidone

  • Biopolar disorder
51
Q

Abilify

A

Aripiprazole

  • Biopolar disorder
52
Q

Eskalith

  • Indication
  • MOA
  • OSA
  • Dose
  • Therapeutic level
  • Dose adjustment
  • SEs
A

Lithium

  • Indication: tx of manic/depressive (bipolar) and depressive disorders.
  • MOA: Positive charged element
  • OSA: Effects usually begin in 1 week and full effect is seen by 2-3 weeks.
  • Dose: 900-1800mg/d (15-20mg/kg) with FOODs to avoid N
    Li carbonates (Eskalith and Lithobid) and Li citrate (syrup) = more GI)
  • Therapeutic level: 0.6 to 1.2mmol/L (MD); 0.8-1.5 (acute level)
  • Dose adjustment in:
    • Elderly and renal: decrease dose
    • Pregnancy: increase dose
  • SEs: LITH APM
    L = Leukocytosis
    I - Nephrogenic diabetic insipidus, GI = N/V/D
    T = final intentional tremor
    H = hypothyroidism => bradycardia
    A = Acne and alopecia
    P = polyuria and polydipsia
    M = Map = weight gain
53
Q

Li toxicity management

A
  • D/C Li
  • Resp and CV support
  • Restore fluid and electrolyte balance
  • Benzodiazepine prn agitation and/or sz
  • Phenytoin prn sz
  • There is no antidote. Care is supportive
54
Q

Drugs increase Li

Drugs decrease Li

Li with SSRIs

A

Drugs inc Li

  • Thiazides, ACEI
  • NSAIDs: reduce kidney’s ability to eliminate Li and lead to elevated levels of Li in blood
  • Na restriction, dehydration, renal fxn

Decrease Li

  • Pregnancy
  • Increase NaCl
  • Drugs caused urine to alkaline

Li with SSRIs
- Serotonin syndrome

55
Q

Li Monitoring

A
  • BUN and SCr
  • Urine specific gravity
  • CBC
  • Electrolyte: hypoNa and hypoK
  • TSH
  • EKG
  • Glucose
56
Q

Flumazenil

  • Indication
A

Antidote for Benzodiazepam

57
Q

Brintellix

  • Class
  • Indication
  • Dose
  • CI
A

Vortioxetine

  • Class: SNRI, 5HT1 agonist, 5HT3 antagonist
  • Indication: MDD
  • Dose: 10-20mg QD
  • CI: do not use w/ linezolid
58
Q

Sarafem

  • Indication
  • MOAIs
A

Fluoxetine

  • Indication: Premenstrual dysphoric disorder
    => start 14d before expected menses onset through first full day of menses.
  • MOAIs: d’c 14d prior to start fluoxetin. To start MOAI, d/c fluoxetin 5wk prior to start MOAI due to long t1/2
59
Q

Aventyl

  • Class
A

Nortriptylin

  • TCA: Secondary amines
60
Q

Aplenzin ER

A

Bupropion

61
Q

Zyban

  • Indication
A

Bupropion

  • Nicotine w/d
62
Q

Buproban

A

Bupropion

63
Q

Wellbutrin XL

  • Indication
A

Bupropoin

  • To prevent SAD. Start Wellbutrin XL in fall; taper off in spring)
64
Q

Oleptro XR

  • Indication
A

Trazodone

  • I: depression
65
Q

Stavzor

A

Valproic acid DR

66
Q

Lithobid

A

Lithium

67
Q

Clinoril

  • Class:
A

Sulindac

  • Class: NSAID that doesn’t increase Li level

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