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PassNaplexNow - NAPLEX review prep > 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
Desyrel IR - Indication - SEs
TraZOdone - Indication: sleep disorder (IR) - Dose: 50mg QHS - SEs: GI, sexual dysfunction, anticholinergic effects, orthostatic hypoTN, **priapism
26
Serzone - MOA - Indication - SEs
NEFazodone - MOA: Blocks serotonin reuptake (less potent than SSRI) and alpha adrenergic blocker - Indication: MDD - SEs: similar to Trazodone. No Priapism
27
REMeron - MOA - Dose - SEs
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
AmiTIPtyline - MOA for all TCA - Indications - Dose - SEs
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
Anafranil - Indication - Class
CLOMipramine - TCA: Tertiary amines - Indication: OCD & MDD
30
Sinequan - Indication - Class
DOXepin - TCA: Tertiary amines - Indication: MDD and anxiety
31
Tofranil - Indication
IMipramine - TCA: Tertiary amines - Indication: MDD, night time bed-wetting episodes
32
Surmontil - Class
TIMipramine - TCA: Tertiary amines
33
Asendin - Indication
aMOxapine - Depression
34
Norpramine - Indications: - Class
DesiPRAMINE - TCA: Secondary amines - Other indication: ADHD
35
Ludiomil - Class
MAProtiline - TCA: Secondary amines
36
Pamelor - Class
Nortriptylin - TCA: Secondary amines
37
Vivactil - Class
PROtriptyline - TCA: Secondary amines
38
Marplan - MOA - Indication - SEs - DDIs - Tyramine containing foods:
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
Nardil
PheNELzine - MOAIs
40
Parnate
TRANylcypromine - MOAIs
41
Emsam - MOAIs - Indication - Forms - Direction
SeLEGiline - MOAIs Type B - Indication: MDD - Forms: patches in 6, 9, 12 mg/24H - Direction: apply to dry intact skin QD.
42
Abilify - Indication - Dose
Aripiprazole - Indication: antipsychotic for MDD, bipolar, scz - Dose: start 2-5mg/d up to 15mg/d (lower dose than use for schizophrenia)
43
SymBYAX - Indication - Dose - Direction to take - SEs
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
Depakote - Indication - SEs
Divalproex Na - Indication: Biopolar disorder - SEs: hepatitis, pancreatitis
45
Lamictal - Indication - SEs
Lamotrigine - Biopolar disorder - SEs: severe hypersensitivity reaction
46
Topamax
Topiramate - Biopolar disorder
47
Equetro - Indication - Dose - SEs
Carbamazepine - Biopolar disorder - Dose: 100, 200, 300mg - SEs: aplastic anemia, agranulocytosis (CBC)
48
Zyprexa - Indication - Dose
Olanzapine - Biopolar disorder - Dose: start 10mg IM for acute mania
49
Resperdal
RISPERidone - Biopolar disorder
50
Geodone
ZIPrasidone - Biopolar disorder
51
Abilify
Aripiprazole - Biopolar disorder
52
Eskalith - Indication - MOA - OSA - Dose - Therapeutic level - Dose adjustment - SEs
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
Li toxicity management
- 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
Drugs increase Li Drugs decrease Li Li with SSRIs
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
Li Monitoring
- BUN and SCr - Urine specific gravity - CBC - Electrolyte: hypoNa and hypoK - TSH - EKG - Glucose
56
Flumazenil - Indication
Antidote for Benzodiazepam
57
Brintellix - Class - Indication - Dose - CI
Vortioxetine - Class: SNRI, 5HT1 agonist, 5HT3 antagonist - Indication: MDD - Dose: 10-20mg QD - CI: do not use w/ linezolid
58
Sarafem - Indication - MOAIs
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
Aventyl - Class
Nortriptylin - TCA: Secondary amines
60
Aplenzin ER
Bupropion
61
Zyban - Indication
Bupropion - Nicotine w/d
62
Buproban
Bupropion
63
Wellbutrin XL - Indication
Bupropoin - To prevent SAD. Start Wellbutrin XL in fall; taper off in spring)
64
Oleptro XR - Indication
Trazodone - I: depression
65
Stavzor
Valproic acid DR
66
Lithobid
Lithium
67
Clinoril - Class:
Sulindac - Class: NSAID that doesn't increase Li level

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