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NAPLEX: Psychiatric Disorders > Anxiety: Drugs > Flashcards

Anxiety: Drugs Flashcards

1
Q

Alprazolam

A

Brand: Xanax, Nirazax, Intensol
Dosage: IR (0.25-2mg QD-TID), ER (0.5-3mg QD, MDD: 4mg/day)
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: Ketoconazole, itraconzaole, EtOH, CNS depressant, digoxin, fluoxetine, propoxyphene, nefazodone
*Other: Schedule C-IV, pregnancy cat. D, smoking decreases concentration 50%, pediatric dosing, rapid onset/SHORT acting

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2
Q

Chlordiazepoxide

A

Brand: Librium
Dosage: 5-25mg TID-QID
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
*Other: CrCl

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3
Q

Clonazepam

A

Brand: Klonopin, Klonopin wafers
Dosage: 0.5-2mg (BID), oral disintegrating tabs (ODTs) 0.125-2mg BID
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
Other: Decrease dose 1/2 if ELDERLY or HEPATIC disease, pregnancy D, schedule C-IV, rapid onset/long-acting

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4
Q

Clorazepate

A

Brand: Gen-XENE, Tranxene (T-Tab), Tranxene
Dosage: IR 3.25-15mg (BID-QID), ER 11.25-22.5mg QD
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
Other: Avoid in elderly, schedule C-IV, pregnancy D, rapid onset/long acting

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5
Q

Diazepam

A

Brand: Vallium, Diazepam Intensol
Dosage: 2-10mg BID-QID
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
Other: IV + liquid, schedule C-IV, pregnancy D, rapid onset/long acting

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6
Q

Lorazepam

A

Brand: Ativan, Intensol
Dosage: 0.5-2mg BID-TID (MDD: 10mg)
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
Other: IV/Liquid, schedule C-IV, pregnancy D, medium onset/short acting

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7
Q

Oxazepam

A

Brand: Alepam, Medopam, Murelax, Noripam, Oxpam, Purata, Serax, Perepax
Dosage: 10-30mg TID-QID
Class: Benzodiazepine
CIs: Hypersensitivity, narrow-angle glaucoma
SEs: Somnolence, ataxia, dizziness, appetite changes, decreased libido, confusion, constipation, blurred vision
Monitoring: Orthostasis, excessive sedation, withdrawl s/sx, BMP, LFTs, CBCs
Drug Interactions: EtOH, CNS depressants, ketoconazole
Other: Schedule C-IV, pregnancy D, medium onset/short acting

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8
Q

Citalopram

“Group 1”

A

Brand: Celexa
Dosage: 10-60mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring: Symptoms, bleeding, suicidal tendencies, withdrawl
Drug Interactions: MAOIs, SSRIs, triptans, linezolid, CYP3A inducers, tramadol
Other: R/S Racemic mixture

Anxiety Indications: Panic (off-label), GAD, PTSD, OCD

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9
Q

Escitalopram

“Group 1”

A

Brand: Lexapro
Dosage: 10-20mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring: Symptoms, bleeding, suicidal tendencies, withdrawl
Drug Interactions:
Other: Pure S isoform (vs. R/S racemic mixture)

Anxiety Indications: GAD

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10
Q

Fluvoxamine

“Group 1”

A

Brand: Luvox
Dosage: 50-300mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring:
Drug Interactions: Serotonergic meds, st. john’s wort, phenytoin, linezolid, CYP450s

Anxiety Indications: OCD, panic attacks

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11
Q

Paroxetine

“Group 1”

A

Brand: Paxil
Dosage: 20-60mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring:
Drug Interactions: Serotonergic meds, st. john’s wort, tramadol
Other: None

Anxiety Indications: PTSD, panic disorders, GAD, OCD, SAD

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12
Q

Sertraline

“Group 1”

A

Brand: Zoloft
Dosage: 50-200mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring:
Drug Interactions: Serotoneric meds, st. john’s wort, tramadol
Other: Oral concentrate contains EtOH

Anxiety Indications:OCD, panic disorder, SAD, PTSD

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13
Q

Fluvoxamine

“Group 1”

A

Brand: Luvox
Dosage: 50-300mg/day
Class: SSRI
SEs: Lightheadedness, snycope, sweating, diarrhea, nausea, xerostomia, confusion, dizziness, somnolence, tremor, hallucinations, ejaculation disorders, impotence, female sexual disorder, rhinitis, fatigue
Monitoring:
Drug Interactions: Serotonergic meds, st. john’s wort, phenytoin, linezolid, CYP450s

Anxiety Indications: OCD

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14
Q

Propranolol

A

Brand: Inderal, InnoPran XL, Intensol
Dosage: 10-80mg 1hr prior to anxiety event
Class: non-specific beta-adrenergic blocker (b1, b2 in heart, vascular smooth muscle, bronchial)
SEs: Dizziness, fatigue, GI upset, hyPOtension
Monitoring: HR, BP
Drug Interactions: CYPs (1A2 major), nonDHP-CCB
Other: Situational anxiety, acute panic (Off-Label)

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15
Q

Busprione

A

Brand: BuSpar
Dosage: 5-30mg BID-TID (MDD: 80mg)
Class: unknown MOA (5-HT 1A, 2 and dopamine D2) affinity
SEs: Headache, dizziness, nausea, hostility, confusion, drowsiness
Monitoring: Mental status changes, anxiety, pseudo-parkinsonism
Drug Interactions: MAOIs, non-DHP CCB, CYPs, macrolides, SSRIs
Other: Pregnancy B, avoid in RENAL/HEPATIC, pediatrics ≥6yr, 2-3wk build up

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16
Q

Venlafaxine

A

Brand: Effexor (XR)
Dosage: 25-100mg QD (ER: 37.5-150mg QD (MDD: 225mg))
Class: SNRI
SEs: Drowsiness, dizziness, insomnia, xerostomia, weakness, changes in appetite
Monitoring: BP, metal status, serotonin syndrome S/Sx
Drug Interactions: EtOH, SSRIs, TCAs, MAOIs, busprione, tramadol, lithium, haloperidol, clonzapine, nefazodone, trazodone
Other: Pregnancy C, use with caution in RENAL

Anxiety: GAD, panic disorder, SAD

17
Q

Hydroxyzine

A

Brand: Vistaril
Dosage: 10-100mg QID
Class: H1-receptor competitive inhibitor
SEs: Dizziness, drowsiness, fatigue, xerostomia, blurry vision, urinary retention
Monitoring: BP, mental status, BUN/SrCr with chronic use
Drug Interactions: Antihistamines, MAOIs, CNS depressants
Other: Caution with benign prostate hyperplasia, pregnancy C, avoid in ELDERLY and RENAL impairment

18
Q

Meprobamate

A

Brand: Miltown
Dosage: 200-400mg TID-QID (MDD: 2400mg)
Class: Hypersensitivity, porphyria
SEs: Drowsiness, ataxia, N/V/D, anorexia, hyPOtension
Monitoring: Withdrawl, mental status, LFTs
Drug Interactions: EtOH, CNS depressant
Other: Schedule C-IV, pregnancy D, HEPATIC/RENAL dose adjustment

NAPLEX: Psychiatric Disorders (7 decks)

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