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RRCCPA Pharmacotherapeutics > Beyond Xanax Meds (Midterm) > Flashcards

Beyond Xanax Meds (Midterm) Flashcards

1
Q

Sx of serotonin syndrome

A
  • dilated pupils
  • N/D
  • restlessness
  • confusion
  • tachy
  • inc BP
  • sweating
  • loss of muscle coordination, twitching
  • muscle rigidity
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2
Q

Preferred SSRIs

A
  1. Sertraline (Zoloft)
  2. Fluoxetine (Prozac)
  3. Escitalopram (Lexapro)
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3
Q

Dosing range for Sertraline (Zoloft)

A

25mg - 250mg

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4
Q

Indications for Sertraline (Zoloft)

A
  • Anxiety
  • Depression
  • OCD
  • Irritability
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5
Q

When do you see results of Sertraline (Zoloft)

A

3 wks (2 if tweaking)

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6
Q

Sertraline (Zoloft) S/Es

A
  • GI disturbance
  • Reflux
  • Somnolence
  • Libido
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7
Q

Dosing range for Fluoxetine (Prozac)

A

10mg - 80mg

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8
Q

Indications for Fluoxetine (Prozac)

A
  • Anxiety
  • Depression
  • OCD
  • Motivation
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9
Q

When do you see results of Fluoxetine (Prozac)

A

4 wks (2-3 if tweaking)

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10
Q

Fluoxetine (Prozac) S/Es

A
  • Anorexia
  • Activation (take in AM)
  • Libido
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11
Q

Dosing range for Escitalopram (Lexapro)

A

5mg - 40mg

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12
Q

Indications for Escitalopram (Lexapro)

A
  • Anxiety
  • Depression
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13
Q

When do you see results of Escitalopram (Lexapro)

A

3 wks (2 if tweaking)

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14
Q

Of the 3 preferred SSRIs, which one is the most activating/serotonergic?

A

Escitalopram (Lexapro)

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15
Q

Escitalopram (Lexapro) S/Es

A
  • Activating
  • Weight gain
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16
Q

Prior to initiation of SSRI Citalopram (Celexa), what do you need to ensure you’ve asked your patient? Why?

A

If they have/had any cardiac issues - concern for QT prolongation

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17
Q

What are the 3 preferred SNRIs

A
  1. Duloxetine (Cymbalta)
  2. Desvenlafaxine (Pristiq)
  3. Venlafaxine (Effexor)
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18
Q

What is the dosing range for Duloxetine (Cymbalta)

A

20mg - 120mg

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19
Q

Indications for Duloxetine (Cymbalta)

A
  • Pain
  • Anxiety
  • Depression

*NOT irritability

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20
Q

When do you see results of Duloxetine (Cymbalta)

A

4 wks (2-3 if tweaking)

21
Q

Duloxetine (Cymbalta) S/Es

A
  • GI disturbance
  • Somnolence
  • Libido
  • W/D syndrome
22
Q

What is the dosing range for Desvenlafaxine (Pristiq)

A

25mg - 100mg

23
Q

Indications for Desvenlafaxine (Pristiq)

A
  • Anxiety
  • Depression
  • Energy
24
Q

When do you see results of Desvenlafaxine (Pristiq)

A

4 wks (3 if tweaking)

25
Q

Desvenlafaxine (Pristiq) S/Es

A
  • Libido
  • W/D syndrome - much more gentle though
26
Q

Which of the 3 preferred SNRIs is well tolerated, has no metabolism in the liver, and lower risk of DDIs?

A

Desvenlafaxine (Pristiq)

27
Q

What is the dosing range for Venlafaxine (Effexor)

A

37.5mg - 300mg

28
Q

Indications for Venlafaxine (Effexor)

A
  • Anxiety
  • Depression
  • Energy
29
Q

When do you see results of Venlafaxine (Effexor)

A

3-4 wks (2 if tweaking)

30
Q

Venlafaxine (Effexor) S/Es

A
  • WICKED W/D SYNDROME
  • Libido
  • Last resort!
31
Q

How many days is needed for initiation and b/w ramping doses of SSRIs

A

3-7 days

32
Q

How many days is needed for initiating and b/w ramping doses of SNRIs

A

14 days (modulating 2 NTs)

33
Q

What are some adjunct medications

A
  • Buspar
  • Wellbutrin
  • Abilify
  • Lithium
  • Lamictal
34
Q

Buspar indication, S/E, dosing

A
  • Anti anxiety
  • S/E: Dizziness
  • Inc to 10mg BID
35
Q

Wellbutrin indication and dosing

A
  • Motivation, sexual side effects, smoking
  • SR 75mg - 400mg, XL 150mg - 450mg
36
Q

Wellbutrin SEs

A
  • Lowers seizure threshold
  • Inc anxiety
37
Q

Abilify indications and dosing

A
  • Super charger for mood lability/emotional reactivity
  • 2mg - (30mg) - typically do not go above 5mg
38
Q

What labs do you need to obtain when a patient is taking Abilify?

A

Alc, Lipids after 6 months - then 1 x yr

39
Q

Abilify S/Es

A
  • Sedation
  • Weight gain
40
Q

Lithium indications

A
  • SI (esp. in adolescents)
  • Depression
41
Q

What is the dosing range for Lithium

A

ER 300mg - 450mg (600mg)

42
Q

What do you need if you are prescribing >600mg of Lithium

A

Labs - lithium level, TSH, CMP

43
Q

Lamictal indications

A

emotional reactivity

44
Q

What is the dosing range for Lamictal

A

25mg - 200mg (400mg) - anything >200mg is not effective

45
Q

What labs do you need to get if a patient is prescribed Lamictal

A

A1c, Lipids after 6 months - then 1 x yr

46
Q

Lamictal S/Es

A
  • SJS
  • Weight gain
47
Q

What are the non stimulants used for ADHD

A
  • Strattera
  • Guanfacine/Intuniv
48
Q

What are the stimulant options for ADHD

A
  • Adderall
  • Vyvanse
  • Focalin
  • Concerta
  • Methylphenidate

RRCCPA Pharmacotherapeutics (11 decks)

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