Classes and Drug names Flashcards
Tricyclics
NOT first line of choice!
action: block SERT and NET (also block Ach and NE on post which causes SE
Kinetics:
- Oral admin and long half life
- highly plasma bound
- met. in liver (longer in elderly
SE: lots of SE “dirty,” interacts with lots of other drugs, not dependent, sedative and lots of anticholinergic effects
uses: dep. (long term and resistant types) and ocd (also reduces anxiety and pain)
imipramine
Tofranil
tricy.
- active metabolite
- Gold standard of tricy.
desipramine
Norpramin
metabolite of Tofranil (tricy.)
amitriptyline
Elavil
tricy.
- active metabolite
clomipramine
Anafranil
tricy.
- can be injected
- more commonly used for OCD
doxepine
Sinequan
tricy.
nortriptyline
Pamelor tricy. lower sedation less anti-cholinergic effects - metabolite of amitriptyline (Elavil)
Heterocyclics
-2nd generation, atypical, NOT first choice
- blocks NET
SE: sedating, anticholinergic
long half life
maprotiline
Ludiomil
heterocycl.
- can cause seizures
amoxapine
Ascendin
hetercycl.
- can cause Parkinsons like sx
- active metabolite
trazodone
Desyrel heterocycl. - absorbtion increases with meal SE: sex. dys., almost no anticholinergic effects - used for sedation
MAOI’s
action: blocks MAOI-A (which breaks down DA, NE, 5HT, Tyramine. Action is irreversible
SERIOUS SE: low HR, low BP, lethal at low dose, anticholinergic effects
STRICT DIET: avoid, tyramine foods, alcohol, caffeine, some meats, veggies, fruits, and cheese
Used for atypical or long term depression, masked depression, anorexia
selegiline
Eldapril
MAOI
-patch that bypasses GI
SSRI
Action: blocks SERT
Used for anxiety, depression, bipolar
SE: GI, headache, dizzy, insomnia, SEX DYS. Rare: neuroleptic malignant syndrome (overheat)
Serious SE include… serotonin syndrome, ANS dysfunction, finish effects,
Avoid Alcohol and OTC
- easy to tolerate, safe with elderly, neutral weight gain
fluoxetine
Prozac
SSRI
sertraline
Zoloft
SSRI
-more potent, fewer SE
paroxetine
Paxil
SSRI
-MOST specific SSRI (increase in risk for serotonin syndrome)
- Weight GAIN
- precipitator for psychosis, cleft lip in infants
fluoxamine
Luvox
SSRI
- good with all anxiety DO, good dcompliance
citalopram
Celexa SSRI - seizure and fatality with high dose - rapid onset - good for people on many drugs - not for elderly - decreases alcohol consumption
escitalopram
Lexapro
SSRI
- not highly protein bound
Dual Action
Anti-depressant
blocks NET and SERT
venlafaxine
Effexor dual action - at high dose blocks DA - low dose blocks SERT - active metabolite - few interactions, sx dys. increase BP
desvenlafaxine
Pristiq
- metabolite of venlafaxine (Effexor)
- decrease depression
duloxetine
Cymbalta
dual action
- used for pain, may cause mania
mirtazepine
Remeron
dual action (blocks release of 5HT and NE on presyn.)
- less SE, increase weight
buproprion
Wellbutrin dual action (blocks NET and DAT) - 1st pass effect - active metabolite - abuse potential - used for depression, adhd, pain, anx.
SNRI
blocks NET
atomoxetine
Strattera
- appropriate for ADHD in children
Mood Stabalizer
increase GABA, decrease Glutamate
- good for bipolar, major depr. anxi.
- not addictive
- monitor bc therapeutic and toxic range is small
lithium
Lithobid
mood stabalizer
- not for recurrent BP
- typically used with another drug
Anti-convulsant
BIG SE: birth defects, headache, nausea, dizzy tremor
used for bipolar and seizures
lamotrigine
Lamictal anti-conv. - not for acute mania (depression) STEVENS JOHNSON - FIRST line for recurrent BP
carbamazepine
Tegretol anti-conv. inhibits glutamate - good for acute mania and depr. HARSH SEL CNS, GI - many drug interactions
gabapentin
Neurontin anti-conv. - increase GABA - also used for pain and substance dependence - active metabolite
pregabalin
Lyrica anti-conv, metabolite of gabapentin (Neurontin) - 2-3 X as potent good for pain, not specifically used for BP
topiramate
Topamax anti-conv. - prevents relasps, not spec. for BP - less interaction monitor when used with Litium bc increases plasma bonding
zonisamide
Zonegran
aniti-conv
mixed results, high drop out, high SE
Antypical ANtipsychotics used for BP
Risperodone
Clozapine
Olanzepin & fluoxetine (Prozac)
Benzo
action: bind to Ch- further opening, decreases excitation
- lipophilic
-active metabolites slow elimination
- highly plasma bound
NOT FIRST LINE FOR DEPRESSION BECAUSE DEPENDENCY
SE: sedation, decrease coord. decrease mental acuity
TOXIC: no alc. dont use when pregnant
lorazepam
Ativan
benzo.
used for anx. alc. withdrawal
aproazolam
Xanax
benzo
oxazepam
Seraz
benzo
diazepam
Valium mothers helper anxiety and alc. withdrawal delayed absorbtion with food ACTIVE metabolites -SE DISINHIBITION
clonozepan
Klonepin
benzo
flumazenil
Romazicon
benzo
**competes with active benzo, reverses effect
buspiron
BusBar
NOT BENZO or BARB
- no dependency
- used for GAD
