Classes and Drug names

Question 1

Tricyclics

Answer 1

NOT first line of choice!

action: block SERT and NET (also block Ach and NE on post which causes SE

Kinetics:

1. Oral admin and long half life
2. highly plasma bound
3. 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)

Question 2

imipramine

Answer 2

Tofranil

tricy.
- active metabolite
- Gold standard of tricy.

Question 3

desipramine

Answer 3

Norpramin

metabolite of Tofranil (tricy.)

Question 4

amitriptyline

Answer 4

Elavil

tricy.
- active metabolite

Question 5

clomipramine

Answer 5

Anafranil

tricy.
- can be injected
- more commonly used for OCD

Question 6

doxepine

Answer 6

Sinequan

tricy.

Question 7

nortriptyline

Answer 7

Pamelor
tricy. 
lower sedation
less anti-cholinergic effects
- metabolite of amitriptyline (Elavil)

Question 8

Heterocyclics

Answer 8

-2nd generation, atypical, NOT first choice
- blocks NET
SE: sedating, anticholinergic
long half life

Question 9

maprotiline

Answer 9

Ludiomil

heterocycl.
- can cause seizures

Question 10

amoxapine

Answer 10

Ascendin

hetercycl.
- can cause Parkinsons like sx
- active metabolite

Question 11

trazodone

Answer 11

Desyrel
heterocycl.
- absorbtion increases with meal
SE: sex. dys., almost no anticholinergic effects
- used for sedation

Question 12

MAOI’s

Answer 12

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

Question 13

selegiline

Answer 13

Eldapril
MAOI
-patch that bypasses GI

Question 14

SSRI

Answer 14

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

Question 15

fluoxetine

Answer 15

Prozac

SSRI

Question 16

sertraline

Answer 16

Zoloft
SSRI
-more potent, fewer SE

Question 17

paroxetine

Answer 17

Paxil
SSRI
-MOST specific SSRI (increase in risk for serotonin syndrome)
- Weight GAIN
- precipitator for psychosis, cleft lip in infants

Question 18

fluoxamine

Answer 18

Luvox
SSRI
- good with all anxiety DO, good dcompliance

Question 19

citalopram

Answer 19

Celexa
SSRI
- seizure and fatality with high dose
- rapid onset
- good for people on many drugs
- not for elderly
- decreases alcohol consumption

Question 20

escitalopram

Answer 20

Lexapro
SSRI
- not highly protein bound

Question 21

Dual Action

Answer 21

Anti-depressant

blocks NET and SERT

Question 22

venlafaxine

Answer 22

Effexor
dual action
- at high dose blocks DA
- low dose blocks SERT
- active metabolite
- few interactions, sx dys. increase BP

Question 23

desvenlafaxine

Answer 23

Pristiq

• metabolite of venlafaxine (Effexor)
• decrease depression

Question 24

duloxetine

Answer 24

Cymbalta
dual action
- used for pain, may cause mania

Question 25

mirtazepine

Answer 25

Remeron dual action (blocks release of 5HT and NE on presyn.) - less SE, increase weight

Question 26

buproprion

Answer 26

``` Wellbutrin dual action (blocks NET and DAT) - 1st pass effect - active metabolite - abuse potential - used for depression, adhd, pain, anx. ```

Question 27

SNRI

Answer 27

blocks NET

Question 28

atomoxetine

Answer 28

Strattera | - appropriate for ADHD in children

Question 29

Mood Stabalizer

Answer 29

increase GABA, decrease Glutamate - good for bipolar, major depr. anxi. - not addictive - monitor bc therapeutic and toxic range is small

Question 30

lithium

Answer 30

Lithobid mood stabalizer - not for recurrent BP - typically used with another drug

Question 31

Anti-convulsant

Answer 31

BIG SE: birth defects, headache, nausea, dizzy tremor | used for bipolar and seizures

Question 32

lamotrigine

Answer 32

``` Lamictal anti-conv. - not for acute mania (depression) STEVENS JOHNSON - FIRST line for recurrent BP ```

Question 33

carbamazepine

Answer 33

``` Tegretol anti-conv. inhibits glutamate - good for acute mania and depr. HARSH SEL CNS, GI - many drug interactions ```

Question 34

gabapentin

Answer 34

``` Neurontin anti-conv. - increase GABA - also used for pain and substance dependence - active metabolite ```

Question 35

pregabalin

Answer 35

``` Lyrica anti-conv, metabolite of gabapentin (Neurontin) - 2-3 X as potent good for pain, not specifically used for BP ```

Question 36

topiramate

Answer 36

``` Topamax anti-conv. - prevents relasps, not spec. for BP - less interaction monitor when used with Litium bc increases plasma bonding ```

Question 37

zonisamide

Answer 37

Zonegran aniti-conv mixed results, high drop out, high SE

Question 38

Antypical ANtipsychotics used for BP

Answer 38

Risperodone Clozapine Olanzepin & fluoxetine (Prozac)

Question 39

Benzo

Answer 39

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

Question 40

lorazepam

Answer 40

Ativan benzo. used for anx. alc. withdrawal

Question 41

aproazolam

Answer 41

Xanax | benzo

Question 42

oxazepam

Answer 42

Seraz | benzo

Question 43

diazepam

Answer 43

``` Valium mothers helper anxiety and alc. withdrawal delayed absorbtion with food ACTIVE metabolites -SE DISINHIBITION ```

Question 44

clonozepan

Answer 44

Klonepin | benzo

Question 45

flumazenil

Answer 45

Romazicon benzo **competes with active benzo, reverses effect

Question 46

buspiron

Answer 46

BusBar NOT BENZO or BARB - no dependency - used for GAD