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