Drugs

Question 1

Fluoxetine

• dose
• effect
• pharmacokinetics
• SE
• CI
• interactions
• duration

Answer 1

Fluoxetine 20mg PO mane

Effect - 1-2 weeks initially; 4-6 weeks for max effect

Pharmacokinetics - peak 4-6 hours

Half-life - 1-6 days

SEs
- CNS - suicidal thoughts, sedation, insomnia, agitation (abate after a few weeks)
- GI - N&V, diarrhoea, abdominal cramps & discomfort (5-HT stimulates GI motility)
- Sexual dysfunction (erectile in M, delayed lubrication in F, anorgasmia in males & females)
Withdrawal - requires weaning
- CV - orthostatic hypotension, QTc prolongation
- Anti-cholinergic (TCAs only) - dry mouth, sweating, orthostatic hypotension

CI - MAOI within 5 weeks, pimozid

Interactions - other anti-Ds, some antipsychotics, MDMA

Duration - at least 6 months

Question 2

Alcohol management meds

Answer 2

naltrexone
acamprosate
disulfiram

Question 3

Opioid management meds

Answer 3

naloxone
buprenorphine
buprenorphine / naloxone
methadone

Question 4

Nicotine management meds

Answer 4

bupropion
varenicline
NRT