Drugs

Question 1

CYP450 inducers

Answer 1

smoking
carbamazepine
barbiturates
st. john’s wart

Question 2

CYP450 inhibitors

Answer 2

fluvoxamine
fluoxetine
paroxetine
duloxetine
sertraline
(all SSRIs except duloxetine)

Question 3

Fluoxetine

Answer 3

SSRI
longest halflife (weekly dosing available)
-->no need to taper
safe in pregnancy + kids
common sleep changes and anxiety
can elevate antipsychotic levels

Question 4

Sertraline

Answer 4

SSRI
highest risk for GI disturbance
very few interactions
common sleep changes

Question 5

Paroxetine

Answer 5

SSRI
highly protein bound –> DDIs
more anti-chol effects
short halflife –> withdrawal

Question 6

Fluvoxamine

Answer 6

SSRI
only for use in OCD
N/V common
lots of DDIs

Question 7

Citalopram

Answer 7

SSRI
fewest DDIs
fewer sexual AEs

Question 8

Escitalopram

Answer 8

SSRI
enantiomer of citalopram
expensive

Question 9

Venlafaxine

Answer 9

SNRI
Tx of depression, anxiety d/o, ADHD
can cause HTN

Question 10

Duloxetine

Answer 10

SNRI
Tx of depression and neuropathic pain
can cause liver AEs

Question 11

Bupropion

Answer 11

NDRI
NO sexual side effects
increases risk of seizures
CI in seizure or eating d/o and patients on MAOI

Question 12

Trazodone

Answer 12

Serotonin receptor antagonists and agonists

• refractory MDD or depression with anxiety/insomnia
• no sex AEs
• no effect on REM sleep
• can cause orthostatic hypoTN, priapism, sadation

Question 13

Nefazodone

Answer 13

Serotonin receptor antagonists and agonists

• refractory MDD or depression with anxiety/insomnia
• no sex AEs
• no effect on REM sleep
• can cause orthostatic hypoTN, priapism, sedation
• BBW for liver failure

Question 14

Mirtazapine

Answer 14

alpha2-receptor antagonist

• tx of refractory major depression
• use in patients that need weight gain
• Can cause sedation
• no sex AEs

Question 15

Amitriptyline

Answer 15

TCA (tertiary amine)

- Tx of chronic pain, migraine, insomnia

Question 16

Imipramine

Answer 16

TCA (tertiary amine)

- Tx of enuresis and panic d/o

Question 17

Clomipramine

Answer 17

TCA (tertiary amine)

- Tx of OCD

Question 18

Doxepin

Answer 18

TCA (tertiary amine)

- Tx of chronic pain, insomnia

Question 19

Nortriptyline

Answer 19

TCA (secondary amine)

• least likely to cause orthostatic hypoTN
• tx of chronic pain

Question 20

Desipramine

Answer 20

TCA (secondary amine)

• least sedating
• least antichol

Question 21

Amoxapine

Answer 21

Tetracyclic antidepressant

• may cause EPS
• side effect profile similar to typical antipsych

Question 22

Maprotiline

Answer 22

tetracyclic antidepressant

- high rates of seizure, arrhythmia, fatal OD

Question 23

3 Cs of tricyclics

Answer 23

cardiotoxicity
convulsions
coma

Question 24

Phenelzine

Answer 24

MAOI

Question 25

Tranylcypromine

Answer 25

MAOI

Question 26

Isocarboxazid

Answer 26

MAOI

Question 27

OCD

Answer 27

SSRI (fluvoxamine)

TCAs (clomipramine)

Question 28

Panic d/o

Answer 28

SSRIs, TCAs (imipramine), MAOI

Question 29

Eating d/o

Answer 29

SSRI (high doses), TCAs, MAOIs

Question 30

Dysthymia

Answer 30

SSRI

Question 31

Social phobia

Answer 31

SSRIs, TCAs, MAOIs

Question 32

GAD

Answer 32

SSRIs, SNRIs (venlafaxine