Exam 2 Flashcards
Mood stabilizer good for Manic
Lithium
VPA
SGA
Can get ECT with manic when on
Li + AED + AED
or
Li + APS + AED
First line hypomania
Li or VPA or SGA or carbamazepine
Mood stabilizers good for depression
Lithium, quetiapine, lurasidone
After optimized mood stabilizer / adding what can be done in depressive episode
Add carbamazepine or anti depressant
Others you can consider in depression
Olanzapine/Fluoxetine
Lamotrigine
Valproate
Need to be on what in depressive state to get ECT
Li +Lamotrigine + AD
or
Li + Quetiapine + AD
Manic general drugs
1st line lithium
carba (or Ox)
SGAs + Halo + chloro
Benzo (loraz, clonaz if needed)
Mixed in general
Divalproex sodium
Maintenance general
1st line Lithium
Can do divalproex sodium
Lamotrigine (good to prevent depression)
Aripiprazole, olanzapine, asenapine, risperidone,
LAI Halo + Fluphen
Depression general
2nd line Lithium in BP II
Quetiapine, Lurasidone, Olanzapine/Fluoxetine, carbamazepine
GAD 1st line
Escitalopram
Paroxetine
Sertraline
Duloxetine
Venlafaxine XR
Pregabalin
GAD 1st line FDA approved
Escitalopram
Paroxetine
Duloxetine
Venlafaxine ER
GAD 2nd line FDA approved
Buspirione
Panic disorder 1st line
Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Venlafaxine XR
Panic disorder 1st line FDA approved
Fluoxetine
Paroxetine
Sertraline
Venlafaxine XR
SAD 1st line
Escitalopram
Fluvoxamine
Paroxetine
Sertraline
Venlafaxine
Pregabalin
SAD 1st line FDA approved
Paroxetine
Sertraline
Venlafaxine XR
PTSD 1st line
Fluoxetine
Paroxetine
Sertraline
Venlafaxine
PTSD 1st line FDA approved
Paroxetine
Sertraline
OCD 1st line
Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Clomipramine
OCD 1st line FDA approved
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Sinemet
Carbidopa/Levodopa
Minimum carbidopa dose
70-100mg QD
Stalveo
Carbidopa/Levodopa/Entacapone
COMT inhibitors
Entacapone
Tolcapone
Entacapone dose
200 with each Carbidopa/Levodopa dose
Levodopa starting dose
200-300mg in divide doses
Carbidopa/Levodopa ratio of dose
1:4
Inbrija
inhaled levodopa
MAOi-Bs
Selegiline
Rasagiline
Safinamide
Ergots
Bromocriptine
Pergolide
Cabergoline
Wearing off effect - solution
increase frequency
add MAOi
add COMT
Off, no on - solution
take on empty stomach, ODT, APO SQ
Delayed onset - solution
take on empty stomach, water, avoid protein
Get some IR
Peak effect dyskinesia
Decrease dose
switch to CR
drug induced psychosis get rid of
anti cholinergic
D/c taper amantadine
Selegiline
taper and D/c DA
decrease dopa end of day dose and d/c COMT
Add SGAs
Quetiapine
clozapine
Pimavanserin
Hallmarks of dementia
beta amyloid plaques and neurofibrillary tangles
Hippocampus
short term to long term
Hypothalamus
monitors certain activities and controls body’s internal clock
Thalamus
sensory and limbic information to send to cerebral cortex
Limbic system
controls emotions and instinctive behavior
Approved drugs for dementia
Donepezil
Rivastigmine
Galantamine
Memantine
Namzaric
Memantine + Donepezil
Targets for new Alzheimer’s drugs
Block B-secretase
block gamma secretase
Increase A-secreatase to out compete B
Increase likelihood of APP processing by A-secreatase
Immunization
enhance proteolytic degradation
