first gen: Dopamine type-2 >>> 5HT2.. antagonists second gen: 5HT2 >>> Dopamine.. antagonists

Heart of the Cards Flashcards by Stephan Green

Atomoxetine risks

suicidal ideations, liver injury/jaundice

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Atomoxetine

Non-stim for ADHD

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Fluoxetine

SSRI, anti-depressant and mood stabilizer

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SSRI risk

CNS (sedation, agitation, nervousness), sex dysfunction (high), wt changes, acute withdrawal (flu-like sxs), serotonin syndrome

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serotonin syndrome

AMS, hyper-reflexia, dilated pupils, hyper-active GI

d/t increased serotonin buildup in brain

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SSRIs

Anti-Depressants, Mood Stabilizers

SPECFVV
Sertraline
Paroxetine
Escitalopram
Citalopram
Fluoxetine
Vortioxetine (Trintellix)
Vilazodone

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methylphenidate (QuilliChew)

Amphetamine-derivative Stimulant

Ritalin LA

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methylphenidate risks

dec appetite, HA, N/V/abd pain, insomnia, anxiety, agitation, inc BP/HR, cardiac death (rare)

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Benzodiazepine risks

dependence, CNS depression (especially with ETOH), rxns w/ CYP3A4 drugs

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Benzodiazepine MOA

promotes GABA binding by binding a special site near GABAR’s, NOT a GABA substitute

sedation, m relaxation, anxiolytic, anticonvulsant

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Second-gen Anti-Psychotics (atypicals/novel), what’s first line? what’s used for multi-drug resistance?

ACOQRZ
Aripiprazole (Abilify)
Clozapine
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Risperidone
Ziprasidone (Geodon)

Also: Lurasidone, Brexpiprazole

Aripiprazole, Ziprasidone
Clozapine

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Second Gen Anti-Psychotics (Atypicals/Novel) risks

metabolic (wt gain, DM, dyslipidemia), no EPS (extra-pyramidal sxs), rare = strokes in elderly w/ dementia

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additional risk for Clozapine

agranulocytosis (CBC)

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Prazosin

a-1 blocker, used for HTN, BPH, and PTSD

smooth m relaxer that combats spikes in BP

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Prazosin risk

hypotension, otherwise well-tolerated

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anti-psychotic MOA

first gen: Dopamine type-2&raquo_space;> 5HT2.. antagonists

second gen: 5HT2&raquo_space;> Dopamine.. antagonists

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generalized risk for anti-psychotics and it’s tx

neuroleptic malignant syndrome (NMS): widespread m contraction d/t persistent Ca channel openings, hyporeflexia, diaphoresis, AMS

tx: Dantrolene (m relaxant/spasmolytic, inh ryanodine R Ca channels blocking Ca release, risk: hepatitis)

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SNRIs

all TCAs
VLADD:
Venlafaxine
Levomilnacipran
Amoxapine + DA
Desvenlafaxine
Duloxetine

SNRIs vs SSRIs regarding sex

SNRI’s have low sexual dysfunction (exception = Venlafaxine), SNRIs have high sexual dysfunction

Bupropion vs Buspirone

Bupropion: NDRI (nor-epi + dopamine) anti-depressant, risk of seizures, also used for smoking cessation

Buspirone: newer hypnotic for anxiety, MOA unknown, risk: tachy, nervousness, GI distress, slow onset, no addictive potential, indication: sleep aid, delirium, anxiety, seizures

Stimulant time-tables

Adderall and Ritalin: 4-5hr
Metadate: 6-8hr
Vyvanse: 10hr

Guanfacine and Clonidine

Non-stim ADHD medication
risk: hypo-TN/brady
MOA: a2-adrenergic R agonists in CNS

dementia medication duo

donepezil (Aricept) and Memantine (Namenda)

donepezil (Aricept) MOA

inc ACh in pts w/ fewer cholinergic neurons

Buspirone use

background anxiety to move away from the "panic" threshold "spear anxiety!" Bu..spir..

DSM-5

diagnostic and statistical manual of mental disorders, fifth edition

What anti-psychotic can inc prolactin?

Risperidone, 2nd generation (novel, atypical)

What are the only FDA-approved txs for autism?

Aripiprazole (low-risk), Risperidone (inc prolactin)

What are the first-line tx options for SGAs?

Aripiprazole, Ziprasidone

diagnostic features of autism spectrum disorder

A) persistent impairment in reciprocal social communication and interaction, not expressing emotions to others, poor eye contact makes nonverbal cue-taking difficult/absent, appropriate behavior for certain situations may not occur, doesn't pick up on irony, poor friends (d/t lack of social understanding) B) restricted, repetitive patterns of behavior, interests, or activities C) sxs present in early childhood D) limit or impair everyday functioning

stimming

means to comfort someone with ASD, can be making vocal noises/parroting, playing with certain objects, etc

catatonic

immobile, unresponsive stupor

Monistat

Miconazole, yeast infection treatment

medication for binge eating

Vyvanse, curbs impulses and may decrease appetite

carb binges can lead to

sugar high then CRASH

what's the mixed amphetamine?

Adderall, can be applied to food

Benztropine

anticholinergic

Lamotrigine

anticonvulsant

Lisdexamphetamine

Vyvanse

Clonidine MOA and risks, indication

a2-agonist, hypo-TN and brady ADHD, tics, aggression

Prazosin

``` used for PTSD to.. Prazosin To Stop Dreams (nightmares) ```

what drugs require lab levels?

Depakote (valproic acid), lithium

methylphenidate

Ritalin, Deytrana (patch)