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just the meds Flashcards

1
Q

antipsychotic agents aka

A 
dopaminergic antagonists
(block D2 dopamine receptors in brain)
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2
Q

antipsychotic black box warning

A

increased mortality in elderly patients with dementia-related psychosis

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3
Q

antidepressant black box warning

A

?

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4
Q

levodopa: definition + 1 interaction

A

oral form of dopamine used to treat parkinsonism

+ antagonized by antipsychotics!!

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5
Q

chlorpromazine (thorazine)

A

typical antipsychotic

  • phenothiazine
  • low potency
  • target sx: antiemetic, hiccup relief
  • more anticholinergic SE
  • sedation, hypotension common
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6
Q

haloperidol (haldol)

A

typical antipsychotic

  • nonphenothiazine (butyrophenone)
  • high potency
  • target sx: agitation, aggression
  • unlikely anticholinergic SE
  • more EPSE
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7
Q

alt: prolixin, stelazine, navane

A

typical antipsychotic, high potency

OTHER

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8
Q

alt: mellaril (thioridazine)

A

typical antipsychotic, low potency

OTHER

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9
Q

butyrophenone

A

type of nonphenothiazine, high potency typical antipsychotic

  • haloperidol (haldol)
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10
Q

benztropin (cogentin)

A

epse treatment!
antiparkinsonian; anticholinergic

moa: anticholinergic - block central cholinergic receptors

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11
Q

trihexyphenidyl (artane)

A

epse treatment!
antiparkinsonian; anticholinergic

moa: anticholinergic - block central cholinergic receptors

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12
Q

diphenhydramine (benadryl)

A

epse treatment!
antihistamine

moa: suppression of central cholinergic activity; prolongs action of dopamine by inhibiting reuptake and storage

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13
Q

clozapine (clozaril)

A

atypical antipsychotic

moa: strong blockade of D1, weaker D2
also blocks 5HT, NE, histamine, ACh

common se: sedation, drowsiness, hypersalivation, tachycardia, dizziness, constipation

adverse: agranulocytosis 1-2%
generalized seizures 3%

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14
Q

risperidone (risperdol)

A

atypical antipsychotic

moa: binds to multiple receptors
- D2 (weak)
- 5HT (strong)
- histamine
- alpha-adrenergic
does NOT block cholinergic receptors

side effects (generally infrequent, mild): fatigue, somnolence, dizziness, agitation

> see especially in non-psych settings <

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15
Q

olanzepine (zyprexa)

A

moa:

  • positive effects: dopamine, 5HT
  • negative effects: NE, histamine
side effects (mild)
somnolence 26%
hypotension
anticholinergic effects
** longterm use: weight gain **
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16
Q

seroquel (quetiapine fumarate)

A

atypical antipsychotic - effective in treatment of mood disorders with psychotic symptoms

common SEs: sedation, hypotension, dizziness, weight gain

OTHER

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17
Q

geodon (ziprasidone)

A

atypical antipsychotic - effective in treatment of mood disorders with psychotic symptoms

historically associated with cardiac side effects

OTHER

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18
Q

saphris (asenapine)

A

atypical antipsychotic - effective in treatment of mood disorders with psychotic symptoms

sublingual

OTHER

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19
Q

fanapt (iloperidone)

A

atypical antipsychotic - effective in treatment of mood disorders with psychotic symptoms

approved for schizophrenia only

OTHER

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20
Q

latuda (lurasidone)

A

atypical antipsychotic - effective in treatment of mood disorders with psychotic symptoms

primarily have D2, 5HT2 actions

OTHER

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21
Q

antidepressant black box warning for youth

A

increased risk of suicidal thinking/suicidality in children, adolescents with major depressive and other psych disorders

applies to ANY antidepressant; ALSO seizure/epilepsy meds

risk vs clinical need
close observation
advise family, caregivers

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22
Q

fluoxetine (prozac)

A

SSRI - first one to be made!

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23
Q

zofran, reglan + SSRI = ?

A

serotonin syndrome. zofran and reglan already increase serotonin alone.

24
Q

atropine

A

anticholinergic!
?
?

25
nifedipine (procardia)
antihypertensive, Calcium channel blocker | used for hypertensive crisis due to MAOI interaction
26
venlafaxine (effexor)
atypical antidepressant: SNRI (serotonin-norepinephrine reuptake inhibitor) does not block cholinergic, histamine, alpha1-adrenergic - very selective, no peripheral side effects use: bipolar disorder (if more depressive) side effects (common): headache, anorexia, insomnia - increased 5HT = more excitatory! - increased NE = excitatory (in this case) adverse effects (less common): serotonin syndrome, neuroleptic malignant syndrome, hypertension, bleeding, increased serum lipids, activation of mania
27
bupropion (wellbutrin)
atypical antidepressant: norepinephrine-dopamine reuptake inhibitor moa: inhibits nicotinic receptors - does NOT block 5HT!! smoking cessation (Zyban) side effects: weight loss, dizziness, dry mouth (NE effects!) nausea, headache, insomnia, tremor, agitation (direct stimulation effects!) increased risk for seizures!
28
trazodone (desyrel)
atypical antidepressant: heterocyclic moa: SSRI and 5HT2 antagonist use: adjunct - sedation for insomnia, potentiates SSRI - dose for depression alone too high side effects: sedation, hypotension, nausea, vomiting, priapism - sedative due to histamine activation - similar to TCA (increase in 5HT and NE levels = added sedative effects) - priapism due to alpha-adrenergic blocking
29
NaSSA (norepinephrine and serotonergic specific antidepressant) also known as...
TeCA (tetracyclic antidepressant)
30
TeCA (tetracyclic antidepressant) also known as...
NaSSA (norepinephrine and serotonergic specific antidepressant)
31
mirtazepine (remeron)
atypical antidepressant: NaSSA/TeCa -- norepinephrine and serotonergic specific antidepressant; also tetracyclic antidepressant moa: moa: blocks alpha-2 adrenergic receptors (those inhibit release of NE & 5HT) elimination half-life: 20 to 40 hours side effects: somnolence (> 50%), increased appetite, cholesterol, dizziness, weight gain (significant: 50-60lbs/year) - - give at bedtime - - increase dose = somnolence decreases dosing: 15mg QHS, max 30mg quick dissolve - first antidepressant with this route - great for compliance (can't hide in cheek, spit out) - - esp. dementia patients with depressive features
32
zyban
atypical antidepressant: norepinephrine-dopamine reuptake inhibitor -- bupropion! EXCEPT USED FOR SMOKING CESSATION
33
divalproex (depakote)
along with lithium, gold standard treatment for bipolar disorder (great for mania)
34
lithium
mood stabilizer moa: interchangeable with Na, modulates synaptic transmissions - - stabilizes neuron electrical activity - influences excitatory second messenger systems - decreases neuronal activity - depends on renal function: RAPID RENAL EXCRETION toxicity: involves kidneys
35
lithium: plasma levels (3)
0.8 - 1.4 mEq/L initial treatment (during acute phase) 0.4 - 1.0 mEq/L maintenance (during stable phase) > 1.5 mEq/L toxic
36
carbamazepine (tegretol)
antiseizure medication: MUST CHECK SERUM LEVELS
37
valproic acid (depakote)
antiseizure medication: MUST CHECK SERUM LEVELS
38
valproic acid vs divalproex
divalproex is a derivative of valproic acid
39
lamotrigine (lamictal)
mood stabilizer, antiepilepsy; ok to use adjunct with antiseizure meds
40
topiramate (topamax)
anticonsulsant; ok to use adjunct with antiseizure meds
41
phenytoin (dilantin)*
moa: suppresses action potential of hyperactive neurons by delayed recovery of select Na channels administration notes: - small dosing changes can result in considerable changes in therapeutic levels - rapid IV administration can result in cardiac collapse ae: gingival hyperplasia! therapeutic dosage range: 10-20 mcg/ml NARROW!
42
valproic acid (depakote)*
first choice for seizure treatment, unofficially first choice for bipolar moa: - suppresses Na channels - suppresses Ca influx - augments GABA adverse effects: can be hepatotoxic dosage range: 50-150mcg/ml
43
alprazolam (xanax)
benzodiazepine: anxiolytic
44
lorazepam (ativan)
benzodiazepine: anxiolytic
45
clonazepam (klonopin)
benzodiazepine: anxiolytic
46
diazepam (valium)
benzodiazepine: anxiolytic
47
flumazenil (romazicon)
benzodiazepine antagonist uses: - to reverse sedation post-anesthesia - overdose may result in generalized seizures with convulsions side effects: dizziness, agitation, mood lability, confusion, n, v, ha, blurred vision
48
benzodiazepines class
sedative-hypnotic: anxiety
49
barbituates class
sedative-hypnotic: anxiety
50
benzodiazepine-like drugs class
sedative-hypnotic: insomnia!
51
zolpidem (ambien)
benzodiazepine-like: insomnia
52
zaleplon (sonata)
benzodiazepine-like: insomnia
53
eszopiclone (lunesta)
benzodiazepine-like: insomnia
54
ramelteon (rozerem)
class: melatonin agonist use: insomnia moa: activates specific receptor subtypes of melatonin adverse effects: drowsiness, dizziness, fatigue - neuroendocrine effects secondary to high prolactin and low testosterone interactions: fluvoxamine (luvox) !!!!! increases levels 50-60x. VERY DANGEROUS
55
buspirone (buspar)
NOT SEDATIVE-HYPNOTIC! class: spiro compound moa: not clearly established - high affinity to 5HT receptors - low affinity to dopamine receptors - DOES NOT BIND to GABA or benzo sites administration: better absorbed when taken with food - lag time to peak effectiveness (3-6 weeks) adverse effects dizziness, headache nausea nervousness, excitement

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