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Undeleted > just the meds > Flashcards

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
Q

nifedipine (procardia)

A

antihypertensive, Calcium channel blocker

used for hypertensive crisis due to MAOI interaction

26
Q

venlafaxine (effexor)

A

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
Q

bupropion (wellbutrin)

A

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
Q

trazodone (desyrel)

A

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
Q

NaSSA (norepinephrine and serotonergic specific antidepressant) also known as…

A

TeCA (tetracyclic antidepressant)

30
Q

TeCA (tetracyclic antidepressant) also known as…

A

NaSSA (norepinephrine and serotonergic specific antidepressant)

31
Q

mirtazepine (remeron)

A

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
Q

zyban

A

atypical antidepressant: norepinephrine-dopamine reuptake inhibitor – bupropion!

EXCEPT USED FOR SMOKING CESSATION

33
Q

divalproex (depakote)

A

along with lithium, gold standard treatment for bipolar disorder (great for mania)

34
Q

lithium

A

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
Q

lithium: plasma levels (3)

A

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
Q

carbamazepine (tegretol)

A

antiseizure medication: MUST CHECK SERUM LEVELS

37
Q

valproic acid (depakote)

A

antiseizure medication: MUST CHECK SERUM LEVELS

38
Q

valproic acid vs divalproex

A

divalproex is a derivative of valproic acid

39
Q

lamotrigine (lamictal)

A

mood stabilizer, antiepilepsy; ok to use adjunct with antiseizure meds

40
Q

topiramate (topamax)

A

anticonsulsant; ok to use adjunct with antiseizure meds

41
Q

phenytoin (dilantin)*

A

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
Q

valproic acid (depakote)*

A

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
Q

alprazolam (xanax)

A

benzodiazepine: anxiolytic

44
Q

lorazepam (ativan)

A

benzodiazepine: anxiolytic

45
Q

clonazepam (klonopin)

A

benzodiazepine: anxiolytic

46
Q

diazepam (valium)

A

benzodiazepine: anxiolytic

47
Q

flumazenil (romazicon)

A

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
Q

benzodiazepines class

A

sedative-hypnotic: anxiety

49
Q

barbituates class

A

sedative-hypnotic: anxiety

50
Q

benzodiazepine-like drugs class

A

sedative-hypnotic: insomnia!

51
Q

zolpidem (ambien)

A

benzodiazepine-like: insomnia

52
Q

zaleplon (sonata)

A

benzodiazepine-like: insomnia

53
Q

eszopiclone (lunesta)

A

benzodiazepine-like: insomnia

54
Q

ramelteon (rozerem)

A

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
Q

buspirone (buspar)

A

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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