Medications Flashcards
Melatonin
Effective for circadian rhythm disorder
Helps initiate sleep
Antihistamine
Help sleep w/o causing daytime drowsiness
Clonidine
Alpha 2 agonist
Reduce sleep latency & night awakenings
2nd line med for impulsive and inappropriate social behavior
Trazodone
Keep asleep longer
SE: priapism
Mirtazapine
Helps with sleep
Effective if anxiety and decreased appetite also a problem
Keep dose low
Zolpidem
Effective for initiation of sleep for a short time
Quetiapine (Seroquel)
Agitation & aggression, Not 1st line med
Helpful with sleep
SE: wt gain
Sertraline (Zoloft)
SSRI
1st line Anxiety/aggression, depression tx
Comes in a liquid
Citalopram (Celexa)
SSRI
1st line Anxiety/aggression, depression tx
Comes in a liquid
Fluoxetine (Prozac), Escitalopram (Lexapro) & Paroxetine (Paxil)
SSRI
1st line Anxiety/aggression, depression tx
More anticholinergic SE
Guanfacine
Alpha 2 agonist
2nd line anxiety/aggression
Less sedating
Longer half life
Propanolol
Beta blocker
Tx Sympathetic storming after TBI or anoxic event
Use HTN dosing guidelines
Benzos
2nd or 3rd line in tx anxiety/aggression
Quick onset of action
Affective in children who don’t tolerate SSRI or alpha 2 agonist
Avoid PRN’s
Avoid in TBI due to slow processing speed
Atypical antipsychotics
3rd or 4th line tx anxiety/aggression
Monitor wt, lipids, glucose and waist circumference
Extrapyramidal SE & tardive dyskinesia
Akathisia common SE when inc & dec med doses
Risperidone
Tx anxiety/aggression
Start on BID dosing & inc after 3-4 weeks at each dose
Consider other dx if 1mg BID not addressing anxiety
SE: wt gain
Aripirazole (Abilify)
Tx anxiety/aggression
SE: less wt gain and sedation as other atypical antipsychotics, akathesia
ADHD Treatment
Stimulants: methylphenidate (Ritalin), amphetamine (Dexedrine)
-Monitor BP, HR, EKG, wt and ht
-Do not use if sleep disturbance is an issue
Atomoxetine (Strattera) or alpha 2 agonist if SE of stim not tolerated
Stimulants in TBI
Demonstrate inc activity in cerebral cortex, caudate nucleus, and mediofrontal cortex
Activate dopamine/NE system
Amantadine
Causes release of dopamine & may have a NMDA rec antagonist effect
Modafinil
Uptake in anterior hypothalamus, hippocampus and amygdala
Baclofen
Tx of spasticity
Well tolerated
Can be given to very young
Start slow to min sedation
Diazepam
Tx of spasticity
Monitor sedation and processing speed
Tizanidine
Tx of spasticity
Monitor sedation
Dantrolene
Tx of spasticity
Monitor LFT’s
