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EOR - Behavioral Med > Meds > Flashcards

Meds Flashcards

1
Q

SSRI drug list

A 
Fluoxetine (Prozac) 
Sertraline (Zoloft) 
Escitalopram (Lexapro) 
Fluvoxamine (Luvox)
Paroxetine (Paxil)
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2
Q

What are the SE of SSRIs in general?

A

sexual dysfunction, decrease libido, prolonged ejactulation
affect platelet function (makes them slippery)
Risk of serotonin syndrome

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3
Q

Serotonin syndrome

A

shivering, hyperreflexia, myoclonus, ataxia, N/V/D

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4
Q

Long-Acting Benzos

A

Chlordiazepoxide (Librium)
Clorazepate (Tranxene)
Diazepam (Valium)
Flurazepam (dalmane)

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5
Q

Intermediate acting Benzos

A

Alprazolam (Xanax)
Clonazepam (Klonopin)
Lorazepam (Ativan)
Temazepam (Restoril)

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6
Q

What receptor does Buspar act on?

A

5HT partial agonist

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7
Q

What is Buspar used for?

A

useful in alcoholics

low addiction potential (good for those addicted to benzos)

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8
Q

Typical Antipsychotic list

A 
Haloperidol (Haldol) 
Fluphenazine (Prolixin) 
Perphenazine (Trilafon) 
Thioridazine (Mellaril) 
Chlorpromazine (Thorazine)

Class overall SE: EPS

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9
Q

Atpyical Antipsychotic List

A 
Aripiprazole (Abilify) 
Asenapine (Saphris) 
Olanzapine (Zyprexa) 
Quetiapine (Seroquel) 
Risperidone (Risperdal) 
Clozapine (Clozaril) 
Lurasidone (Latuda)

Overall class SE: weight gain, DM

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10
Q

Dopamine antagonists

A

antipsychotic effect
relief of + sxs of schizophrenia
increase EPS
increase prolactin

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11
Q

Serotonin 1A agonists

A

antidepressants

anxiolytic effects

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12
Q

Serotonin 2A antagonist

A

improvement of neg sxs of schizophrenia and improved cognition

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13
Q

Serotonin 2X antagonists

A

weight gain and associated risks

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14
Q

Fluoxetine

A

prozac
SSRI

lowest weight gain - good for ED pts
most stimulating SSRI
longest half life

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15
Q

Citalopram

A

Celexa

SSRI

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16
Q

Escitalopram

A

Lexapro

SSRI

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17
Q

Fluvoxamine

A

Luvox

SSRI

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18
Q

Sertraline

A

Zoloft
SSRI

highest risk of GI problems

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19
Q

Paroxetine

A

Paxil
SSRI

most sedating SSRI and greatest weight gain and sexual SE
shortest half life

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20
Q

As a class, what are the SE of SSRIs in general?

A

GI, CNS, sexual dysfunction, fatigue, dry mouth, hypotension, withdrawal if d/c abruptly, prolonged QT, rash, insomnia, asthenia, seizure, tremor, somnolence, mania, SI, worsened depression
risk of Serotonin syndrome

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21
Q

Venlafaxine

A

Effexor
SNRI

SE: HTN, sedating

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22
Q

Duloxetine

A

Cymbalta
SNRI

less SE than venlafazine
works well for fibromylagia, sleep, and pain

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23
Q

Desvenlafaxine

A

Pristiq

SNRI

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24
Q

As a class, what are the SE of SNRIs in general?

A

equally effective as SSRIs in treating major depression
may be more effective in the setting of diabetic neuropathy, fibromyalgia, msk pain, stress incontinence, sedation, fatigue, and pts with comorbid anxiety

SE: GI, HTN, CNS, diaphoresis, dizziness, fatigue, insomnia, blurred vision, suicidal idea

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25
Q

Bupropion

A

Wellbutrin
atypical antidepressant

may increase sexual function
has stimulant effects
helps with smoking cessation

NOT to be used in eating disorder pts

SE: lower seizure threshold 
insomnia
nervousness
agitation
anxiety
tremor
weight loss 
suicidal ideation
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26
Q

Mirtazapine

A

Remeron
atypical antidepressant

the most sedating antidepressant - good for insomnia

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27
Q

Trazodone

A

Oleptro

atypical antidepressant

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28
Q

Amitryptyline

A

Elavil

tricyclic antidepressants

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29
Q

Clomipramine

A

Anafranil
tricyclic antidepressant

only FDA OCD tx

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30
Q

Desipramine

A

norpramin

tricyclic antidepressant

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31
Q

Doxepin

A

Silenor

tricyclic anitdpressant

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32
Q

Impiramine

A

Tofranil

tricycylic antidepressant

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33
Q

Nortriptyline

A

Pamelor

tricyclic antidepressant

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34
Q

What are the side effects in general for the class of tricyclic antidepressants?

A

anticholinergic
CV, CNS, weight gain, sexual dysfunction, decreased seizure threshold
cardiotoxicity

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35
Q

MOA of MAOIs

A

block destruction of monoamines both centrally and peripherally

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36
Q

MOA of TCA

A

inhibit reuptake of both serotonin and NE (like SNRI)

37
Q

MOA of SNRI

A

inhibit reuptake of both serotonin and NE (like TCA)

38
Q

Phenelzine

A

Nardil
MAOI

irreversible

39
Q

Tranylcypromine

A

Parnate
MAOI

irreversible

40
Q

Selegiline

A

Emsam
MAOI

reversible

41
Q

Carbamazepine

A

tegretol
mood stabilizer

MOA: inhibits voltage gated Na channels

CI: pregnancy
decrease effectiveness of warfarin and OCPs

SE: diplopia, dizziness, drowsiness, nausea, SJS (don’t use in Asians) SIADH, hypoCa/Na

42
Q

Valproate

A

Depakote/Depakene
mood stabilizer

MOA: increases GABA

SE: GI upset, sedation, unsteadiness, tremor, thombocytopenia, palpitations, ototoxic

CI: pregnancy, liver disease

43
Q

Lamotrigine

A

Lamictal
mood stabilizer

MOA: block voltage gated Na channels, inhibit glutamate release

SE: hematologic, liver failure

44
Q

What are the side effects of TCA?

A 
anticholinergic effects lead to: 
blurry vision 
constipation 
urinary retention 
dry mouth
45
Q

What are the side effects of typical antipsychotics?

A 
EPS 
Hyperporlactinemia 
Tardive dyskinesia 
NMS
rare: agranulocytosis (low potency typical antipsychotics)
46
Q

What meds put you at risk for Tardive dyskinesia?

A

typical antipsychotics - 5% risk each year

clozapine (the first atypical antipsychotic - less likely to cause tardive dyskinesia)

47
Q

NMS

A

possible side effect of typical antipsychotics
medical emergency - 20% mortality rate if left untreated

Fever 
Autonomic instability (tachycardia, labile HTN, diaphoresis) 
Leukocytosis 
tremor
Elevated CPK 
Rigidity (lead pipe) 
Delirium (AMS)
48
Q

What is the treatment for NSM?

A

dantrolene, bromocriptine, amantadine

49
Q

Typical vs atypical antipsychotics

A

typical: DA receptor antagonist
atypical DA + 5HT receptor antagonist
atypical less likely to cause EPS, TD, or NMS
atypicals have risk of metabolic syndrome

50
Q

What is the risk of using Lithium while pregnant?

A

Ebstein’s anomaly in the unborn fetus

51
Q

What levels must be monitored when a pt is on cloazpine?

A

atypical antipsychotic

must monitor WBC every week for first 6 months dt risk of agranulocytosis

52
Q

What levels must be monitored when a pt is on lithium?

A

lithium levels
thyroid funciton
Cr - d/t being metabolized by the kidneys

should be checked 5 days after start of drug and then every 2-3 days until therapeutic (therapeutic range is 0.6-1.2)

there is a risk of increasing the lithium levels in the blood to possibly toxic levels (>1.5) if the pt is on NSAIDs, ASA or gets dehydrated

53
Q

What is the MOA of carbamazepine?

A

tegretol - anticonvulsant that is used as a mood stabilizer

blocs sodium channels - inhibits action potentials

54
Q

What are the SE of carbamazepine?

A

GI and CNS (drowsiness, ataxia, sedation, confusion)

Teratogenic - neural tube defects

55
Q

What is the MOA of Depakote?

A

valproate

blocks sodium channels and increases [GABA] in the brain

56
Q

Fluoxetine

A

Prozac - SSRI

57
Q

Sertraline

A

Zoloft - SSRI

58
Q

Paroxetine

A

Paxil - SSRI

59
Q

Fluvoxamine

A

Luvox - SSRI

60
Q

Citalopram

A

Celexa - SSRI

61
Q

Escitalopram

A

Lexapro - SSRI

62
Q

Venalfaxine

A

Effexor - SNRI

63
Q

Desvenlafazine

A

Pristiq - SNRI

64
Q

Duloxetine

A

Cymbalta - SNRI

65
Q

Bupropion

A

Wellbutrin - NE-DA Reuptake inhibitor

66
Q

Trazodone

A

Desyrel - 5HT Receptor Modulator

67
Q

Nefazodone

A

Serzone - 5HT receptor modulator

68
Q

Mirtazapine

A

Remeron - alpha 2 antagonist/5HT antagonist
–histaminigeric (sleepy + fat)
sedation + weight gain
tx for AN

69
Q

Imipramine

A

Rofranil - TCA

70
Q

Selegiline

A

Emsam - MAOI

71
Q

Chlorpromazine

A

Thorazine - first gen antipsychotic

72
Q

Thioridazine

A

mellaril - first gen antipsych

73
Q

Loxapine

A

Loxitane - first gen antipsych

74
Q

Thiothizene

A

Navane - first gen antipsych

75
Q

Molindone

A

Moban - first gen antipsych

76
Q

Perphenazine

A

Trilafon - first gen antipsych

77
Q

Haloperidol

A

Haldol - first gen antipsych

78
Q

Fluphenazine

A

Prolixin - first gen antipsych

79
Q

Trifluoperazine

A

Stelazine - first gen antipsych

80
Q

Pimozide

A

Orap - first gen antipsych

81
Q

Clozapine

A

Clozaril - second gen anitpsych

82
Q

Risperidone

A

Risperdal - second gen antipsych

83
Q

Quetiapine

A

Seroquel - second gen antipsych

84
Q

Olanzapine

A

Zyprexa - second gen antipsych

85
Q

Ziprasidone

A

Geodon - second gen antipsych

86
Q

Aripiprazole

A

Abilify - second gen antipsych

87
Q

Lurasidone

A

Latuda - second gen antipsych

88
Q

Anticonvulsants used for mood

A 
Carbamazepine (tegretol) 
Valproate (Depakote)
Lamotrigine (Lamictal) 
Oxcarbazepine (trileptal) 
Gabapentin (neurontin) 
Pregabalin (lyrica) 
Topiramate (Topamax)
89
Q

Klonipin

A

clonazepam - benzo

EOR - Behavioral Med (2 decks)

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