Pharm Flashcards
SSRI indications
anxiety D, OCD (fluvoxamine- luvox), premenstral dysphoric D. depression
SSRI SE
fewer than TCA and MAOI bc serotonin selectivity. don’t act on His, a, muscarinic R
sexual dysfuc, GI disturbance, insomnia, HA, anorexia, wt loss, serotonin sydrom e when used with MAOI
atypical antidepressants
SNRI, NDRI, SARI, NASA
Venlafaxine
effexor. snri. tx refractory depression and CAP. low drug interaction potential. SE ~ SSRI + incr BP. has w/d sx
buproprion
wellbutrin. smoking cessation. seasonal affective D and ADHD. lack of sexual SE. its dopaminergic effect in higher doses can exacerbate psychosis. SE ~ SSRI + incr sweating, incr risk of seizure and psychosis. CI: seizure, eating D, MAOI
SARI
nefazodone (serzone) and trazodone (Desyrel). refractory MDD with anxiety and insomnia. SE: N, dizziness, hypotension, cardiac arrhythmias, sedation, priapism
mirtazapine
NASA. tx refractory major depression in pt who need to gain wt. SE_ sedation, wt gain, dizziness, somnolence, tremor, agranulocytosis
low potency traditional antipsychotics
higher incidence of anticholinergic and antihistaminic SE. lower EPSE and NMS
high potency traditional antipsychotic
higher incidence of EPSE and NMS.
dopamine normally inhibits
prolactin and acetylcholine secretion.
tardive dyskinesia
caused by incr in number of dopa R, causing lower lvl of Ach.
antidopaminergic effects
see in traditional antipsychotics- EPSE- parkinsonism, akathisia, dystonia (sustained contraction of M of neck, tongue, eyes), hyperprolactinemia.
tx by decr dose and admin antiparkinsonian, anticholinergic or anti histaminic med like amantadine (symmetry), benadryl or benztropine (cogent)
traditional antipsychotic SE
antidopaminergic effects, anti his/a/mus effects. wt gain, elevated LFT, jaundice, ophthalmologic prob, dermatologic prob, seizures, tradeoff dyskinesia
neuroleptic malignant syndrome FALTER
fever, autonomic instability, leukocytosis, tremor, elevated CPK, rigidity. disconti med + supportive crae, sodium dantrolene, bromocriptine and amantadine are useful but infer use bc has own SE. not an allergic run
atypical antipsychotic
rarely cause EPSE, tardive dyskinesia or NMS. do cause some anti His/a/mus, 1% agranulocytosis (clozapine so need weekly WBC count), seizures- clozapine, olancapine (hyperlipidemia, glucose intol, wt gain, liver tox). quetiapine (less wt gain but do slip lamp examination bc incr risk of cataracts)
