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Pharm Flashcards

1
Q

Tx for Extrapyramidal symptoms caused by antipsychotics

A

Benzotropine

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2
Q

Prozac

A

Fluoxetine

Longest half life of an SSRI

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3
Q

Zoloft

A

Sertaline

Higher risk for GI probs

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4
Q

Paxil

A

Paroxetine

High incidence of withdrawal

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5
Q

Fluvoxamine

A

SSRI that is Only used for OCD

CYP inhibitor

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6
Q

Celexa

A

Citalopram

Possible QT prolongation

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7
Q

SSRI ADRs

A

Due to widespread nature of serotonin receptors

Nausea, diarrhea

Headache

Anorexia

Sexual dysfnxn

Akathisia

Serotonin syndrome: fever, diaphoresis, tachycardia, HTN
OTC cough medicine like dextromethorphan has some activity at here receptors so they can possible ppt a serotonin syndrome

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8
Q

Effexor

A

Venlafaxine

Used for GAD and neuropathic pain

Can increase BP so don’t give to these pts

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9
Q

Cymbalta

A

Duloxetine

Used for depression, neuropathic pain, and fibromyalgia

Due to norepinephrine effects, there is more dry mouth and constipation otherwise similar ADRs to SSRIs

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10
Q

Wellbutrin

A

Buproprion

Norepinephrine-dopamine reuptake inhibitor

Used for smoking cessation and depression in pts with sexual ADRs with SSRIs

CI’d in pts with seizure or eating disorders as well as pts on MAOIs

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11
Q

Desyrel

A

Trazadone

Serotonin receptor antagonist and agonist

Used for depression and insomnia

️Assoc. With dizziness, Orthostatic hypotension, arrhythmia, sedation, and priapism

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12
Q

Remeron

A

Mirtazapine

a2-inhibitor

Used for depression

ADRs are sedation, weight gain, dizziness, dry mouth, constipation, and rarely agranulocytosis

Few sexual ADRs

⭐️Used in elderly to treat for sleep, appetite probs, and depression

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13
Q

Elavil

A

Amitryptyline

Used in chronic pain, migraines, and insomnia

Serotonin and norepinephrine Reuptake inhibitor

TCAs have a greater anticholinergic, anithistaminergic profile with greater lethality

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14
Q

Tofranil

A

Imipramine

Used in enuresis and panic disorder

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15
Q

Anafranil

A

Clomipramine

Used for OCD

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16
Q

Aventyl

A

Nortriptyline (secondary amine which is a metabolite of tca)

Useful for chronic pain, unlikely to cause Orthostatic hypotension like the other tcs

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17
Q

Norpramin

A

Desipramine

Secondary amine (like TCA but less sedating)

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18
Q

Nardil

A

Phenelzine

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19
Q

Parnate

A

Tranylcypromine

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20
Q

Marplan

A

Isocarboxazid (MAOI)

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21
Q

ADRs of MAOIs

A

Serotonin syndrome

Hypertensive crisis (elevated BP w/ headache, N/V, sweating, photophobia, and autonomic instability)

Orthostatic hypotension *most common

Weight gain

Sexual dysfnxn

Dry mouth

Drowsiness

Sleep probs

Pyridoxine deficiency (supplement if pts. have numbness or paresthesia)

Liver toxicity, edema, seizure (rare)

“Start low and go slow”

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22
Q

Antidepressants for OCD

A

SSRIs (high doses)

Clomipramine (anafranil)

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23
Q

Antidepressants in panic disorder

A

SSRIs

TCAs

MAOIs

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24
Q

Antidepressants in eating disorders

A

SSRIs (high dose)

TCA

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25
Antidepressants in dysthymia
"Persistent depressive disorder" SSRI SNRI
26
Antidepressants in GAD
SSRIs Venlafaxine TCAs
27
Antidepressants in neuropathic pain
Amitriptyline Nortirptyline SNRIs
28
Antidepressants in chronic pain
SNRIs TCAs
29
Antidepressants in fibromyalgia
Duloxetine
30
Antidepressants in premenstrual dysphoric disorder
SSRIs
31
Antidepressants used for insomnia
Mirtazapine Trazadone Doxepin (TCA)
32
Difference between typical and atypical antipsychotics
Typical: Block only D2 receptors Atypical: ALSO blocks serotonin (2A) receptors
33
Low potency typical antipyschotics
Thorazine (chlorpromazine): causes orthostatic hypotension, blue-gray skin discoloration, photosensitivity -Also used to treat N/V, intractable hiccups Mellaril (thioridazine): assoc. w/ retinitis pigmentosa
34
Midpotency typical antipsychotics
Loxitane (loxapine): increased risk of seizure; metabolite is an antidepressant (Trilafon) perphenazine Molindone (generic) Thiothexane (generic)
35
High potency typical antipsychotics
Haldol (haloperidol): can be given PO/IM/IV Prolixin (fluphenazine) Stelazine (trifluoperazine): also approved for nonpsychotic anxiety Pimozide (generic) QT prolongation
36
General ADRs of typical antipsychotics
Anti-HAM Tardive dyskinesia ``` NMS -Fever Autonomic instability (tachycardia, labile HTN) Leukocytosis Tremor Elevated CK Rigidity Excess sweating Delirium ``` -Elevated LFTs, jaundice
37
Clozaril
Clozapine (atypical antipsychotic) Less likely to cause TD or dystonia (like Haldol) *****USED FOR TREATMENT REFRACTORY SCHIZOPHRENIA ADRs: tachycardia, hypersalivation, anticholinergics, agranulocytosis (look for new infxn with low WBCs in pts), seizures * Get pts. weekly blood draws for first 6 months to check WBCs - *Decreases risk of suicide
38
Risperdal
Risperidone (atypical antipsychotic) - Increases prolactin - Orthostatic hypotension w/ reflex tachycardia
39
Seroquel
Queitapine -Sedation and orthostatic hypotension
40
Zyprexa
Olanzapine (atypical antipsychotic) - Weight gain - Sedation
41
Ziprasidone
Atypical antipsychotic - Assoc w/ QT prolongation, must be taken w/ food to be absorbed - Less likely to gain weight
42
Abilify
Aripiprazole (atypical antipsychotic) - Partial D2 agonist (unique) - Can cause akathisia - Less potential for weight gain
43
Latuda
Lurasidone (atypical antipsychotic) ***USED for BIPOLAR DEPRESSION
44
General ADRs to atypical antipsychotics
Weight gain Hyperlipidemia, hyperglycemia (possible DKA) Mild anti-HAM (not like typical tho) Elevated LFTs (Check these and NH4+ annually)
45
Lithium
Used for bipolar disorder, acute mania, schizoaffective disorder, cyclothymic disorder - Adjust dose for kidney failure pts. - Pts. need baseling EKG, chemistries, TFTs, CBC, and pregnancy test ADRs: Nephrogenic DI, GI disturbance, weight gain, hypothyroidism, Toxicity =>> AMS, tremors, delirium
46
Tegretol
Carbamazepine Blocks Na+ channels and inhibits APs; long onset of action ADRs: GI, sedation, SJS, leukopenia, hyponatremia, hepatitis, teratogenic,
47
Depakote, Depakene
Valproic Acid Used for acute mania; blocks Na+ channels and increases GABA in the brain Monitor LFTs and CBCs
48
Lamictal
Lamotrogine Used for bipolar depression but NOT EFFECTIVE FOR MANIA ADRs: SJS*****, will increase valproic acid levels
49
Trileptal
Oxcarbazepine Better tolerated than carbamazepine but otherwise the same
50
Lyrica
Pregabalin Used in GAD and fibromyalgia
51
Long acting benzos
Valium (diazepam): rapid onset and used for muscle spasm and alcohol detoxification Klonopin (clonazepam): Used in panic attacks and anxiety; avoid w/ renal dysfnxn
52
Intermediate acting benzos
Xanax (alprazolam): used for anxiety and panic attacks; high abuse potential due to euphoric effects Ativan (lorazepam): used for panic attacks, alcohol and sedative detoxification, Akathisia Oxazepam: used for alcohol and sedative detoxification Restoril (temazepam): rarely used for insomnia
53
Short acting benzos
Triazolam: Insomnia tx; risk of retrograde amnesia and sleep-related activity Versed (midazolam): VERY SHORT HALF LIFE; used in medical and surgical setting
54
General ADRs of benzos
Drowsiness Impaired mental fnxn Reduced motor coordination (limits use in elderly) Anterograde amnesia Withdrawal w/ seizures Respiratory depression in OD (especially when combined w/ alcohol)
55
Ambien
Zolpidem Non-benzo hypnotic Works by binding to omega-1 receptor on GABA-1 receptor =>> sedation Less tolerance/dependence than w/ benzos
56
Lunesta
Eszopiclone Non-benzo hypnotic
57
Benadryl
Diphenhydramine Antihistamin w/ moderate anticholinergic effects
58
Ramelteo
Selective melatonin agonist
59
Buspar
Buspirone Non-benzo anxiolytic that is a Partial serotonin agonist that takes 1-2 weeks to have an effect Often used in combo w/ SSRI for GAD Low abuse potential
60
Atarax
Hydroxyzine Antihistamine Useful for pts. w/ quick-acting, short-term medication but cannot take benzos
61
Propanolol
Used to treat autonomic effects of panic attacks or social phobias such as palpitations, sweating, and tachycardia Can also be used to treat akathisia assoc. w/ antipsychotic use
62
Adderall
Dextroamphetamine
63
Ritalin
Methylphenidate
64
Concerta
Methylphenidate
65
Strattera
Atomoxetine Inhibits presynpatic NER reuptake resulting in increased synaptic NER and dopamine Causes less appetite suppression and insomnia compared to other stimulant meds Rare liver toxicity
66
Modafinil
Stimulant used in narcolepsy but NOT ADHD
67
Aricept
Donepezil AChE-inhibitor Mild GI side effefcts
68
Galantamine
AChE-inhibito
69
Rivastigmine
Patch form for a AchE-i
70
Namenda
Memantine NMDA (glutamate)-receptor antagonist Used in severe neurocognitive dementia Fewer ADRs than AchE-inhibitors but should be used with them for some reason
71
ECT is most effective for..
MDD especially if there are psychotic features as well as for acute mania and catatonia
72
Fiorcet
Combo of acetaminophen, butalbital, and caffeine Used as abortive therapy for migraines

Psych/neuro (3 decks)

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