Pharm 6 Flashcards
What medications can you add to help with neuroleptic induced Akathisia?
(In order of preferential treatment)
- Beta-Blocker (Propranolol)
- 5HT 2A antagonist (Mirtazapine)
- Anticholinergic medications (Benzatropine)
- Cyproheptadine
- BZD
- Clonidine
What is the mechanism in which Clonidine helps with opioid withdrawal?
Agonist of alpha 2 receptors on the presynaptic membrane prevents NE release into synaptic cleft, leading to decreased sympathetic tone and arousal response.
What medications classically increase Carbamazepine levels by inhibiting CYP3A4 which metabolizes the drug? (6)
- Fluconazole
- Cimetidine
- Diltiazem
- Verapamil
- Erythromycin
- some SSRIs
Carbamazepine is a potent induce of what liver enzyme?
CYP 3A4
Carbamazepine’s induction of CYP 3A4 results in a decrease of other drug plasma levels…
What are the classic drugs that are decreased by Carbamazepine? (9)
- Most SSRI
- Most Antipsychotics
- BZDs
- Warfarin
- Zolpidem
- Methadone
- Thyroxine
- Theophylline (asthma med)
- Oestrogens (OCP)
VPA should be avoided in pregnancy due to neural tube defects…IF it is absolutely necessary what medication can you prescribe to reduce the change of defects?
Folic Acid 1-4 grams.
Which antidepressant is classically associated with HTN as SE?
Venlafaxine.
Thioridozine is an older typical antipsychotic. What sexual SE if classically associated?
Retrograde ejaculation and impotence.
(retrograde ejaculation is not dangerous. Patients should be advised that they may have milky white urination after sex.)
What is the MOA of Mirtazapine?
Presynaptic alpha 2 receptor blockade, therefore inhibiting feedback inhibition and increasing NE and Serotonin in synaptic cleft.
What are the 6 notable antidepressant medications that don’t have much sexual SE?
- Mirtazapine
- Bupoprion
- Buspirone
- Nefazadone
