psych Flashcards
What is the brand name of Amitriptyline?
Elavil
What drug class is Amitriptyline in?
Tricyclic Antidepressant
What is the indication for Amitriptyline?
Depression
What is the mechanism of action of Amitriptyline?
Tricyclic antidepressant that blocks presynaptic reuptake of serotonin and norepinephrine with subsequent down regulation of adrenergic receptors
What are the major contraindications for Amitriptyline?
Hypersensitivity to the drug, Concurrent MAOI or MAOI use in last 14 days, Use during acute recovery period after Myocardial Infarction (MI), Coadministration of Cisapride
What are the black box warnings for Amitriptyline?
Suicidality, Not approved for children < 12 years of age
What are the common adverse drug reactions for Amitriptyline?
Sedation
What are the rare but serious adverse drug reactions for Amitriptyline?
Cardiac Dysrhythmia, Hepatotoxicity, Seizures, Suicidal Thoughts
What are the key counseling points for Amitriptyline?
Avoid activities requiring mental alertness, alcohol, and other CNS depressants. Symptomatic improvement may not be seen for a few weeks. Avoid sudden discontinuation of drug. Do not use alcohol
What are the brand names of Doxepin?
Sinequan, Silenor
What drug class is Doxepin in?
Tricyclic Antidepressant
What are the indications for Doxepin?
Depression, Anxiety, Alcoholism, Insomnia
What is the mechanism of action of Doxepin?
Tricyclic antidepressant, influences the adrenergic activity at the synapses where it prevents norepinephrine deactivation through reuptake into the nerve terminals. By binding to histamine receptor sites, it competitively inhibits the biological activation of histamine receptors. Antagonism of the H1 receptor is the most likely mechanism by which doxepin exerts its sleep maintenance effect.
What are the major contraindications of Doxepin?
Hypersensitivity to the drug, MAOI use, Glaucoma, Severe Urinary Retention
What are the black box warnings for Doxepin?
Suicidality
What are the common adverse drug reactions for Doxepin?
Xerostomia
What are the rare but serious adverse drug reactions for Doxepin?
Cardiac, Dysrhythmia, Hepatotoxicity, Suicidal Thoughts
What are the key counseling points for Doxepin?
Avoid activities requiring
mental alertness until drug effects are realized. Symptomatic improvement in de-
pression may not be seen for a few weeks. Avoid abrupt discontinuation of drug. Do
not drink alcohol.
What is the brand name of Nortriptyline?
Pamelor
What drug class is Nortriptyline in?
Tricyclic Antidepressant
What is the indication for Nortriptyline?
Depression
What is the mechanism of action of Nortriptyline?
Demethylated metabolite
of amitriptyline, a heterocyclic antidepressant that blocks presynaptic reuptake of norepinephrine with subsequent down regulation of adrenergic receptors. Heterocyclic antidepressants have less effect on serotonergic activity than on other
neurotransmitters.
What are the major contraindications for Nortriptyline?
Hypersensitivity to
the drug or other TCAs, MAOI concurrent use or use within 14 days, Use during recovery period after Myocardial Infarction (MI), Patient using linezolid or IV methylene blue
What are the black box warnings for Nortriptyline?
Suicidality
What are the common adverse drug reactions for Nortriptyline?
Constipation, Dry mouth
What are the rare but serious adverse drug reactions for Nortriptyline?
Cardiac Dysrhythmia, Heart Block, Hepatotoxicity,
Seizures, Suicidal Thoughts
What are the key counseling points for Nortriptyline?
Avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause somnolence and dizziness. Report worsening depression, suicidal ideation,
unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation; may
precipitate withdrawal symptoms. Do not drink alcohol while taking this drug.
What is the brand name of Citalopram?
Celexa
What drug class is Citalopram in?
SSRI Antidepressant
What is the indication for Citalopram?
Depression
What is the mechanism of action for Citalopram?
Bicyclic antidepressant
that is selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI). It does not affect reuptake of norepinephrine or dopamine and has a relative lack of
affinity for muscarinic, histamine, a1 and a2 adrenergic, and serotonin receptors.
What are the major contraindications for Citalopram?
Hypersensitivity to
the drug, Concomitant use of Pimozide, MAOIs
What are the black box warnings for Citalopram?
Suicidal Ideation, Not approved for use in children
What are the common adverse drug reactions for Citalopram?
Constipation, Dizziness, Headache, Insomnia, Nausea, Sedation, Xerostomia
What are the rare but serious adverse drug reactions for Citalopram?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsades de Pointes (Fatal Heart Rhythm), Agranulocytosis
What are the key counseling points for Citalopram?
Avoid activities requir-
ing mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression,
suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.
What is the brand name of Escitalopram?
Lexapro
What drug class is Escitalopram in?
SSRI Antidepressant
What are the indications for Escitalopram?
Depression, Generalized Anxiety Disorder
What is the mechanism of action of Escitalopram?
S-enantiomer of racemic
citalopram and is an antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI). It does not affect reuptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine, a1- and a2-adrenergic, and serotonin receptors.
What are the major contraindications for Escitalopram?
Hypersensitivity to the drug or citalopram, Concurrent MAOI use
What are the black box warnings for Escitalopram?
Suicidality
What are the common adverse drug reactions for Escitalopram?
Headache, Nausea, Sedation
What are the rare but serious adverse drug reactions for Escitalopram?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsades de Pointes (Fatal Heart Rhythm)
What are the key counseling points for Escitalopram?
Avoid activities re-
quiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for 4-6 weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs
or aspirin while taking this drug.
What are the brand names of Fluoxetine?
Prozac, Sarafem
What drug class is Fluoxetine in?
SSRI Antidepressant
What are the indications for Fluoxetine?
Bipolar Major Depression, Major Depressive Disorder,
OCD, Panic Disorder, Premenstrual Dysphoric Disorder,
Bulimea nervosa
What is the mechanism of action of Fluoxetine?
Bicyclic antidepressant that
is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI)
What are the major contraindications for Fluoxetine?
Hypersensitivity to the
drug Concomitant pimozide, thioridazine, or MAOIs
What are the black box warnings for Fluoxetine?
Suicidality, Approved in children (>7 years of age, OCD; 8 years of age, MDD)
What are the common adverse drug reactions for Fluoxetine?
Diarrhea, Headache, Insomnia, Nausea, Somnolence, Tremor,
Xerostomia
What are the rare but serious adverse drug reactions for Fluoxetine?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsade de Pointes (Fatal Heart Rhythm), SIADH
What are the key counseling points for Fluoxetine?
Take without meals and
in the morning. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks, while adverse effects often present in the 1st week of therapy. Report worsening
depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.
What are the brand names of Paroxetine?
Paxil, Paxil CR
What drug class is Paroxetine in?
SSRI Antidepressant
What are the indications for Paroxetine?
Depression, Generalized Anxiety Disorder, Social Anxiety Disorder, OCD
Panic Disorder, Post traumatic Stress Disorder (PTSD), Premenstrual Syndrome, Vasomotor Symptoms of Menopause
What is the mechanism of action of Paroxetine?
Highly selective and potent
inhibitor of serotonin reuptake (SSRI)
What are the major contraindications for Paroxetine?
Hypersensitivity to the
drug, Concomitant use of thioridazine or MAOIs, Pregnancy
What are the black box warnings for Paroxetine?
Suicidality
What are the common adverse drug reactions for Paroxetine?
Abnormal Ejaculation, Asthenia, Constipation,
Diarrhea, Headache
Insomnia, Nausea, Somnolence
What are the rare but serious adverse drug reactions for Paroxetine?
Serotonin Syndrome, Suicidal Thoughts
What are the key counseling points for Paroxetine
Do not chew or crush
controlled-release tablet.
Shake suspension well before using. Avoid activities requiring mental alertness or
coordination until drug effects are realized.
Symptomatic improvement may not be seen for several weeks. Avoid abrupt discontinuation. Do not drink alcohol. Use caution with NSAIDs or aspirin while taking this drug.
What is the brand name of Sertraline?
Zoloft
What drug class is Sertraline in?
SSRI antidepressant
What are the indications for Sertraline?
Depression, OCD, Panic Disorder, PTSD, Social Phobia Disorder, Premenstrual Dysphoric Disorder
What is the mechanism of action of Sertraline?
SSRI that indirectly results in a down regulation of Beta-adrenergic receptors. It has no clinically important effect on noradrenergic or histamine receptors and no effect on MAO. It lacks stimulant, cardiovascular, anticholinergic, and convulsant effects.
What are the major contraindications for Sertraline?
Hypersensitivity to the
drug, Concomitant use of pimozide, thioridazine, or MAOIs
What are the black box warnings for Sertraline?
Suicidality
What are the common adverse drug reactions for Sertraline?
Diarrhea, Fatigue
Headache, Insomnia, Nausea
What are the rare but serious adverse drug reactions for Sertraline?
Serotonin Syndrome,
Suicidal Thoughts
What are the key counseling points for Sertraline?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation; may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.
What are the brand names of Desvenlafaxine?
Pristiq, Khedezla
What drug class is Desvenlafaxine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
What are the indications for Desvenlafaxine?
Depression
What is the mechanism of action of Desvenlafaxine?
Potent reuptake inhibitor of serotonin and norepinephrine but lacks effects on muscarinic, a-adrenergic, or histamine receptors.
What are the major contraindications for Desvenlafaxine?
Hypersensitivity to the drug
or venlafaxine, MAOI use
What are the black box warnings for Desvenlafaxine?
Suicidality, Not for use in children, Not for bipolar disorder
What are the common adverse drug reactions for Desvenlafaxine?
Diaphoresis, Dizziness
Headache, Nausea, Xerostomia
What are the rare but serious adverse drug reactions for Desvenlafaxine?
GI hemorrhage, Serotonin syndrome, Suicidal thoughts
What are the key counseling points for Desvenlafaxine?
Take with or without food. Avoid alcohol. Symptomatic improvement may not be evident for a few weeks. Do not discontinue drug abruptly as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Avoid activities requiring mental alertness or coordination until drug effects are realized, as this medicine may cause dizziness or somnolence.
What is the brand name of Duloxetine?
Cymbalta
What drug class is Duloxetine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
What are the indications for Duloxetine?
Anxiety, Depression, Diabetic Peripheral Neuropathy Pain, Fibromyalgia, Musculoskeletal Pain
What is the mechanism of action of Duloxetine?
Selective serotonin norepinephrine reuptake inhibitor that exerts its antidepressant and pain inhibitory actions by potentiating the serotonergic and noradrenergic activity in the CNS. It has no significant affinity for adrenergic, dopaminergic, cholinergic, opioid, glutamate, or histaminergic receptors in vitro and does not inhibit monoamine oxidase.
What are the major contraindications for Duloxetine?
Hypersensitivity to the
drug, Concurrent MAOI use,
Concurrent TCA use, Linezolid use, Uncontrolled Glaucoma
What are the black box warnings for Duloxetine?
Suicidality, Not approved for children
What are the common adverse drug reactions for Duloxetine?
Headache, Nausea
What are the rare but serious adverse drug reactions for Duloxetine?
Hepatotoxicity, Serotonin Syndrome, Suicidal Thoughts
What are the key counseling points for Duloxetine?
Report withdrawal symptoms (e.g., dysphoric mood, irritability, agitation, sensory disturbances), especially during abrupt discontinuation of therapy. Drug may cause hepatotoxicity and increased risk of bleeding (GI, ecchymosis, epistaxis, petechiae). May require 1-4 week for improvement of depression symptoms. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children at higher risk for these effects during the first few months of therapy. Patient should watch for signs/symptoms of bleeding events and hepatotoxicity. Avoid alcohol. Monitor carefully if on concurrent medications that alter coagulation. If discontinuing therapy, taper dose downward slowly and do not discontinue abruptly.
What are the brand names of Venlafaxine?
Effexor, Effexor XR
What drug class is Venlafaxine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
What are the indications for Venlafaxine?
Generalized Anxiety Disorder, Depression, Panic Disorder, Social Anxiety Disorder
What is the mechanism of action of Venlafaxine?
Potent reuptake inhibitor of serotonin and norepinephrine but lacks effects on muscarinic, ±- adrenergic, or
histamine receptors
What are the major contraindications of Venlafaxine?
Hypersensitivity, MAOIs
What are the black box warnings for Venlafaxine?
Suicidal Ideation, Not approved in children
What are the common adverse drug reactions for Venlafaxine?
Dizziness, Headache, Insomnia, Nausea, Somnolence, Xerostomia, Weakness
What are the rare but serious adverse drug reactions for Venlafaxine?
GI Hemorrhage, Hepatotoxicity, Serotonin Syndrome, Suicidal Thoughts
What are the key counseling points for Venlafaxine?
Take with food, but avoid alcohol. Extended-release capsules and tablets should be swallowed whole. Contents of extended-release capsules may be sprinkled on food and swallowed without chewing, followed by water. Symptomatic improvement may not be evident
for weeks. Do not discontinue drug abruptly, as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Avoid activities requiring mental alertness; may cause dizziness or somnolence.
What are the brand names of Bupropion?
Aplensin, Forfivo XL, Wellbutrin, SR/XL, Zyban
What drug class is Bupropion in?
Monocyclic Antidepressant
What are the indications for Bupropion?
Depression, Season Affective Disorder (SAD), Smoking Cessation Assistance
What is the mechanism of action of Bupropion?
Monocyclic antidepressant, unique as a mild dopamine and norepinephrine uptake inhibitor with no direct effect on serotonin receptors or MAO.
What are the major contraindications for Bupropion?
Seizure Disorder, History of Anorexia/Bulimia, Use of MAOI within 14d, Patients undergoing abrupt discontinuation of ethanol, benzodiazepines, barbiturates, or antiepileptics
What are the black box warnings for Bupropion?
Suicidality, Neuropsychiatric Reactions
What are the common adverse drug reactions for Bupropion?
Agitation, Constipation, Dizziness, Headache,
Insomnia, Nausea, Tachyarrhythmia, Tremor, Xerostomia
What are the rare but serious adverse drug reactions for Bupropion?
Cardiac Dysrhythmia,
Mania, Seizure, Suicidal Thoughts, Wide QRS Complex
What are the key counseling points for Bupropion?
Avoid alcohol, CNS depressants, and activities requiring mental alertness. Take at the same time each day and at bedtime if possible. If taking the extended-release tablet, the tablet shell may remain intact and be visible in the stool.
What is the brand name of Mirtazapine?
Remeron
What drug class is Mirtazapine in?
Antidepressant, ±2- Antagonist
What are the indications for Mirtazapine?
Headache, Panic Disorder
What is the mechanism of action of Mirtazapine?
Antidepressant that an-
tagonizes presynaptic ±2- adrenergic auto- and heteroreceptors that are responsible for controlling the release of norepinephrine and serotonin (5-HT). It is also a potent antagonist of postsynaptic 5-HT2 and 5-HT3 receptors. The net outcome of these effects is increased noradrenergic activity and enhanced 5-HT activity, especially at 5-HT1a receptors. This unique mechanism of action preserves antidepressant efficacy but minimizes many of the adverse effects common to heterocyclic antidepressants and SSRIs.
What are the major contraindications for Mirtazapine?
Hypersensitivity to
the drug, Concurrent use or use within 14d of MAOI, linezolid, IV methylene blue use
What are the black box warnings for Mirtazapine?
Suicidality, Not for use in children
What are the common adverse drug reactions for Mirtazapine?
Constipation, Increased Appetite, Somnolence,
Xerostomia, Increased Serum Cholesterol, Weight Gain
What are the rare but serious adverse drug reactions for Mirtazapine?
Neutropenia, Suicidal Thoughts, QTc Prolongation,
Torsades de Pointes (Fatal Heart Rhythm)
What are the key counseling points for Mirtazapine?
Orally disintegrating tablet blister pack should be opened with dry hands and placed on tongue; no water is needed; tablet should be used immediately after removal from package; once removed, it cannot be stored. Avoid activities requiring mental alertness until drug effects are realized. Report worsening depression, suicidal ideation, or unusual changes in behavior. Do not drink alcohol while taking this drug. Take in the evening prior to sleep.
What is the brand name of Vilazodone?
Viibryd
What drug class is Vilazodone in?
Antidepressant, SSRI/5-HT1A Receptor, Partial Agonist
What is the indication for Vilazodone?
Depression
What is the mechanism of action of Vilazodone?
Inhibits CNS neuron sero-
tonin uptake, with minimal or no effect on reuptake of norepinephrine or dopamine. It binds selectively with high affinity to 5-HT1A receptors (altered in depression and
anxiety patients) and is a 5-HT1A receptor partial agonist.
What are the major contraindications for Vilazodone?
Hypersensitivity, Concurrent use of MAOI
What are the black box warnings for Vilazodone?
Suicidal Thinking, Suicidal Behavior, Not approved for children
What are the common adverse drug reactions for Vilazodone?
Diarrhea, Nausea, Headache
What are the rare but serious adverse drug reactions for Vilazodone?
Hyponatremia, Serotonin Syndrome, Suicidal Ideation
What are the key counseling points for Vilazodone?
Patients should avoid
activities requiring mental alertness or coordination until drug effects are realized. Advise patient that symptomatic improvement may not be seen for a few weeks. Advise patients against sudden discontinuation of drug. Patient may take with or without food but should always take drug consistently. Patient should not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant use with MAOIs.
What is the brand name of Aripiprazole?
Abilify
What drug class is Aripiprazole in?
Second Generation Antipsychotic (SGA)
What are the indications for Aripiprazole?
Bipolar Disorder, manic or mixed episodes, Schizophrenia, Depression, Tourette Syndrome, Irritability with Autistic Disorder
What is the mechanism of action of Aripiprazole?
Atypical antipsychotic
agent (quinoline derivative). It exhibits partial agonist activity at dopamine D2 and
D3 receptors and serotonin 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
What are the major contraindications for Aripiprazole?
Hypersensitivity
What are the black box warnings for Aripiprazole?
Suicidality, Dementia
What are the common adverse drug reactions for Aripiprazole?
Akathisia, Anxiety, Extrapyramidal Effects, Headache, Increased Appetite, Somnolence,
Weight Gain, Hyperglycemia
What are the rare but serious adverse drug reactions for Aripiprazole?
Slowed or difficult breathing when used in combination with opioids,
Compulsive Behaviors, Neuroleptic Malignant Syndrome, Pancytopenia, QTc Prolongation, Seizures, Suicidal Thoughts,
Dyskinesia
What are the key counseling points for Aripiprazole?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Drug may impair heat regulation. Drug may also lower seizure threshold. Patients with history
of seizures or conditions that lower seizure threshold should report increased seizure activity. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children, adolescents, and young adults are at higher risk for these effects during the first few months of therapy. Report signs/symptoms of hyperglycemia, extrapyramidal effects, and neuroleptic malignant syndrome. Avoid sudden discontinuation. Avoid alcohol.
What is the brand name of Lurasidone?
Latuda
What drug class is Lurasidone in?
Second Generation Antipsychotic (SGA)
What are the indications for Lurasidone?
Depressive episodes associated with Bipolar Disorder, Schizophrenia
What is the mechanism of action of Lurasidone?
Atypical antipsychotic
agent (benzisothiazole-derivative). Exhibits relatively high affinity for dopamine D2
receptor and serotonin 5-HT7 and 5-HT2A receptors.
What are the major contraindications for Lurasidone?
Hypersensitivity
Concurrent strong CYP3A4/5 inducers and inhibitors
What are the black box warnings for Lurasidone?
Dementia (increased
mortality), Suicidality
What are the common adverse drug reactions for Lurasidone?
Akathisia, Extrapyramidal Effects, Headache, Nausea, Somnolence
What are the rare but serious adverse drug reactions for Lurasidone?
Abnormal Dreams, Angioedema, Bradycardia, Neuroleptic Malignancy Syndrome, Pancytopenia, Seizures, Suicidal Thoughts, Stroke, Tardive Dyskinesia
What are the key counseling points for Lurasidone?
Take with food. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children, adolescents, and young adults are at higher risk for these effects during the first few months of therapy. Report signs/symptoms of hyperglycemia, extrapyramidal effects, and neuroleptic malignant syndrome. Avoid sudden discontinuation. Avoid alcohol.
What is the brand name of Olanzapine?
Zyprexa
What drug class is Olanzapine in?
Second Generation Antipsychotic (SGA),
Thienobenzodiazepine
What are the indications for Olanzapine?
Bipolar Disorder, acute mixed or manic episodes, and maintenance therapy
Schizophrenia, Depression (treatment resistant)
What is the mechanism of action of Olanzapine?
Atypical antipsychotic agent that is a potent serotonin-5-HT2 and dopamine-D2 antagonist. Antipsychotic effect is most likely related to blockade of postsynaptic dopaminergic receptors in
the mesolimbic and prefrontal cortexes of the brain, although other neurotransmitter systems also are involved.
What are the major contraindications for Olanzapine?
Hypersensitivity
What are the black box warnings for Olanzapine?
Mortality in elderly patients with dementia-related psychosis, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)
What are the common adverse drug reactions for Olanzapine?
Akathisia, Asthenia, Dizziness, Hypercholesterolemia,
Hyperglycemia, Increased appetite, Increased prolactin levels, Increased triglycerides, Somnolence, Tremor, Weight gain, Xerostomia, Orthostatic hypotension, Increased LFTs
What are the rare but serious adverse drug reactions for Olanzapine?
Neuroleptic malignant syndrome, Pancreatitis, Sudden cardiac death, Suicidal thoughts, Tardive dyskinesia, DRESS, Slowed or difficult breathing when used in combination with opioids
What are the key counseling points for Olanzapine?
Avoid activities requir-
ing mental alertness or coordination until drug effects are realized. Drug may impair heat regulation. Rise from a sitting/lying-down position slowly. Report symptoms of tardive dyskinesia, neuroleptic malignant syndrome of DRESS syndrome. Diabetic
patients should monitor for hyperglycemia and report difficulties with glycemic
control. Avoid alcohol while taking this drug.
What are the brand names of Quetiapine?
Seroquel, Seroquel XR
What drug class is Quetiapine in?
Second Generation Antipsychotic (SGA)
What are the indications for Quetiapine?
Bipolar Disorder, Schizophrenia, Major Depressive Disorder
What is the mechanism of action of Quetiapine?
Antagonist at multiple neurotransmitter receptors in the brain. It antagonizes serotonin 5-HT1A and 5-HT2,
dopamine D1 and D2, histamine H1, and adrenergic ±1 and ±2 receptors. Efficacy in schizophrenia and bipolar disorder is due to the antagonism of a combination of D2 and 5-HT2 receptors
What are the major contraindications for Quetiapine?
Hypersensitivity
What are the black box warnings for Quetiapine?
Mortality in elderly with dementia, Suicidality, Not approved for children <10 y of age
What are the common adverse drug reactions for Quetiapine?
Agitation, Headache, Hypertension, Somnolence, Weight Gain, Xerostomia
What are the rare but serious adverse drug reactions for Quetiapine?
Neuroleptic Malignant Syndrome, Neutropenia, Pancreatitis, Sudden Cardiac Death, Syncope, Tardive Dyskinesia, Slowed or difficult breathing when used in combination with opioids
What are the key counseling points for Quetiapine?
Take with food but avoid alcohol. Avoid activities requiring mental alertness or coordination. Use caution with activities leading to an increased core temperature. Rise slowly from sitting/lying
down position. Report signs/symptoms of hyperglycemia, bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome
What is the brand name for Risperidone?
Risperdal
What drug class is Risperidone in?
Second Generation Antipsychotic
(SGA), Benzisoxazole
What are the indications for Risperidone?
Autistic Disorder, Irritability, Acute Manic or Mixed Episodes of Bipolar I Disorder, Schizophrenia
What is the mechanism of action of Risperidone?
Potent serotonin 5-HT2 antagonist with weaker dopamine-D2 antagonism. Whereas typical antipsychotics are dopamine antagonists, the additional serotonin antagonism increases efficacy
for negative symptoms of schizophrenia and reduces the likelihood of extrapyramidal symptoms
What are the major contraindications for Risperidone?
Hypersensitivity, Agents that increase QTc interval
What are the black box warnings for Risperidone?
Mortality in elderly with
dementia
What are the common adverse drug reactions for Risperidone?
Extrapyramidal Symptoms, Insomnia, Anxiety, Fatigue, Metabolic Changes, (Hyperglycemia, Dyslipidemia, Weight Gain, DM)
What are the rare but serious adverse drug reactions for Risperidone?
Neuroleptic Malignant Syndrome, Pancreatitis, Stroke, Pancytopenia, Sudden cardiac death, Syncope,
Tardive Dyskinesia, Priapism,
Slowed or difficult breathing when used in combination with opioids, Seizure, Suicidal ideation or behavior
What are the key counseling points for Risperidone?
Take with food. Avoid alcohol or other CNS depressants. Avoid activities requiring mental alertness or coordination until drug effects are realized. Use caution during activities leading to an increased core temperature. Rise slowly from a sitting/lying down position. Report signs/symptoms of hyperglycemia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome. Keep dispersible tablet in blister pack until use. Place on tongue and swallow after dissolved. Oral solution may be mixed with water, coffee, orange juice, or low-fat milk but should not be mixed with cola or tea.
What is the brand name of Ziprasidone?
Geodon Oral
What drug class is Ziprasidone in?
Second Generation Antipsychotic (SGA)
What are the indications for Ziprasidone?
Bipolar Disorder, acute manic or mixed episodes, Schizophrenia
What is the mechanism of action of Ziprasidone?
Atypical antipsychotic
drug with a very high ratio of 5-HT2A to dopamine-2 blockage, suggesting a very low risk of extrapyramidal effects. In addition, it is a 5-HT1A agonist and inhibits reuptake of both serotonin and norepinephrin-like antidepressants. The clinical value of the latter 2 effects is not established.
What are the major contraindications for Ziprasidone?
Hypersensitivity, Acute or recent AMI, Uncompensated heart failure, QTc prolongation, including congenital long QTc syndrome, Concomitant administration of other drugs that cause QTc prolongation
What are the black box warnings for Ziprasidone?
Elderly patients with dementia are at increased risk of death, Not approved for dementia related psychosis
What are the common adverse drug reactions for Ziprasidone?
Dizziness, Extrapyramidal disease, Headache
Nausea, Somnolence
What are the rare but serious adverse drug reactions for Ziprasidone?
Bone marrow depression, Diabetes, Neuroleptic malignant syndrome, Prolonged
QTc interval, Syncope, Tardive dyskinesia, Torsades de Pointes (Fatal Heart Rhythm), DRESS, Slowed or difficult breathing when used in combination with
opioids.
What are the key counseling points for Ziprasidone?
Take with food to increase absorption, but avoid alcohol. Avoid activities requiring mental alertness or coordination, as this medicine may cause dizziness and somnolence. Use caution with activities leading to an increased core temperature, such as strenuous exercise, exposure to extreme heat, or dehydration. Rise slowly from a sitting/lying down position, as drug may cause orthostatic hypotension. Report signs/symptoms of bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome.
Patient with diabetes should report worsening glycemic control
What is the brand name of Clonazepam?
Klonopin
What drug class is Clonazepam in?
Benzodiazepine (C-IV)
What is the indication for Clonazepam?
Seizure
What is the mechanism of action of Clonazepam?
Enhances the postsynaptic effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
What are the major contraindications for Clonazepam?
Hypersensitivity to
benzodiazepines, Narrow-angle glaucoma, Liver disease
What are the black box warnings for Clonazepam?
Concurrent use with opioids, Abuse, misude, and addiction, dependence and withdrawal reactions
What are the common adverse drug reactions for Clonazepam?
Ataxia, Lethargy, Somnolence, Weight gain
What are the rare but serious adverse drug reactions for Clonazepam?
Seizures, Mania, Depression, Withdrawal symptoms
What are the key counseling points for Clonazepam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Allow orally disintegrating tablet to dissolve on your tongue.
What is the brand name of Alprazolam?
Xanax
What drug class is Alprazolam in?
Benzodiazepine, Short or Intermediate Acting (C-IV)
What are the indications for Alprazolam?
Anxiety, Panic disorder, with or without Agoraphobia
What is the mechanism of action of Alprazolam?
Enhances the postsynap-
tic effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
What are the major contraindications for Alprazolam?
Hypersensitivity to
benzodiazepines
Narrow-angle glaucoma
Concurrent ketoconazole, or itraconazole
What are the black box warnings for Alprazolam?
Concurrent use with
opioids, Abuse potential,
Withdrawal reactions
What are the common adverse drug reactions of Alprazolam?
Ataxia, Lethargy, Retrograde amnesia, Somnolence, Weight gain, Change in appetite, Constipation,
Fatigue, Cognitive dysfunction, Decreased libido
What are the rare but serious adverse drug reactions for Alprazolam?
Seizures, Mania, Depression, Liver failure, Stevens-Johnson syndrome
What are the key counseling points for Alprazolam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Do not
crush or break extended-release product. Oral disintegrating tablet may be divided but are unstable after breaking. May mix solution in liquid or semi-solid food for administration. If only 1/2 tablet taken, discard the other half. Allow oral disintegrating tablet to dissolve on your tongue. Do not self-increase or abruptly discontinue use.
What is the brand name for Diazepam?
Valium
What drug class is Diazepam in?
Benzodiazepine (C-IV)
What are the indications for Diazepam?
Substance abuse withdrawal syndrome, Anxiety, Seizure
What is the mechanism of action of Diazepam?
Enhanced postsynaptic
effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
What are the major contraindications for Diazepam?
Hypersensitivity to benzodiazepines, Narrow-angle glaucoma, Severe liver disease, Myasthenia gravis,
Sleep apnea, Respiratory insufficiency, Children <6 mo
What are the black box warnings for Diazepam?
Concurrent use with
opioids, Addiction, dependence, and withdrawal reactions
What are the common adverse drug reactions for Diazepam?
Drowsiness, Impaired motor coordination
What are the rare but serious adverse drug reactions for Diazepam?
Seizures, Mania, Depression, Withdrawal symptoms, Elevated LFTs
What are the key counseling points for Diazepam?
May cause drowsiness;
avoid driving or other tasks requiring motor coordination. Avoid alcohol.
What is the brand name of Lorazepam?
Ativan
What drug class is Lorazepam in?
Benzodiazepine, Short or Intermediate
Acting (C-IV)
What are the indications for Lorazepam?
Anxiety, Insomnia, due to anxiety or situational stress
What is the mechanism of action of Lorazepam?
Enhance the postsynaptic
effect of the inhibitory neurotransmitter, GABA
What are the major contraindications for Lorazepam?
Hypersensitivity to benzodiazepines, Narrow-angle glaucoma
What are the black box warnings for Lorazepam?
Concurrent use with
opioids, Abuse, misuse, addiction, Dependence and withdrawal symptoms
What are the common adverse drug reactions for Lorazepam?
Drowsiness, Impaired motor coordination
Retrograde amnesia
What are the rare but serious adverse drug reactions for Lorazepam?
Seizures, Mania, Depression, Withdrawal symptoms
What are the key counseling points for Lorazepam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
What is the brand name of Temazepam?
Restoril
What drug class is Temazepam in?
Benzodiazepine (C-IV)
What is the indication for Temazepam?
Insomnia
What is the mechanism of action of Temazepam?
Minor metabolite of
diazepam. Enhances the postsynaptic effect of the inhibitory neurotransmitter,
y-aminobutyric acid (GABA)
What are the major contraindications for Temazepam?
Hypersensitivity to
benzodiazepines, Narrow-angle glaucoma, Pregnancy
What are the black box warnings for Temazepam?
Concurrent use with
opioids, Abuse and dependence
What are the common adverse drug reactions for Temazepam
Drowsiness, Somnolence,
Impaired motor coordination
What are the rare but serious adverse drug reactions for Temazepam
Complex behavior, Anaphylaxis, Worsening of depression, Angioedema, Drug dependence
What are the key counseling points for Temazepam?
May cause drowsi-
ness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Take 30 mins prior to bedtime. Hazardous activites (eg., driving, cooking) and unusual
activities (eg., making phone calls) while asleep has been reported while taking triazolam; use with caution, especially if living alone and discontinue use if activities occur.
What is the brand name of Triazolam?
Halcion
What drug class is Triazolam in?
Benzodiazepine, Short or Intermediate
Acting (C-IV)
What is the indication of Triazolam?
Insomnia
What is the mechanism of action of Triazolam?
Enhances the postsynaptic
effect of the inhibitory neurotransmitter, GABA
What are the major contraindications for Triazolam?
Hypersensitivity to
benzodiazepines, Concurrent strong CYP3A4/5 inhibitors
What are black box warnings for Triazolam?
Concurrent use with opioids, Abuse, misuse, and addiction, which can lead to overdose or death
Dependence, which can lead to withdrawal reactions
What are the common adverse drug reactions for Triazolam?
Ataxia, Lethargy, Retrograde amnesia, Somnolence, Weight gain, Change in appetite,
Constipation, Fatigue, Cognitive dysfunction, Decreased libido
What are the rare but serious adverse drug reactions for Triazolam?
Seizures, Mania, Depression, Liver failure, Stevens-Johnson syndrome
What are the key counseling points for Triazolam?
May cause drowsiness;
avoid driving or other tasks requiring motor coordination. Avoid alcohol. Do not increase dose or use longer than 7 d without consult HCP. Hazardous activities (e.g., driving, cooking) and unusual activities (e.g., making phone calls) while asleep has been reported while taking triazolam; use with caution, especially if living alone and discontinue use if activities occur.
What are the brand names of Clobazam?
Onfi, Sympazan
What drug class is Clobazam in?
Benzodiazepine, Anticonvulsant (C-IV)
What is the indication for Clobazam?
Lennox-Gastaut Syndrome
What is the mechanism of action of Clobazam?
Thought to involve potentiation of neurotransmission resulting from binding at the benzodiazepine site of the GABAa receptor.
What are the major contraindications of Clobazam?
Hypersensitivity to the
drug
What are the black box warnings for Clobazam?
Concurrent use with
opioids, Abuse and addiction, Dependence and withdrawal reactions
What are the common adverse drug reactions for Clobazam?
Constipation, Drooling, Ataxia, Lethargy, Respiratory infections, Somnolence, Fever
What are the rare but serious adverse drug reactions for Clobazam?
Depression, Stevens-Johnson syndrome, Suicidal attempts, Toxic epidermal necrolysis, DRESS syndrome
What are the key counseling points for Clobazam?
Often causes lethargy
and somnolence. Avoid alcohol and opioids while using. Avoid activities requiring mental alertness. Do not discontinue abruptly.
What is the brand name of Atomoxetine?
Strattera
What drug class is Atomoxetine in?
Norepinephrine Reuptake Inhibitor, CNS Stimulant
What is the indication for Atomoxetine?
ADHD
What is the mechanism of action of Atomoxetine?
Selective norepinephrine reuptake inhibitor that produces therapeutic effects in patients with ADHD.
What are the major contraindications for Atomoxetine?
Hypersensitivity to the drug, Concomitant sue of MAOIs or use within 2 wk, Narrow-angle glaucoma, Pheochromocytoma,
Severe cardiac or vascular disorders in which condition would be expected to deteriorate with clinically important increases in BP or HR
What are the black box warnings for Atomoxetine?
Suicidality in children
and adolescents
What are the common adverse drug reactions for Atomoxetine?
Abdominal pain, Headache,
Insomnia, Loss of appetite, Nausea, Weight loss, Xerostomia
What are the rare but serious adverse drug reactions for Atomoxetine?
Dyskinesia, Mania,
Prolonged QTc interval, Psychotic disorders, Seizure, Suicidal thoughts, Sudden cardiac death,
Tachycardia, Hepatotoxicity
What are the key counseling points for Atomoxetine?
Avoid activities
requiring mental alertness or coordination until drug effects are realized. Growth rate and weight may need to be monitored more frequently in children. Report new or worsened psychiatric problems, chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmias, MI, or cerebrovascular accident. Do not open cap-
sules as atomoxetine is an ocular irritant.
What is the brand name for Buspirone?
BuSpar
What drug class is Buspirone in?
Antianxiety
What is the indication for Buspirone?
Anxiety
What is the mechanism of action of Buspirone?
Selective serotonin
5-HT1A receptor partial agonists. It also has some effect on dopamine-D2 auto-receptors and, like antidepressants, can downregulate ²- adrenergic receptors. Unlike
benzodiazepines, it lacks amnestic, anticonvulsant, muscle relaxant, and hypnotic effects.
What are the major contraindications for Buspirone?
Hypersensitivity
What are the black box warnings for Buspirone?
None
What are the common adverse drug reactions for Buspirone?
Dizziness
What are the rare but serious adverse drug reactions for Buspirone?
Mania, Psychiatric disorder
What are the key counseling points for Buspirone?
Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Advise patient that symptomatic improvement may not be seen for a few weeks. Advise patient against sudden discontinuation of drug. Patient may take with or without food but should always take drug consistently. Patient should not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant
use with MAOI.
What are the brand names for Lithium?
Eskalith, Eskalith-CR, Lithobid
What drug class is Lithium in?
Antimanic
What is the indication for Lithium?
Bipolar Disorder
What is the mechanism of action of Lithium?
Alters the actions of several
second-messenger systems (e.g., adenylate cyclase and phosphoinositol). Alters
cation transport across cell membrane in nerve and muscle cells and influences reuptake of serotonin and/or norepinephrine; second-messenger systems involving
phosphatidylinositol cycle are inhibited.
What are the major contraindications for Lithium?
Severe debilitation, dehydration, or sodium depletion, Significant cardiovascular disease, Significant renal impairment, Concomitant diuretic therapy
What are the black box warnings for Lithium?
Lithium level monitoring required
What are the common adverse drug reactions for Lithium?
Cardiac dysrhythmias, Fine tremor, Hypothyroidism, Leukocytosis, Thrombocytosis, Xerostomia
What are the rare but serious adverse drug reactions for Lithium?
Hypotension, Nephrotoxicity, Seizure, Hypercalcemia, Hyperparathyroidism
What are the key counseling points for Lithium?
An FDA-approved patient
medication guide must be dispensed with this medication. Swallow extended-re-
lease tablets whole; do not crush or chew. Avoid activities requiring mental alertness
or coordination until drug effects are realized. Report signs/symptoms of toxicity,
which may vary depending on the degree of toxicity. These may include diarrhea,
vomiting, tremor, ataxia, drowsiness, muscle weakness, lack of coordination, gid-
diness, blurred vision, tinnitus, or large volumes of dilute urine. Maintain adequate
fluid intake and normal salt intake.
