Psych Drugs Flashcards
Side effects of Benzodiazepines
Drowsiness, impaired intellect, reduced motor coordination, anterograde amnesia, withdrawal can be life threatening and cause seizures, respiratory depression in overdose, esp when combined with alcohol.
Diazepam
AKA Valium. Long-acting benzodiazepine; half-life >20 hrs. Rapid onset, used during detoxification from alcohol or sedative-hypnotic anxiolytics and for seizures; less commonly prescribed to treat anxiety than previously.
Clonazepam
AKA Klonopin. Long-acting benzodiazepine; half-life >20 hrs. Treatment of anxiety, including panic attacks; avoid with renal dysfunction, longer half-life allows for once daily dosing. This drug is effective in 90% of pts with REM sleep behavior disorder, and a lot of other sleep issues.
Alprazolam
AKA Xanax. Intermidate-acting benzodiazepine; half-life 6-20 hrs. Used in treatment of anxiety, including panic attacks. Short onset of action –> euphoria, high abuse potential.
Lorazepam
AKA Ativan. Intermiadate-acting benzodiazepine; half-life 6-20 hrs. Treatment of panic attacks, alcohol and sedative-hypnotic anxiolytic detoxification and agitation, not mettabolized by liver so good for treatment of alcoholics!
Oxazepam
AKA Serax. Intermediate-acting benzodiazepine; half-life 6-20 hrs. Alcohol and sedative-hypnotic anxiolytic detoxification; not metabolized by the liver so good for treatment of alcoholics!
Temazepam
AKA Restoril. Intermediate-acting benzodiazepine; half-life 6-20 hrs. Decreasingly used for treatment of insomnia due to dependence, not metabolized by the liver so good for treatment of alcoholics!
Triazolam
AKA Halcion. Short-acting benzodiazepine. Half-life <6 hours. Treatment of insomnia, primarily used in medical and surgical settings
Midazolam
AKA Versed. Short-acting benzodiazepine. Primarily used in medical and surgical settings
Zolpidem
AKA Ambien. A non-benzodiazepine hypnotic. Works by selective receptor binding to benzodiazepine receptor 1, responsible for sedation, used for short-term insomnia treatment, less tolerance/dependence occurs with prolonged use (but still can occur), Zaleplon has a shorter half-life than zolpidem. Anterograde amnesia, hallucinations, sleepwalking, GI side effects may limit tolerability.
Zaleplon
AKA Sonata. A non-benzodiazepine hypnotic. Works by selective receptor binding to benzodiazepine receptor 1, responsible for sedation, used for short-term insomnia treatment, less tolerance/dependence occurs with prolonged use (but still can occur), Zaleplon has a shorter half-life than zolpidem. Anterograde amnesia, hallucinations, sleepwalking, GI side effects may limit tolerability.
Eszopiclone
AKA Lunesta. A non-benzodiazepine hypnotic. Works by selective receptor binding to benzodiazepine receptor 1, responsible for sedation, used for short-term insomnia treatment, less tolerance/dependence occurs with prolonged use (but still can occur), Zaleplon has a shorter half-life than zolpidem. Anterograde amnesia, hallucinations, sleepwalking, GI side effects may limit tolerability.
Diphenhydramine
AKA Benedryl. A non-benzodiazepine hypnotic. An antihistamine; side effects include sedation, dry mouth, constipation, urinary retention, blurry vision.
Chloral hydrate
AKA Noctec or Somnote. A non-benzodiazepine hypnotic. Not commonly prescribed due to tolerance and dependence; lethal in overdose, causing hepatic and liver failure.
Ramelteon
AKA Rozerem. A non-benzodiazepine hypnotic. Selective melatonin MT1 and MT2 agonist; no tolerance or dependence.
Buspirone
AKA Buspar. An anxiolytic. 5HT-1A receptor partial agonist. Slower onset of action than benzodiazepine - 1-2 weeks for effect. Not as effective as other options, so often used in combination. Does not potentiate CNS depression of alcohol so useful in alcoholics. Low potential for a
Hydroxyzine
AKA Atarax. An anxiolytic. Antihistamine; side effects are sedation, dry mouth, constipation, urinary retention, blurry vision; useful for pts who want quick-acting short-term medication but who cannot take benzos.
Barbiturates
Anxiolytics. Still used in general anesthesia, for epilepsy, and assisted suicide. Positive allosteric modulation of GABA-A receptor. Bind to the GABA-A receptor at the beta subunit. Rarely used because of lethality of overdose and side effect profile. Barbiturates produce effects similar to ethanol during intoxication.
Propanolol
Beta blocker, useful in treating the autonomic effects of panic attacks or performance anxiety, such as palpitations, sweating, and tachycardia. It can also be used to treat akathisia (side effect of typical antipsychotics).
Dextroamphetamine and amphetamines
AKA Dexadrine and Adderall. Stimulant. Dextroamphetamine is the D-isomer of amphetamine; Adderall is Schedule II, RX in triplicate and high potential for abuse; monitor BP and watch for wt loss, insomnia. Treats excessive daytime sleepiness in narcolepsy.
Methylphenidate
AKA Ritalin, Concerta. CNS stimulant, similar to amphetamine, schedule II, Rx in triplicate and high potential for abuse; watch for leukopenia, anemia, increased LFTs - monitor labs - monitor BP and watch for wt loss, insomnia. Treats excessive daytime sleepiness in narcolepsy.
Atomoxetine
AKA Strattera. Presynaptic norepinephrine transporter inhibitor; less appetite suppression and insomnia than psychostimulants; rare liver toxicity; possible increased SI in children/adolescents.
Modafanil
AKA Provigil. Listed under psychostimulants. Used in Narcolepsy
Donepezil
AKA Aricept – an acetylcholinesterase inhibitor. Once daily dosing, some GI effects, mild to moderate dementia
