Psychiatric Drugs Flashcards
1
Q
Most commonly used Drugs for Depression and Anxiety =
A
- SSRIs
- Benzos
- SNRIs
2
Q
SSRIs =
A
- first line tx for depression/anxiety
- safety in overdose
- easy of titration to target dose
- main side effects: GI( D/C), appetite changes, HA, sexual, agitation/anxiety, sedation or insomnia
3
Q
Main types of SSRIs
A
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Citalopram ( Celexa)
- Escitalopram ( Lexapro)
4
Q
Benzos: examples, SE, use
A
- Valium, Ativan, Xanax
- can worsen depression
- use if anxiety is severe
- high abuse potential
5
Q
Fluoxetine (Prozac)
A
- oldest SSRI
- longest half life
- high potential for drug-drug interaction
- can be used in Bulimia and PMDD
- can be used in pregnancy and breastfeeding
6
Q
Sertraline (Zoloft)
A
- low drug-drug interactions
- GI upset (diarrhea)
- can be used in pregnancy and breast feeding
7
Q
Paroxetine (Paxil_
A
- mod-high drug-drug interactions
- more prominent anti-cholinergic side effects, wt gain, sedation
- potential for discontinuation syndrome
- **Do not give while pregnant
8
Q
Fluvoxamine (Luvox)
A
- **first SSRI to get approval for OCD
- initial nausea sometimes problematic
- high drug-drug interactions
- avoid in pregnancy and breast feeding
9
Q
Citalopram ( Celexa)
A
- Low drug-drug interactions
- fairly well tolerated
10
Q
Escitalopram (Lexapro)
A
-better tolerated then celexa, twice as potent as celexa
11
Q
Discontinuation Syndrome
A
- lasts on avg about 10 days after abrupt d/c of SSRIs
- flu-like ax’s, Nausea, dizziness, HA, insomnia, nervousness, “zaps”
- can occur with paroxetine, venlafaxine, duloxetine and sertraline
12
Q
Trazodone =
A
- seratonergic agent
- heavily sedating
- free of cardiac conduction concerns
- can cause priapism
- common side effect = orthostasis
13
Q
Buproprion (Wellbutrin)
A
- Increases dopamine and NE (no effect on serotonin)
- avoid in pregnancy/breastfeeding
- effective in anergic/atypical depression and good for smoking cessation
14
Q
Advantages of Buproprion
A
-NO SEXUAL side effects, non sedating, minimal anticholinergic effects, NO WT GAIN, low drug-drug interaction, safe in overdose
15
Q
Disadvantages of Buproprion
A
- potentially activating/agitating
- rarely tx’s panic
- seizure risk
16
Q
SNRIs (Serotonin NE Reuptake Inhibs)
A
- dual action antidepressants : increase serotonin and NE
- Venlafaxine
- Mirtazapine
- Duloxetine
17
Q
Venlafaxine (Effexor)
A
- similar side effect profile as an SSRI
- potential for increased BP
- safe in overdose
- no contraindications for cardiac pts
18
Q
Mirtazapine (Remeron)
A
- predominant sedation
- wt gain
- low occurrence of sexual side effects
- inverse rltnshp btwn dose and sedative effects
19
Q
Duloxetine (Cymbalta)
A
- used for diabetic peripheral neuropathic pain
- can increase BP
20
Q
Main things to add to SSRIs
A
- Wellbutrin
- Remeron
- Thyroid hormone
- Lithium
- low dose anti psych
21
Q
Psychotic Drugs: 2 main types
A
- Typical
- Atypical
22
Q
Typical Antipsychs
A
- Phenothiazines: low potency (Chlorpromazine)
- Butyrophenones: high potency (Haloperidol)
23
Q
Atypical Antipsychs
A
- Clozapine
- Risperidone
- Olanzapine
- Quetiapine
- Ziprasidone
- Apriprazole
24
Q
Clozapine (Clozaril)
A
- ***gold stand for atypicals
- poorly tolerated
- wt gain, sedation, orthostasis, hypersalivation
- Seizure risk
- agranulocytosis
25
Risperidone (Risperidol)
- less wt gain
- less anticholinergic side effects
- disadvantages: Increase prolactin, orthostasis, sinus tach, dose related EPS
26
Olanzapine (Zyprexa)
- advantages: IM prep (acute administration), sedation, FDA approval for maintenance phase of bipolar d/o
- disadvantages: metabolic syndrome, wt. gain,sedation
27
Quetiapine (Serquel)
- tx's Parkinson's related psychosis
- low anticholinergic load
- least EPS
- problems: wt gain,sedation, orthostasis, underdosing, BID dosing
28
Ziprasidone (Geodon)
- Advantages: IM prep, low propensity for wt gain and met syndrome
- disadvantages: potential QT elongation, BID dosing, EPS, anxiety, insomnia at lower doses
29
Apriprazole (Abilify)
- advantages: FDA approval for maintenance phase of bipolar d/o, fairly well tolerated, lower propensity for met syndrome
- disadvantages: initial akasthesia, insomnia
