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Psychiatry > Psychiatric Drugs > Flashcards

Psychiatric Drugs Flashcards

1
Q

Most commonly used Drugs for Depression and Anxiety =

A
  • SSRIs
  • Benzos
  • SNRIs
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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
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3
Q

Main types of SSRIs

A
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Citalopram ( Celexa)
  • Escitalopram ( Lexapro)
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4
Q

Benzos: examples, SE, use

A
  • Valium, Ativan, Xanax
  • can worsen depression
  • use if anxiety is severe
  • high abuse potential
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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
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6
Q

Sertraline (Zoloft)

A
  • low drug-drug interactions
  • GI upset (diarrhea)
  • can be used in pregnancy and breast feeding
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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
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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
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9
Q

Citalopram ( Celexa)

A
  • Low drug-drug interactions

- fairly well tolerated

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10
Q

Escitalopram (Lexapro)

A

-better tolerated then celexa, twice as potent as celexa

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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
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12
Q

Trazodone =

A
  • seratonergic agent
  • heavily sedating
  • free of cardiac conduction concerns
  • can cause priapism
  • common side effect = orthostasis
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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
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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

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15
Q

Disadvantages of Buproprion

A
  • potentially activating/agitating
  • rarely tx’s panic
  • seizure risk
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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
Q

Risperidone (Risperidol)

A
  • less wt gain
  • less anticholinergic side effects
  • disadvantages: Increase prolactin, orthostasis, sinus tach, dose related EPS
26
Q

Olanzapine (Zyprexa)

A
  • advantages: IM prep (acute administration), sedation, FDA approval for maintenance phase of bipolar d/o
  • disadvantages: metabolic syndrome, wt. gain,sedation
27
Q

Quetiapine (Serquel)

A
  • tx’s Parkinson’s related psychosis
  • low anticholinergic load
  • least EPS
  • problems: wt gain,sedation, orthostasis, underdosing, BID dosing
28
Q

Ziprasidone (Geodon)

A
  • Advantages: IM prep, low propensity for wt gain and met syndrome
  • disadvantages: potential QT elongation, BID dosing, EPS, anxiety, insomnia at lower doses
29
Q

Apriprazole (Abilify)

A
  • advantages: FDA approval for maintenance phase of bipolar d/o, fairly well tolerated, lower propensity for met syndrome
  • disadvantages: initial akasthesia, insomnia

Psychiatry (9 decks)

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