Pysch Flashcards
BZDs of choice in the elderly
LOT- safer in the elderly and those with liver impairment since they are metabolized to inactive glucoronides
- lorazepam
- oxazepam
- temazepam
Best BZDs for anxiety
CLAD
- clonazepam
- lorazepam
- alprazaolam
- diazepam
Best BZDs for sleep
Lorazepam
Temazepam
Drug for OD of BZDs
Flumazenil
When to taper BZDs?
If using regularly, for longer than 10 days
BZDs for alcohol withdrawal
Lorazepam
Diazepam
Chlordiazepoxide
Best drugs for falling asleep
Eszopiclone
Zolpidem
Ramelteon
Zaleplon
Best drugs for staying asleep
Eszopiclone
Zolpidem
Doxepin
Suvorexant
Eszopiclone, zaleplon, zolpidem MOA
Non-BZDs
-act selectively and BZDs receptors to increase GABA
Doxylamine
Unison
-antihistamine used for sleep
Dopamine-blocking drugs that can worsen Parkinsons
Prochlorperazine
Metoclopramide
1st/2nd gen antipsychotics
(Decreased risk with quetiapine, but metabolic SEs)
Sx for Parkinsons
TRAP
- tremor
- rigidity
- akinesia/bradykinesia
- postural instability/falls
COMT inhibitor
Entacapone
- increases duration of action of levodopa
- ONLY USED WITH LEVODOPA
- decrease dose of levodopa 10-30% when adding-on
Dopamine agonists
Ropinorole (Requip)
Pramipexole (Mirapex)
-slow titration due to orthostasis and somnolence
-bromocriptine no longer used
-SE: orthostasis, somnolence, hallucinations, impulse control
Amantadine
Blocks DA reuptake
-primarily used to tx dyskinesias associated with peak-dose Sinemet
Selective MAO-B inhibitors
Block breakdown of DA
- used as adjunctive tx to Sinemet
- selegiline (activating SEs)
- rasagiline (can be used as monotherapy)
- safinamide
Benztropine in Parkinsons
Primarily used for tremor
-centrally acting anticholinergic
Parkinsons disease MOA
Occurs when neurons in the substantia nigra die/become impaired
-these cells produce DA which allows smooth coordinated function of body muscles and movement
Alzheimer’s disease MOA
Involves neuritic plaques and tangles in brain tissue which interrupt neuron signalling, and/or alteration of transmitters
-DECREASES ACETYLCHOLINE
Acetylcholinesterase inhibitors
Donepezil Rivastigmine Galantamine -SEs: insomnia, NVD, wt loss, tremor CAUTION WITH LOW HR
Memantine MOA
Blocks NMDA receptors which decreases glutamate
