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psychopharmacology 2

advanced pharm

paxil shortest 1/2 life- given to anxious pt w/insomnia- withdrawal is just the opposite- agitation and sz- pregnancy cat D-
prozac longest 1/2 life- given to pt who cannot get out of bed- energizing
importance of 1/2 life with serotonin never give 2 serotonin drugs together=serotonin syndtome- do NOT use with Tramodol
serotonin syndrome causes coma, twitching, and death
TCA MOA serotonin and NE reuptake inhibitor- also sodium and calcium channel blockers- can cause arrhythmia/tachycardia- antagonize Ach and antihistamine- alpha blocking effecting
MAOI MOA prevents Serotonin, NE, and DA metabolism
1/2 life of Prozac/fluoxetine to be out of system 7 days (like the flu)- so 5 1/2 life= about 1 month to switch drugs
bad effect of paxil and prozac cytochrome P450 inhibitor- inhibits 2D6- if pt was on prodrug tamoxifen for cancer- needs 2D6 to activate drug and these are inhibitors
best two antidepressants with least drug-drug interaction (x) celexa and Lexapro- safest
s/e of celexa prolonged QT interval- watch to give with antibiotic (azithromycin/quinolone/macrolides)
drugs that prolong the QT interval macrolides, Quinolones, Geodon and celexa
antidepressant good for pregnancy, lactation, anhedonia and elderly sertraline/Zoloft
best drug for a pt to use if taking tamoxifen is venlafaxine/Effexor- SNRI
drugs that may cause serotonin syndrome dextromethorphan, Demerol, St. Johns, TCA, MAOI, tramadol and ecstasy- use ms relaxant, antiseizure
imipramine/tofranil for peeing- nocturnal enuresis- TCA
amitriptyline/Elavil for neuropathic pain (d/t N/E), also depression
OD with TCA cardiac, convulsions, coma- wide QRS complex
MAOIB medication selegline- Parkinson's medication
tyramine is what? precursor to DA- and then serotonin and NR- phenelzine/Nardil and tranylcypromine/Parnate>MAOIA selegline is>MAOIB
tyramine s/e HTN crisis- wine, nuts, aged cheese
duloxetine is... and helps with what Cymbalta- SNRI and helps with neuropathic pain- d/t NE
Effexor/venlafaxine is a what and helps with what? SNRI and helps with neuropathic pain- d/t NE can cause dose dependent HTN- best to use with tamoxifen
TCAs can also be used for (other uses) n.pain (amitriptyline/Elavil), bipolar d/o, acute panic attack, enuresis (imipramine)
SNRIs can also be used for Cymbalta/duloxetine>pain
TCA OCD med clomipramine
GAD tx of choice SSRI
PTSD tx choice SSRI- phobias
NMS from typical antipsychotics- ms rigidity, lactic acidosis, arrhythmias, antihistamine, anticholinergic, alpha blocking and EPS, FEVER
Dopamine does what to prolactin______ and so when dopamine is inhibited, what happens? it inhibits prolactin, so when dopamine is inhibited, it goes up and causes gynomastia= milk caused by Risperdal
ziprasidone is what? geodon
mania dx 1 week DIGFAST- need 3
depression dx 2 blue weeks of 5 s/s SIGECAPS- sleep, interest, energy, concentration, appetite, psychomotor, suicidal
lithium s/e nephrotoxicity- keep hydrated- also tremors, ataxia, aphasia, goiter, diabetes insipidus, edema, teratogenic
3 benzos that can be given to pts with bad livers OTL -outside the liver- oxazepam/serax, temazepam/restoril, lorazepam/ativan
short acting benzos TOM- 1 12h triazolm (halcyon), oxazepam (serax), midazolam (versed)
medium acting benzos CAAT-12-40h clonazepam, alprazolam, Ativan, and temazepam
long acting benzos DC- 40-250h diazepam and chlordiazepoxide
sleep meds zolpidem/ambien, zaleplon/sonata, lunesta/eszopiclone- act on BZ subtype GABA- lunesta best for staying asleep
why do amphetamines calm down children increased levels of catecholamines
Strattera is also called________, and MOA Atomoxetine NE reuptake inhibitor- s/e SI, HA
Intuniv also called _______ also called Guanfacine SR- selective α2A agonist Was used for HTN
Created by: arsho453