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psychopharmacology 2
advanced pharm
| Question | Answer |
|---|---|
| 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
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