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CNS 2 Quizzes

GenericBrandClassUseDoseMOAContraindicationsBBW
Quetiapine Seroquel (XR) Antipsychotic, dibenzothiazpeine atypical Schizophrenia, bipolar disorder IR: 150-750mg PO/d given BID-TID ER: 400-800mg PO qPM Antagonizes multiple neurotransmitter receptors in the brain (5-HT2, D1 + 2, H1, alpha 1 + 2) Electrolyte abnormalities, hypokalemia, long QT syndrome, arrhythmia Suicidal thoughts
Aripiprazole Abilify (Maintena/MyCite) Antipyschotic, 2nd generation Schizophrenia, bipolar 1 disorder, MDD Tabs: 10-15 mg PO qD Partially agonizes dopamine D2 and serotonin 5HT1A receptors, antagonizes serotonin 5HT2A receptors N/A Not for dementia related psychosis
Risperidone Risperdal (Consta) Antipyschotic, 2nd generation Schizophrenia, bipolar 1 disorder, MDD 1-4 mg/d PO divided qD-BID INJ: 25mg IM q2wk Antagonizes dopamine D2, serotonin 5-HT2, and other receptors Hypersensitivity to paliperidone Not for dementia related psychosis
Olanzapine Zyprexa (Relprevv/Zydis) Antipyschotic, 2nd generation Schizophrenia, bipolar 1 disorder, agitation 10-20 mg PO qD Antagonizes dopamine, serotonin 5-HT2, and other receptors Alcohol use, CCNS depressant use Not for dementia related psychosis
Clozapine Clozaril, FazaClo, Versacloz Antipyschotic, 2nd generation N/A 12.5 mg PO daily or BID increased to 300-450 mg/day (max dose 900 mg/day) Dibenzodiazepine, primary action through antagonism of dopamine type 2 (D2) receptor and serotonin type 2A (5-HT2A) receptors N/A Orthostatic hypotension, bradycardia, syncope, and cardiac arrest reported, severe and fatal myocarditis and cardiomyopathy, fatal hepatotoxicity, severe neutropenia (ANC less than 500), seizure risk, dementia risk
Haloperidol Haldol Antipyschotic, 1st generation N/A Psychosis: 0.5-5 mg PO in divided doses. Schizophrenia: 2-5 mg IV in divided doses (20 mg/day) Butyrophenone antipsychotic that nonselectively blocks post-synaptic dopamine (D2) receptors in the brain N/A Not for dementia related psychosis
Lithium Lithobid Bipolar disorder agent Bipolar disorder, mania and maintenance IR: 600-1800 mg/d divided BID-TID. ER: 900-1200 mg/d divided BID-TID Alters neuronal sodium transport Brugada syndrome Narrow therapeutic index - start tx only if facility available for prompt accurate lithium levels
Lamotrigine Lamictal (XR) Anticonvulsant (anti-mania) Bipolar disorder, partial seizures Varies significantly by dz Inhibits voltage dependent sodium channels, decreasing presynaptic glutamate and aspartate release Avoid abrupt withdrawal Serious rashes requiring hospitalization may occur
Varenicline Chantix Smoking cessation N/A Days 1-3: 0.5 mg PO daily Days 4-7: 0.5 mg PO BID Maintenance (week 2- 12): 1 mg PO BID Partial alpha-4, beta-2 nicotininc receptor agonist, also binds to 5-HT3 receptors, small stimulation of dopamine activity Caution in seizure history, increases intoxicating effects of alcohol None
Bupropion Budeprion (SR/XL), Wellbutrin (SR/XL), Zyban NDRI MDD, seasonal affective disorder, smoking cessation IR: 100 mg PO TID. 12hr: 150 mg PO BID 24 hr: 300 mg PO qAM Inhibits neuronal reuptakte of NE and dopamine MAOi use, seizures, bulimia, anorexia Suicidal thoughts
Escitalopram Lexapro SSRI MDD, GAD 10 mg PO qD Selectively inhibits serotonin reuptake N/A Suicidal thoughts
Fluoxetine Prozac (Weekly), Sarafem SSRI MDD, OCD, panic disorder, premenstrual dysphoric disorder 20-80 mg PO qAM Selectively inhibits serotonin reuptake N/A Suicidal thoughts
Sertraline Zoloft SSRI MDD, OCD, panic disorder 50-200 mg PO qD Selectively inhibits serotonin reuptake Disulfiram use Suicidal thoughts
Venlafaxine Effexor (XR) SNRI MDD, GAD, panic disorder IR: 75-225 mg/d PO divided BID-TID. ER: 75-225 mg PO qD Inhibits NE, serotonin, and dopamine reuptake Avoid abrupt withdrawal Suicidal thoughts
Paroxetine Paxil (CR) SSRI MDD, OCD, panic disorder, social anxiety disorder, GAD, PTSD 20-50 mg PO qAM Selectively inhibits serotonin reuptake N/A Suicidal thoughts
Desvenlafaxine Pristiq SNRI MDD 50 mg PO qD Inhibits NE, serotonin, and dopamine reuptake Avoid abrupt withdrawal Suicidal thoughts
Duloxetine Cymbalta SNRI MDD, GAD 60 mg PO qD Inhibits serotonin and NE reuptake Avoid abrupt withdrawal, alcohol abuse Suicidal thoughts
Citalopram Celexa SSRI MDD 20-40 mg PO qD Selectively inhibits serotonin reuptake Electrolyte abnormality, QT prolongation, arrhythmias, CHF Suicidal thoughts
Buspirone BuSpar Anxiolytic, non-BZD Anxiety 20-30 mg PO qD divided BID-TID Binds to serotonin and dopamine D2 receptors MAOi use, renal impairment N/A
Mirtazapine Remeron (SolTab) Antidepressant, tetracyclic MDD 15-45 mg PO qHS Antagonizes alpha-2 adrenergic and serotonin 5-HT2 receptors MAOi use, avoid abrupt withdrawal Suicidal thoughts
Temazepam Restoril BZD, intermediate-acting Insomnia 7.5-30 mg PO qHS prn Binds to BZD receptors, enhances GABA effects Avoid abrupt withdrawal Use with opioids may result in profound sedation, respiratory depression, coma or death.
Clonazepam Klonopin BZD, long-acting Seizures disorders, panic disorder 0.5-5 mg PO TID. Binds to BZD receptors, enhances GABA effects Avoid abrupt withdrawal, hepatic impairment Use with opioids may result in profound sedation, respiratory depression, coma or death.
Lorazepam Ativan BZD, intermediate-acting Anxiety, insomnia, status epilepticus 2-6 mg/d PO/IM/IV divided BID-TID Binds to BZD receptors, enhances GABA effects Avoid abrupt withdrawal, renal failure, respiratory impairment, sleep apnea Use with opioids may result in profound sedation, respiratory depression, coma or death.
Diazepam Valium, Diastat BZD, long-acting Seizure disorders, anxiety, sedation 2-10 mg PO BID-QID 5-10 mg IM/IV q3-4 hrs Binds to BZD receptors, enhances GABA effects Avoid abrupt withdrawal Use with opioids may result in profound sedation, respiratory depression, coma or death.
Alprazolam Xanax (XR), Niravam (ODT) BZD, short-acting Anxiety, panic disorder 0.5-3 mg PO TID ER: 3-6 mg PO qD Binds to BZD receptors, enhances GABA effects Avoid abrupt withdrawal Use with opioids may result in profound sedation, respiratory depression, coma or death.
Trazodone Oleptro Serotonin modulators MDD, insomnia 50-100 mg PO BID-TID Antagonizes serotonin 5-HT2A/C and alpha-1 adrenergic receptors, inhibits serotonin reuptake Avoid abrupt withdrawal May cause suicidal thoughts in children and young adults
Ramelteron Rozerem Hypnotic, melatonin receptor agonist N/A 8 mg PO within 30 minutes of bedtime Potent select agonist of melatonin receptors (MT1 and MT2), little affinity for MT3. Acts within the suprachiasmatic nucleus of the hypothalamus Avoid alcohol N/A
Eszopiclone Lunesta Hypnotic, non-BZD N/A 1-3 mg PO at bedtime (max 3 mg) Interacts with GABA-receptor complexes coupled to binding domains close to benzodiazepine receptors Caution in those with a history of drug dependence N/A
Hydroxyzine Atarax, Vistaril Antihistamine (H1) Anxiety, pruritus/urticaria, N/V 25-100 mg PO/IV q4-6 hr prn Non-selectively antagonizes central and peripheral histamine H1 receptors QT prolongation, hypersensitivity to cetirizine or levocetirizine N/A
Zolpidem Ambien (CR) Insomnia (anxiolytic/hypnotic) Insomnia, short-term IR: 5-10 mg PO qHS. ER: 6.25-12.5 mg PO qHS Interacts with GABA-benzodiazepine receptor complexes Alcohol use, hepatic impairment, hx of complex sleep behavior Complex sleep behavior may occur. Sleep walking, sleep driving, other activities.
Fenatnyl Abstral, Duragesic, Fentora Analgesic N/A IV: 50-100 mcg LD with 25-50 mcg/hr titrated to patient need. Transdermal: 25-100 mcg/hr Opioid agonist at the mu-receptor Do not use in opioid-naive N/A
Dexmedetomidine Precedex Alpha-2 receptor agonist N/A ICU Sedation IV: 1 mcg/kg over 10 minutes followed by 0.2-0.7 mcg/kg/hr maintenance for ICU sedation. Procedural Sedation: IV: loading 1 mcg/kg over 10 minutes with 0.6mcg/kg/hour for maintenance Selective alpha-2 adrenergic agonist, inhibits NE release, peripheral alpha-2b adrenoceptors N/A N/A
Ketamine Ketalar General anesthetic N/A Anesthesia IM: 4-10 mg/kg. IV: 0.5-2 mg/kg Noncompetitive NMDA receptor antagonist that blocks glutamate N/A N/A
Lidocaine Lidoderm, Xylocaine Class 1B and anesthetic analgesic N/A Topical: apply 4.5 mg/kg/day divided in four doses OR apply 5% patch to painful area for 12 hours every day Local antiarrhythmic, Class IB Caution in those with known drug sensitivities Fatal if high blood exposure from topicals, watch in kids, caution in those with known drug sensitivities, may be increased in renal dysfunction
Midazolam Nayzilam, Versed BZD, short-acting N/A Pre-op sedation: 0.1-0.35 mg/kg IV over 20-30 sec. Seizures: 5 mg (one nasal spray) as a single dose in one nostril; may repeat dose in 10 minutes in alternate nostril Binds stereospecific benzodiazepines receptors on the postsynaptic GABA neuron. Essentially enhances the inhibitor effect of GABA on neuronal excitability. Impact GABA-A receptors, not GABA-B N/A Associated with respiratory depression/arrest, especially used in sedation in non-critical care setting , anterograde amnesia.
Naloxone Evzio, Narcan Opioid antagonist N/A Opioid overdose: IM, IV, SC: 0.4-2 mg repeated q2-3 min up to 10 mg in total. Intranasal: 4 mg (1 spray) as a single dose in one nostril. May repeat in 3-5 minutes if respiratory distress persists Pure opioid antagonist that competes and displaces opioids at receptor sites N/A N/A
Propofol Diprivan General anesthetic N/A IV: initial 5 mcg/kg/min (or 0.3 mg/kg/hr); increase by 5 to 10 mcg/kg/min (or 0.3 to 0.6 mg/kg/hr) q5-10min until desired sedation level is achieved; usual maintenance: 5-50 mcg/kg/min (or 0.3-3 mg/kg/hr) Short-acting lipophilic IV general anesthetic. Results in CNS depression through GABA-A agonism and glutamatergic activity through NMDA receptor blockade. Hypersensitivity to eggs/soybeans/soy products, hypertriglyceridemia N/A
Created by: hmariner1
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