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