Term
|
Definition
TA, high potency
PO, IM, and depot IM (decanoate)
LAI (long acting injection) |
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Term
|
Definition
TA, high potency
PO, IM, and depot IM (decanoate)
LAI |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
TA, mid potency
PO, IM forms available |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
TA, low potency
highly sedating (good for pts w/ difficulty sleeping)
siginificant antiadrenergic (hypotension) & anticholinergic SE
low EPS |
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Term
|
Definition
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Term
|
Definition
TA, low potency
least EPS of all TA, but most anticholinergic
significant QT prolongation! & retinitis pigmentosa |
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Term
Clozaril
Clozapine
most efficacious antipsychotic
antagonism where?
Indications/Contraindications?
Adverse Effects? |
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Definition
AtA
Antagonism at : 5HT2a, D1, D2, H1, muscarnic, alpha-1 rctpr
Indications:
TA indications
Treatment-refractory Sz
Sz concurrent w/ tardive dyskinesia
Contraindications:
Granulocytopenia
Diabetes/hyperlipidemias
SE:
sedation
anticholinergic SE
orthostatic hypotentsion
weight gain, substantial
hypersalivation
seizures (especiall high doses/fast titrations)
Metabolic
Agranulocytosis (need frequent WBC monitoring)
-Think Ms. Dormurat |
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|
Term
Risperdal
Risperidone
PO, dissolvable tab, and depot forms
LAI
antagonism where?
Indications/Contraindications?
Adverse Effects? |
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Definition
AtA
Antagonism at 5HT2a, D2, alpha-1 rctprs
Indications:
TA indications
Acute mania
SE:
orthostatic hypotension
insomina
agitation
weight gain
hyperprolactinemia
EPS (high doses above 6 mg)
metabolic |
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|
Term
Zyprexa
Olanzapine
PO, IM, and dissolvable tab forms available
LAI
among atypicals, efficacy second only to clozapine
antagonism where?
Indications/Contraindications?
Adverse Effects? |
|
Definition
AtA
Antagonism at 5HT2a, D1, D2, D4, H1, muscarinic, alpha-1 rcptrs
Indications:
TA indications
Acute mania
Bipolar Maintenance
Contraindications:
Diabetes/HL
SE:
anticholinergic
orthostatic hypotension
sedation
weight gain
hyperglycemia, T2D, diabetic ketoacidosis
HL |
|
|
Term
Seroquel
Quetiapine
antagonism where?
Indications/Contraindications?
Adverse Effects? |
|
Definition
AtA
antagonism at 5HT2a, D2, alpha-1 and alpha-2, H1 rcpts
Indications:
TA indications
Acute mania
BP depression
adjunct for unipolar depression
SE:
orthostatic hypotension
sedation
weight gain
metabolic
-Think Ms. Sager and Mr. Roth |
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|
Term
Geodon
Ziprasidone
PO and fast-acting IM forms
antagonism where?
Indications/Contraindications?
Adverse Effects? |
|
Definition
AtA
Antagonism at 5HT1a, 5HT2a, D2, D3 rcptrs and monoamine (NE, 5HT, DA) reuptake pumps!
Indications:
TA Indications
Acute Mania
SE:
sedation
weight gain (lesser than clozapine, olanzapine, and risperidone)
Metabolic (less than clozapine and olanzapine)
QT prolongation |
|
|
Term
Abilify
Aripiprazole
antagonism where?
Indications/Contraindications?
Adverse Effects? |
|
Definition
AtA
Antagonism at 5HT2a, partial agonist at D2 and 5HT1a
Indications:
TA indications
Acute mania
BP maintenance
adjunct for unipolar depression
SE:
sedation
weight gain (lesser than clozapine, olanzapine, and risperidone)
Metabolic
weight gain |
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|
Term
Invega
Paliperidone
metabolite of risperidone |
|
Definition
AtA
TA indications
less EPS than risperidone |
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Term
|
Definition
AtA
TA indications
less weight gain than other AtA
increased risk of QT prolongation |
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Term
|
Definition
AtA
TA indications
?novel mechanism of action |
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Term
|
Definition
AtA
TA indications
?less weight gain than other AtA
-Think Mr. Khondaker |
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Term
|
Definition
TCA
tertiary amine
-pain, headached, insomnia |
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Term
|
Definition
TCA
tertiary amine
-highly serotonergic, indicated for OC |
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Term
|
Definition
TCA
tertiary amine
-pain, insomnia, anxiety
-SE: sedation, weight gain |
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Term
|
Definition
TCA
tertiary amine
-panic, enuresis
-pure noradrenergic |
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Term
|
Definition
TCA
Secondary amine (fewer SE, less sedation, safer in OD)...like tertiary TCA antagonism at 5HT & NE, but less H.A.M blockade
-demethylated amitriptyline
-least orthostasis
-pure nor adrenergic |
|
|
Term
|
Definition
TCA
Secondary amine (fewer SE, less sedation, safer in OD)...like tertiary TCA antagonism at 5HT & NE, but less H.A.M blockade
-demethylated imipramine
-least anticholinergic |
|
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Term
|
Definition
MAOi
Pro DA, Pro NE, Pro 5HT |
|
|
Term
| Tranylcypromine (Parnate) |
|
Definition
MAOi
Pro DA, Pro NE, Pro 5HT |
|
|
Term
| Transdermal selegiline (Emsam) |
|
Definition
MAOi
Pro DA, Pro NE, Pro 5HT
-patch form
-lower dietary restrictions at lower doses |
|
|
Term
| Fluoxetine (Prozac, Sarafem) |
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-longest 1/2 life
-efficacy in bulimia
-activating |
|
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Term
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-more sedating than fluoxetine & sertraline
-short 1/2 life
-social anxiety d/o |
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Term
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-less sedating than paroxetine
-increased risk of GI disturbances
-activating |
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Term
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-indicated for OCD only
-many drug/drug interactions
-sedating |
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Term
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-fewest drug-drug interactions |
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Term
|
Definition
SSRI (selective antagonism at 5HT presynaptic reuptake pumps)
-s-enantiomer of citalopram, more expensive
-less medication interactions |
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Term
|
Definition
SNRI (No HAM blockade, cleaner than TCAs, give in morning)
-Dual-acting (NE & 5HT), SUPERIOR EFFICACY, best single drug there is. NE effect at higher doses |
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Term
|
Definition
SNRI (No HAM blockade, cleaner than TCAs, give in morning)
-nauseau common SE
-treats diabetic nephorpathy & fibromyalgia |
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Term
|
Definition
SNRI (No HAM blockade, cleaner than TCAs, give in morning)
-metablite of venlafaxine (but more $)
-dual action at lower doses |
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Term
|
Definition
NaSSAs (Noradrenergic and Specific Serotonergic Antidepressants). Central alpha-2 rcptr antagonist --> subsequent disinhibition so increased NE and 5HT release!
-MDD and refractory MDD (especially for those that need sleep and need to gain weight)
-Think Mr. Rodriguez |
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Term
|
Definition
SARI (Serotonin Antagonist and Reuptake Inhibitor)
-most prescribed for chronic insomnia and depressive Sx (think Mr. Soltero)
-SE priapism! |
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Term
|
Definition
SARI (Serotonin Antagonist and Reuptake Inhibitor)
-SE liver toxicity (Black box) |
|
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Term
| Bupropion (Wellbutrin, Zyban) |
|
Definition
Noradrenergic and Dopamine Reuptake Inhibitors (NDRI)
-activating, NE gives energy
-For: MDD, BP depression, ADHD, smoking cessation
-avoid with: anorexia, bulimia, seizures, MAOis
-can cause seizures at high doses!
-lack of sexual SE compared to SSRIs |
|
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Term
|
Definition
Selective Serotonin Reuptake inhibitor and partial agonist
-for MDD, avoid with MAOis
-similar to SSRIs, less sexual dysfxn & weight gain |
|
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Term
|
Definition
Benzodiazepine
-short 1/2 life, worry abt seizures w/ w/d
-greater addictive potential, highest potency
-effective for panic
-bimodal metabolism, don't five PRN!! |
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|
Term
|
Definition
Benzodiazepine
-short 1/2 life
-PO, IM, and IV forms
-widely used |
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Term
|
Definition
Benzodiazepine
-short 1/2 life |
|
|
Term
|
Definition
Benzodiazepine
-short 1/2 life
-effective short-term sleep aid, lowest potency of short 1/2 lives |
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Term
|
Definition
Benzodiazepine
-long1/2 life, once daily dosing possible. Don't worry abt seizures w/ w/d (self-tapers).
-most potent, anxiety
-AVOID w/ renal dysfxn |
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Term
|
Definition
Benzodiazepine
-long1/2 life, once daily dosing possible
-dissolves highly in body fat, can accumulate
-fast onset but with active metabolite
-can use with detox & seizures |
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|
Term
| Chlordiazepoxide (Librium) |
|
Definition
Benzodiazepine
-long1/2 life, once daily dosing possible
-can use with alcohol detox |
|
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Term
| Benzos not metabolized by liver |
|
Definition
"LOT"
Lorazepam
Oxazepam
Temazepam |
|
|
Term
| Benzo overdose, use what BX antagonist? |
|
Definition
|
|
Term
|
Definition
Non BZ Anxiolytic, non-addictive
-partial agonist at 5HT, effective in anxiety
-onset of action 2 wks, slower than BZs: GAD, adjunct for MDD w/ SSRI |
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|
Term
| Hydroxyzine (Atarax, Vistaril) |
|
Definition
Non BZ Anxiolytic, non-addictive
-sedating anti-Histamine
-for situational anxiety, quick acting, for pts who can't take BZs |
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Term
|
Definition
Non BZ Anxiolytic, non-addictive
-beta adrenergic blocker (treats palpitations, sweating, tachycardia)
-for performance anxiety, and akathesia
-avoid w/ asthma |
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Term
|
Definition
Non BZ Hypnotics, for insomnia
-GABAergic, yields progressive tolerance and dependence
-binds BZ-rctpr --> sedation
-shorter 1/2 life
-SE: GI distress, anterograde amnesia, hallucinations, sleep walking |
|
|
Term
|
Definition
Non BZ Hypnotics, for insomnia
-GABAergic, yields progressive tolerance and dependence
-short-acting, can dose in middle of night (shorter 1/2 life than ambien) |
|
|
Term
|
Definition
Non BZ Hypnotics, for insomnia
-GABAergic
-suggested to not yield tolerance
-longest 1/2 life (Lunesta>ambien>sonata) |
|
|
Term
| Diphenhydramine (Benadryl) |
|
Definition
Non BZ Hypnotics, for insomnia
-sedating antihistamine
-SE: sedation, weight fain, antichol SE |
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Term
|
Definition
Non BZ Hypnotics, for insomnia
-agonist at melatonin MT-1 and MT-2 rcptrs, thought to normalize circadian rhythms
-no tolerance or dependence |
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Term
| Lithium (Eskalith, Lithobid) |
|
Definition
Mood Stabilizer
-modulates 2nd messenger system in brain, neurogenesis, BDNF, arborization. Increases brain health!
-good for: BAD I (*euphoric mania), BAD II, BP maintenance, Intermittent Explosive D/o, adjunct to antidepressants (potentiation)
-not metabolized by liver but by KIDNEY
-AVOID in pregnant women (Ebstein's anomaly), thiazide diuretics, ACE-inhibitors, NSAIDs (all can raise Li levels)
-may decrease suicidality |
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Term
|
Definition
Mood Stabilizer - Anticonvulsant
-inhibits AP (effects Na/K channels, possibly enhance GABA)
-good for: BAD I (*mixed mania, *rapid cycling), BAD II, Epilepsy, Neuralgias, alcohol w/d
-onset of action: 5-7 days
-autoinducer (more take, more CYP3A4 activity), drug
clearance and half life speeds up
-AVOID in pregnant women (neural tube defects)
-Serious SE: Blood dyscrasias
-Must monitor blood count, liver and metabolic fxn |
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