Term
Methylphenidate
Mech
Use
Tox |
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Definition
CNS stimulant, increases catecholamines at synaptic cleft, esp. NE and dopamine
ADHD, narcolepsy, appetite control
Myosis, prolonged wakefullness, delusions, hallucinations, fever. |
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Term
Dextroamphetamine
Mech
Use
Tox |
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Definition
CNS stimulant, increases catecholamines at synaptic cleft, esp. NE and dopamine
ADHD, narcolepsy, appetite control
Myosis, prolonged wakefullness, delusions, hallucinations, fever. |
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Term
Mixed amphetamine salts
Mech
Use
Tox |
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Definition
CNS stimulant, increases catecholamines at synaptic cleft, esp. NE and dopamine
ADHD, narcolepsy, appetite control
Myosis, prolonged wakefullness, delusions, hallucinations, fever. |
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Term
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Definition
Typical antipsychotic, blocks dopamine D2 receptors (increasing cAMP).
HIGH POTENCY = greater EPS effects.
Schizophrenia (+ sx), psychosis, acute mania, Tourette's
Lipid storage, slow removal. Extrapyramidal side effects. Hyperprolactinemia. Antimuscarinic, antiadrenergic, antihistamine effects. Neuroleptic malignant syndrome (FEVER). Tardive dyskinesia. |
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Term
Trifluoperazine
Mech
Use
Tox |
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Definition
Typical antipsychotic, blocks dopamine D2 receptors (increasing cAMP).
HIGH POTENCY = greater EPS effects.
Schizophrenia (+ sx), psychosis, acute mania, Tourette's
Lipid storage, slow removal. Extrapyramidal side effects. Hyperprolactinemia. Antimuscarinic, antiadrenergic, antihistamine effects. Neuroleptic malignant syndrome (FEVER). Tardive dyskinesia. |
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Term
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Definition
Typical antipsychotic, blocks dopamine D2 receptors (increasing cAMP).
HIGH POTENCY = greater EPS effects.
Schizophrenia (+ sx), psychosis, acute mania, Tourette's
Lipid storage, slow removal. Extrapyramidal side effects. Hyperprolactinemia. Antimuscarinic, antiadrenergic, antihistamine effects. Neuroleptic malignant syndrome (FEVER). Tardive dyskinesia. |
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Term
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Definition
Typical antipsychotic, blocks dopamine D2 receptors (increasing cAMP).
LOW POTENCY = greater anti-muscarinic, -adrenergic, -histamine AEs.
Schizophrenia (+ sx), psychosis, acute mania, Tourette's
Lipid storage, slow removal. Extrapyramidal side effects. Hyperprolactinemia. Antimuscarinic, antiadrenergic, antihistamine effects. Neuroleptic malignant syndrome (FEVER). Tardive dyskinesia.
*Retinal deposits |
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Term
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Definition
Typical antipsychotic, blocks dopamine D2 receptors (increasing cAMP).
LOW POTENCY = greater anti-muscarinic, -adrenergic, -histamine AEs.
Schizophrenia (+ sx), psychosis, acute mania, Tourette's
Lipid storage, slow removal. Extrapyramidal side effects. Hyperprolactinemia. Antimuscarinic, antiadrenergic, antihistamine effects. Neuroleptic malignant syndrome (FEVER). Tardive dyskinesia.
*Corneal deposits. |
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Term
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Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Olanzapine: OCD, anxiety, depression, mania, Tourette's
Fewer EPS and anticholinergic AEs than typicals. Olanzapine: Weight gain. |
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Term
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Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Fewer EPS and anticholinergic AEs than typicals. Clozapine: AGRANULOCYTOSIS, weight gain. |
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Term
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Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Fewer EPS and anticholinergic AEs than typicals. |
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Term
|
Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Fewer EPS and anticholinergic AEs than typicals. |
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Term
|
Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Fewer EPS and anticholinergic AEs than typicals. |
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Term
|
Definition
Atypical antipsychotic. Blocks 5-HT2, dopamine, alpha, and H1 receptors.
Schizophrenia, positive AND negative sx.
Fewer EPS and anticholinergic AEs than typicals. |
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Term
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Definition
Not established; inhibit IP3 cascade?
Bipolar disorder, SIADH
LMNOP: movement (tremor), Nephrogenic DI, hypOthyroidism, pregnancy CI (Ebstein abnormality, malformation of great vessels).
Follows Na in kidney reabsorption - any changes to that will affect Li levels. |
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Term
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Definition
5-HT1 agonist.
Generalized anxiety disorder (NOT panic disorder, social phobia, specific phobias)
Good; no sedation, addiction, tolerance. No interaction with alcohol (unlike BZD, barbituates) |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy. Imipramine: bedwetting.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Imipramine is tertiary amine, more anticholinergic AEs (avoid in elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Amitriptyline is tertiary amine, more anticholinergic effects (avoid in elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Desipramine: least sedating, but lowest seizure threshold. Secondary amine, fewer anticholinergic AEs (better for elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Nortriptylene: Secondary amine, fewer anticholinergic AEs (better for elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Clomipramine: Tertiary amine, more anticholinergic AEs (avoid in elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Doxepin: Tertiary amine, more anticholinergic AEs (avoid in elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
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Definition
TCA. Blocks NE and 5-HT reuptake.
Depression, fibromyalgia, painful diabetic neuropathy.
Toxicity: also...
Inhibits cardiac fast Na channels: arrythmias, hypoTN.
Antimuscarinic: Hyperthermia, flushing, dilated pupils, ileus, urinary retention, sinus tachycardia.
Inhibits alpha1: vasodilation, orthostatic hypoTN.
Inhibits H1: sedation.
Amoxapine: Secondary amine, less anticholinergic AEs (better for elderly).
Severe: CCC: Convulsions, Cardiotoxicity, Coma. Treat with NaHCO3 (urine alkalinzation). |
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Term
Tertiary TCAs?
Secondary TCAs?
Difference? |
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Definition
3*: Imipramine, Amitriptyline, Clomipramine, Doxepin
2*: Desipramine, Nortriptyline, Amoxapine
3* has more anticholinergic AEs (ACID). 2* has fewer, better for elderly (DAN). |
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Term
Fluoxetine
Mech
Use
Tox
Antidote |
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Definition
SSRI. 2-4 weeks before effect.
Depression, OCD, bulemia, social phobias.
Fewer AEs than TCAs. GI distress, sexual dysfunction (anorgasmia). Serotonin syndrome with MAOis - hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures. Antidote: Cyproheptadine (5-HT antagonist). |
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Term
Paroxetine
Mech
Use
Tox
Antidote |
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Definition
SSRI. 2-4 weeks before effect.
Depression, OCD, bulemia, social phobias.
Fewer AEs than TCAs. GI distress, sexual dysfunction (anorgasmia). Serotonin syndrome with MAOis - hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures. Antidote: Cyproheptadine (5-HT antagonist). |
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Term
Sertraline
Mech
Use
Tox
Antidote |
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Definition
SSRI. 2-4 weeks before effect.
Depression, OCD, bulemia, social phobias.
Fewer AEs than TCAs. GI distress, sexual dysfunction (anorgasmia). Serotonin syndrome with MAOis - hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures. Antidote: Cyproheptadine (5-HT antagonist). |
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Term
Citalopram
Mech
Use
Tox
Antidote |
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Definition
SSRI. 2-4 weeks before effect.
Depression, OCD, bulemia, social phobias.
Fewer AEs than TCAs. GI distress, sexual dysfunction (anorgasmia). Serotonin syndrome with MAOis - hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures. Antidote: Cyproheptadine (5-HT antagonist). |
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Term
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Definition
5-HT receptor antagonist
Use for serotonin syndrome (SSRI + MAOi overdose) |
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Term
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Definition
SNRI: 5HT and NE reuptake inhibitor.
Depression. Venlaflaxine also for anxiety.
HyperTN, stimulant, sedation, nausea. |
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Term
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Definition
SNRI: 5HT and NE reuptake inhibitor (Duloxetine: greater NE effect).
Depression. Duloxetine also for diabetic peripheral neuropathy.
HyperTN, stimulant, sedation, nausea. |
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Term
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Definition
MAOi. Increases NE, 5HT, dopamine.
Atypical depression, anxiety, hypochondriasis.
Hypertensive crisis with tyramine ingestion (wine, cheese) or beta-agonists. CNS stimulation. Contraindicated with SSRIs or meperidine to prevent serotonin syndrome. |
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Term
Tranylcypromine
Mech
Use
Tox |
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Definition
MAOi. Increases NE, 5HT, dopamine.
Atypical depression, anxiety, hypochondriasis.
Hypertensive crisis with tyramine ingestion (wine, cheese) or beta-agonists. CNS stimulation. Contraindicated with SSRIs or meperidine to prevent serotonin syndrome. |
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Term
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Definition
MAOi. Increases NE, 5HT, dopamine.
Atypical depression, anxiety, hypochondriasis.
Hypertensive crisis with tyramine ingestion (wine, cheese) or beta-agonists. CNS stimulation. Contraindicated with SSRIs or meperidine to prevent serotonin syndrome. |
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Term
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Definition
Selective MAOi-B inhibitor. Increases NE, 5HT, dopamine.
Atypical depression, anxiety, hypochondriasis. Selegiline also for Parkinson's.
Hypertensive crisis with tyramine ingestion (wine, cheese) or beta-agonists. CNS stimulation. Contraindicated with SSRIs or meperidine to prevent serotonin syndrome. |
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Term
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Definition
Atypical antidepressant. Increases NE and dopamine by unknown mechanism.
Depression, smoking cessation.
Stimulant, headache, seizure in bulemic patients. No sexual side effects (vs. SSRIs) |
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Term
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Definition
Atypical antidepressant. Alpha-2 antagonist (increases NE and 5HT release), also 5HT2 and 5HT3 receptor antagonist.
Depression.
Sedation, increased appetite, weight gain, dry mouth. |
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Term
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Definition
Atypical antidepressant. Blocks NE reuptake.
Depression.
Sedation, orthostatic hypotension. |
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Term
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Definition
Atypical antidepressant. Mostly inhibits serotonin reuptake.
Insomnia - high doses needed for antidepressant effects.
Sedation, nasea, priapism (trazoBone), postural hypotension. |
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Term
| Evolution of EPS side effects? |
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Definition
4 hrs: acute dystonia (muscle spasm, stiffness, oculogyric crisis)
4 dys: akinesia (parkinsonian)
4 wks: akathisia (anxiety, restlessness)
4 mo: tardive dyskinesia (involuntary perioral movements, choreoathetoid movements, irreversible) |
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