Individual Drugs Flashcards
(93 cards)
1
Q
Haloperidol
A
Haldol
Typical antipsychotic - high potency
Worse EPS, tardive dyskinesia, NMS
Less cholinergic/histaminergic/adrenergic side effects
2
Q
Fluphenazine
A
Prolixin
Typical antipsychotic - high potency
Worse EPS, tardive dyskinesia, NMS
Less cholinergic/histaminergic/adrenergic side effects
3
Q
Pimozide
A
Orap
Typical antipsychotic - high potency
Only used for Tourettes!
4
Q
Thiothixine
A
Navane
Typical antipsychotic - high potency
5
Q
Trifluoperazine
A
Stelazine
Typical antipsychotic - high potency
6
Q
Perphenazine
A
Trilafon
Typical antipsychotic - mid potency
Balanced side effect profile Most sedating of the mid potency
7
Q
Loxapine
A
Loxitane
Typical antipsychotic - mid potency
Balanced side effect profile
8
Q
Molindone
A
Moban
Typical antipsychotic - mid potency
Balanced side effect profile
9
Q
Chlorpromazine
A
Thorazine
Typical antipsychotic - low potency
Most sedating, most orthostatic hypotension, most anticholinergic
Least EPS
Decreases seizure threshold
Most QT prolongation of typicals
Risk for retinitis pigmentosa at high doses
10
Q
Mesoridazine
A
Serentil
Typical antipsychotic - low potency
Not on the market
11
Q
Thioridazine
A
Mellaril
Typical antipsychotic - low potency
Not on the market
12
Q
Clozapine
Class
Indications
Minor side effects
Serious side effects
Contraindications
A
Clozaril
Atypical antipsychotic
- Good for
- Treatment refractory
- Tardive dyskinesia
- Decreases suicide and aggression
- Minor side effects
- Orthostatic hypotension is most common
- Significant anti-cholinergic
- Sedation
- Hypersalivation = treat with glycopyrrolate
- Myoclonus
- Serious side effects
- Metabolic syndrome
- Agranulocytosis
- Seizures
- Myocarditis, dilated cardiomyopathy
- Contraindicateds
- With anticholinergics (benztropine) for risk of acute megacolon and intestinal perforation
- Diabetes/hyperlipidemia
- Granulocytopenia
13
Q
Risperidone
Typical side effects
Atypical side effects
A
Risperdal
Atypical antipsychotic
High potency = popular
Typical side effects = EPS ( when > 6 mg/day), hyperprolactinemia, sexual dysfunction, most likely to cause tardive
Atypical side effects = metabolic syndrome, insomnia, agitation
14
Q
Olanzapine
Side effect
Contraindication
A
Zyprexa
Atypical antipsychotic
Longest compliance per CATIE trial
Worst weight gain!
Contraindicated in diabetes/hyperlipidemia
15
Q
Quetiapine
Indications
SIde effects
A
Seroquel
Atypical antipsychotic
Indications
- Sleep aid at low doses
- Adjunct for unipolar depression
- Parkinson’s disease
Side effects
- Causes weight gain
- Causes QT prolongation
16
Q
Ziprasidone
A
Geodon
Atypical antipsychotic
Causes metabolic syndrome but not as much as clozapine, olanzapine, and risperidone
QT prolongation that is dose dependant
17
Q
Aripiprazole
A
Abilify
Atypical antipsychotic
WEIGHT NEUTRAL YAY - partial agnoist at 5-HT1A
Causes some sedation
18
Q
Paliperidone
A
Invega
Atypical antipsychotic
Metabolite of risperidone - possibly less EPS
19
Q
Iloperidone
A
Fanapt
Atypical antipsychotic
Increased risk of QT prolongation
Possibly less weight gain
20
Q
Asenapine
A
Saphris
Atypical antipsychotic
Novel mechanism of action
21
Q
Lurasidone
A
Latuda
Atypical antipsychotic
Good for bipolar depression!
Possibly less weight gain
22
Q
Phenelzine
A
Nardil
MAOI
Used for atypical depression
23
Q
Tranylcypromine
A
Parnate
MAOI
Atypical depression, BPD, refractory panic disorder
24
Q
Isocarboxazid
A
Marplan
MAOI
Used for MDD
25
Selegeline
Emsam
MAOI
**Transdermal form used for MDD**
In low doses, is selective MAOB inhibitor which can be used as adjunct to levodopa/carbidopa (sinemet) for Parkinson's
26
Amitriptyline
Elavil
TCA - tertiary amine
Good for MDD, neuropathic pain, headache, insomnia
27
Clomipramine
Anafranil
TCA - tertiary amine
Most specific for serotonin
Used for **OCD,** depression, panic
28
Doxepin
Sinequan
TCA - tertiary amine
Depression, anxiety, neuropathic pain, insomnia, PTSD
29
Trimipramine
Surmontil
TCA - tertiary amine
Depression
30
Imipramine
Tofranil
TCA - tertiary amine
PTSD, depression, panic
In children - **enuresis, ADHD**
31
Desipramine
Norpramin
TCA - secondary amine
**Depressive disorder in adults and kids**
**Least sedating**
32
Nortriptyline
Pamelor
TCA - secondary amine
**ADHD,** depression, anxiety, enuresis in kids, neuropathic pain
**Adjunct for smoking cessation**
**Least orthostatic hypotension**
33
Protriptyline
Vivactil
TCA - secondary amine
Depression
34
Fluoxetine
Prozac/Sarafem
SSRI
Longest half-life
**Safest SSRI in pregnancy!**
Can also be used for **Bulimia and premature ejaculation**
Side effects = **activating** - worsens anxiety, prominent sexual side effects
Can cause persistent pulmonary hypertension in fetus/baby
35
Paroxetine
Paxil SSRI
Shortest half-life
**Worst withdrawal syndrome!**
Can be used for social anxiety disorder, GAD, OCD, PTSD
**More sedating**
Worst anticholinergic side effects = GI
36
Sertraline
Zoloft SSRI
**Safest SSRI in breastfeeding**
**Less sedating = can be used in elderly**
Metabolized by liver, safe for kidneys
37
Fluvoxamine
Luvox SSRI
38
Citalopram
Celexa SSRI
39
Escitalopram
Lexapro SSRI
Can be used in **GAD and MDD**
40
Venlafexine
Effexor SNRI
Superior to all new antidepressants
Short half-life = withdrawal
Good for GAD, social anxiety, panic
Side effects = **Worsens BPH**
41
Duloxetine
Cymbalta SNRI
Expensive
Can be used for trigeminal neuralgia/fibromyalgia
**Severe nausea**
42
Desvenlafexine
Pristiq SNRI
43
Mirtazepine
Remeron
NaSSA - Noradrenergic and Specific Serotonergic antidepressant
* alpha 2 antagonist
* alpha 1 agonist
Good for terminally ill - **induces appetite/weight gain, sedating for sleep**
Contraindication = **MAOI (Serotonin syndrome)**
Really bad for weight gain
Serious side effect = **agranulocytosis,** other blood dyscrasias (need to check levels weekly)
44
Trazodone
Desyrel SARI - Serotonin antagonist and reuptake inhibitor
Very sedating at high doses
Also nausea, dizziness, mania
Can cause **priapism!** and vivid nightmares
Prevents **sexual dysfunction** - post-synaptic 5-HT antagonism
45
Nefazodone
Serzone SARI
Liver toxicity is black box warning
sedating, nausea, dizziness, mania
46
Bupropion
Wellbutrin, Zyban
NDRI - noradrenergic and dopaminergic reuptake inhibitor
**No sexual side effects! No metabolic side effects!**
**Lowers seizure threshold (contraindicated in epilepsy, eating disorders, alcoholism)\*\*\***
also used for smoking cessation and ADHD
Minor side effects - activation, insomnia, nausea, tremor
47
Vilazodone
Viibryd SSRI/SPA
Less sexual dysfunction and weight gain compared to regular SSRIs
Same side effects as SSRIs
48
Lithium
Eskalith/Lithobid Mood stabilizer - mania/maintenance, intermittent explosive disorder, adjunct for depressive disorders, patient on clozapine with dropping WBC
**\*Cleared by kidneys**
Low therapeutic levels - requires monitoring q2-3 month, then q6 mo Therapeutic range of 0.8-1.2 mo
Contraindications - **pregnancy for ebsteins anomaly, renal disease**
Causes **benign leukocytosis**, GI, tremor, weight gain
Li toxicity - N/V/D, oliguria, ataxia, coarse tremor, coma, seizures, death -treatment = kayexalate or dialysis
Can cause **thyrotoxicity** - monitor TSH/T4
Can cause **nephrotoxicity**
Can cause **cardiac arrhythmias, T wave flattening**
49
What drugs increase Li levels
Thiazide diuretics
Ace I
Spironolactone
triamterene
Most NSAIDs
50
What drugs do not affect Li levels
ASA, sulindac
51
What drugs decrease Li levels
Mannitol
Acetazolamide
Caffeine, theophylline
52
Valproic acid
Depakote/depakene Anticonvulsant
Enhances GABA, decreases glu
Metabolized by liver
Inhibits metabolism of **lamotrigine = increases level**
**Contraindicated in pregnancy - NTD**, cardiac defects, facial defects, skeletal defects
Contraindicated in **women of child-bearing age - causes PCOS**
Minor side efects - N/V/D, sedation, tremor, weight gain, alopecia
Serious side effects - **thrombocytopenia, hemorrhagic pancreatitis, hepatotoxicity, PCOS**
Overdose - coarse tremor, lethargy, coma, death
Needs monitoring
53
Carbamazepine
Tegretol Anticonvulsant
Enhances GABA
**1st line for trigeminal neuralgia**
**Contraindicated in pregnancy - craniofacial abnormalities**, NTD, learning disorders, hypospadias
Can cause **SIADH - hyponatremia**
Minor side effects - N/V?D, sedation, anti-cholinergic, weight gain
Serious side effects - blood dyscrasias (aplastic anemia, agranulocytosis, thrombocytopenia)
Causes **SJS!**
Hepatotoxic
Overdose - coarse tremor, coma, death Needs monitoring
54
Oxcarbazepine
Trileptal Anticonvulsant
Enhances GABA
Fewer side effects than carbamazepine
No blood monitoring needed
**Can also cause hyponatremia via SIADH**
55
Lamotrigine
Lamictal Anticonvulsant
Inhibits glutamate
Induces **metabolism of valproic acid = lowers levels**
**Maintenance in pregnancy!**
Most **efficacious for bipolar depression**
**Can cause SJS!**
Minor side effects - N/V/D, sedation, lightheadedness, tremor
56
What is a common side effect of all anticonvulsants
N/V/D Sedation, lightheadedness, tremor weight gain (except for gabapentin and topiramate)
57
Gabapentin
Neurontin Anticonvulsant
GABAergic
Trigeminal neuralgia
adjunct for mania
**Contraindicated in renal disease**
58
Topiramate
Topamax Anticonvulsant
Adjunct for mania
Used for epilepsy, migraines, neuralgia
**"Dopamax**" - sedation, lightheaded, cognitive dulling
**Nephrolithiasis - CaPO4 stones**
**Anorexia and weight LOSS!**
59
Alprazolam
Xanax Benzo
Short half-life
Fast/intermediate onset, equivalent dose 0.25-0.5
Gets rid of symptoms the **fastest with panic attacks**
60
Lorazepam
Ativan Benzo
Short half-life
**Can be used in liver disease**
Equivalent dose - 1 mg
Gets rid of panic attack symptoms quickly
61
Oxazepam
Serax Benzo
Short half-life
Can be used in liver disease
62
Temazepam
Resteril
Benzo
Short half-life
Can be used in liver disease
63
Clonazepam
Klonopin Benzo
Longer half-life Slow onset Equivalent dose - 0.5 mg
Least addictive but slow to relieve symptoms
64
Diazepam
Valium Benzo
Longer half-life
Fast onset
Active metabolite
Used in ETOH withdrawal
65
Chlordiazepoxide
Librium Benzo
Longer half-life
Intermediate onset
Equivalent dose 10 mg
Used in ETOH withdrawal
66
Buspirone
Buspar
Non-benzo anxiolytic
**5-HT1a agonist** = positive effects of SSRIs
**Takes at least 2 weeks**
Good for anxiety and history of substance abuse
Side effects - dizziness, headaches, fatigue, GI distress
**Absent side effects - sedation, addiction!**
67
Hydroxyzine
Atarax, Vistaril
Non-benzo anxiolytic
Anti-H1
Used for **situational anxiety**
Side effects = sedation, anti-cholinergic, weight gain
68
Propranolol
Inderal Non-benzo anxiolytic
Used for **performance anxiety**
**Contraindicated in asthma!**
Side effects - dizziness, fatigue, bradycardia, hypotension
69
Zolpidem
Ambien Non-benzo hypnotic
Gabaergic
**Temporary\* use for insomnia - efficacy decreases after 2 weeks**
**Contraindicated in substance abuse history**
Side effects - dizziness, GI distress, strange dreams, progressive tolerance/dependence
70
Zaleplon
Sonata Non-benzo hypnotic
Gabaergic
Short-acting, can use in middle of night
Used for **terminal\* insomnia** - waking up early in the morning and needing to function the next day
Side effects - dizziness, dyspepsia, progressive tolerance/dependence, **habit-forming** because short half-life
71
Eszopiclone
Lunesta Non-benzo hypnotic
Gabaergic
**No tolerance! Used for chronic insomnia**
Side effects - headaches, withdrawal
72
Diphenhydramine
Benadryl Non-benzo hypnotic
Anti-histaminergic
**Contraindicated in elderly or medically ill**
Side effects - sedation, weight gain, anti-cholinergic, delirium
73
Ramelteon
Rozarem Non-benzo hypnotic
**Melatonin agonist**
Used for **insomnia and circadian rhythm disturbances (jet lag)**
Side effects - dizziness, fatigue
74
Methylphenidate
Ritalin CNS stimulant
75
Methylphenidate extended release
Concerta/Metadate CD/Metadate ER CNS stimulant
76
Dexmethylphenidate
Focalin CNS stimulant
77
Dextroamphetamine
Dexadrine CNS stimulant
78
Amphetamine/dextroamphetamine
Adderall CNS stimulant
79
Pemoline
Cylert CNS stimulant
80
Modafinil
Provigil Novel CNS stimulant
Unknown mechanism of action, not adrenergic agonist
Used for ADD/ADHD, narcolepsy, hypersomnia
Minor side effects - headache, nausea, rhinitis, anxiety, insomnia
81
Atomoxetine
Straterra Novel CNS stimulant
Unclear mechanism, **possible selective inhibition of NE reuptake**
Used for ADD/ADHD
**\*Contraindicated with MAOIs, narrow angle glaucoma**
Minor side effects - GI, dizziness, insomnia, sexual dysfunction
**Serious side effects - \*Suicidal ideation, severe liver injury**
82
Nicotine replacement therapy
NRT Gum, lozenges, nasal spray, inhaler, long-acting patch
83
Buproprion
Wellbutrin NDRI antidepressant
84
Varenicline
Chantix
## Footnote
**Nicotinic acetylcholinergic receptor partial agonist**
**Side effect - psychosis**
85
Nortriptyline
Pamelor Adjunct for smoking cessation
86
Clonidine
**Alpha 2 adrenergic agonist** - sympatholytics
Decreases noradrenergic release
**Decreases SNS activation**
87
Disulfuram
Antabuse
**Inhibits aldehyde dehydrogenase** causes buildup of acetylaldehyde
Used for alcohol abuse
88
Acamprosate
Campral
Glutamate antagonist GABA agonist
Diminishes cravings
**NO liver toxicity**
89
Naltrexone
Mu agonist
Diminishes cravings for ETOH and opioids
**Liver toxicity**
90
Depot naltrexone
Vivitrol opioid antagonist for poor compliance
## Footnote
**Liver toxicity**
91
Methadone
Mu agonist = long acting
## Footnote
**Side effects - sweating, constipation, urinary retention, orgasm dysfunction**
**Prolongs QTc**
92
Buprenorphine
**Mu partial agonist**
**NO QTC prolongation!**
Will precipitate withdrawal if patient still has opioids in system
93
Suboxone
Buprenorphine and Naloxone
Naloxone **prevents abuse** if patients try to inject Naloxone does not really get absorbed through PO version which is safe
