psych Flashcards
(270 cards)
1
Q
What is the brand name of Amitriptyline?
A
Elavil
2
Q
What drug class is Amitriptyline in?
A
Tricyclic Antidepressant
3
Q
What is the indication for Amitriptyline?
A
Depression
4
Q
What is the mechanism of action of Amitriptyline?
A
Tricyclic antidepressant that blocks presynaptic reuptake of serotonin and norepinephrine with subsequent down regulation of adrenergic receptors
5
Q
What are the major contraindications for Amitriptyline?
A
Hypersensitivity to the drug, Concurrent MAOI or MAOI use in last 14 days, Use during acute recovery period after Myocardial Infarction (MI), Coadministration of Cisapride
6
Q
What are the black box warnings for Amitriptyline?
A
Suicidality, Not approved for children < 12 years of age
7
Q
What are the common adverse drug reactions for Amitriptyline?
A
Sedation
8
Q
What are the rare but serious adverse drug reactions for Amitriptyline?
A
Cardiac Dysrhythmia, Hepatotoxicity, Seizures, Suicidal Thoughts
9
Q
What are the key counseling points for Amitriptyline?
A
Avoid activities requiring mental alertness, alcohol, and other CNS depressants. Symptomatic improvement may not be seen for a few weeks. Avoid sudden discontinuation of drug. Do not use alcohol
10
Q
What are the brand names of Doxepin?
A
Sinequan, Silenor
11
Q
What drug class is Doxepin in?
A
Tricyclic Antidepressant
12
Q
What are the indications for Doxepin?
A
Depression, Anxiety, Alcoholism, Insomnia
13
Q
What is the mechanism of action of Doxepin?
A
Tricyclic antidepressant, influences the adrenergic activity at the synapses where it prevents norepinephrine deactivation through reuptake into the nerve terminals. By binding to histamine receptor sites, it competitively inhibits the biological activation of histamine receptors. Antagonism of the H1 receptor is the most likely mechanism by which doxepin exerts its sleep maintenance effect.
14
Q
What are the major contraindications of Doxepin?
A
Hypersensitivity to the drug, MAOI use, Glaucoma, Severe Urinary Retention
15
Q
What are the black box warnings for Doxepin?
A
Suicidality
16
Q
What are the common adverse drug reactions for Doxepin?
A
Xerostomia
17
Q
What are the rare but serious adverse drug reactions for Doxepin?
A
Cardiac, Dysrhythmia, Hepatotoxicity, Suicidal Thoughts
18
Q
What are the key counseling points for Doxepin?
A
Avoid activities requiring mental alertness until drug effects are realized. Symptomatic improvement in depression may not be seen for a few weeks. Avoid abrupt discontinuation of drug. Do not drink alcohol.
19
Q
What is the brand name of Nortriptyline?
A
Pamelor
20
Q
What drug class is Nortriptyline in?
A
Tricyclic Antidepressant
21
Q
What is the indication for Nortriptyline?
A
Depression
22
Q
What is the mechanism of action of Nortriptyline?
A
Demethylated metabolite of amitriptyline, a heterocyclic antidepressant that blocks presynaptic reuptake of norepinephrine with subsequent down regulation of adrenergic receptors. Heterocyclic antidepressants have less effect on serotonergic activity than on other neurotransmitters.
23
Q
What are the major contraindications for Nortriptyline?
A
Hypersensitivity to the drug or other TCAs, MAOI concurrent use or use within 14 days, Use during recovery period after Myocardial Infarction (MI), Patient using linezolid or IV methylene blue
24
Q
What are the black box warnings for Nortriptyline?
A
Suicidality
25
What are the common adverse drug reactions for Nortriptyline?
Constipation, Dry mouth
26
What are the rare but serious adverse drug reactions for Nortriptyline?
Cardiac Dysrhythmia, Heart Block, Hepatotoxicity, Seizures, Suicidal Thoughts
27
What are the key counseling points for Nortriptyline?
Avoid activities requiring the **mental alertness** or coordination until drug effects are realized, as drug may cause somnolence and dizziness. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. **Avoid abrupt discontinuation**; may precipitate withdrawal symptoms. **Do not drink alcohol** while taking this drug.
28
What is the brand name of Citalopram?
Celexa
29
What drug class is Citalopram in?
SSRI Antidepressant
30
What is the indication for Citalopram?
Depression
31
What is the mechanism of action for Citalopram?
Bicyclic antidepressant that is selective and **potent inhibitor of presynaptic reuptake of serotonin (an SSRI).** It does not affect reuptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine, a1 and a2 adrenergic, and serotonin receptors.
32
What are the major contraindications for Citalopram?
Hypersensitivity to
the drug, Concomitant use of Pimozide, MAOIs
33
What are the black box warnings for Citalopram?
Suicidal Ideation, Not approved for use in children
34
What are the common adverse drug reactions for Citalopram?
Constipation, Dizziness, Headache, Insomnia, Nausea, Sedation, Xerostomia
35
What are the rare but serious adverse drug reactions for Citalopram?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsades de Pointes (Fatal Heart Rhythm), Agranulocytosis
36
What are the key counseling points for Citalopram?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression,
suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. **Do not drink alcohol or use NSAIDs or aspirin while taking this drug.**
37
What is the brand name of Escitalopram?
Lexapro
38
What drug class is Escitalopram in?
SSRI Antidepressant
39
What are the indications for Escitalopram?
Depression, Generalized Anxiety Disorder
40
What is the mechanism of action of Escitalopram?
S-enantiomer of racemic citalopram and is an antidepressant that is a selective and **potent inhibitor of presynaptic reuptake of serotonin (an SSRI)**. It does not affect reuptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine, a1- and a2-adrenergic, and serotonin receptors.
41
What are the major contraindications for Escitalopram?
Hypersensitivity to the drug or citalopram, Concurrent MAOI use
42
What are the black box warnings for Escitalopram?
Suicidality
43
What are the common adverse drug reactions for Escitalopram?
Headache, Nausea, Sedation
44
What are the rare but serious adverse drug reactions for Escitalopram?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsades de Pointes (Fatal Heart Rhythm)
45
What are the key counseling points for Escitalopram?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for 4-6 weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. **Do not drink alcohol or use NSAIDs or aspirin while taking this drug.**
46
What are the brand names of Fluoxetine?
Prozac, Sarafem
47
What drug class is Fluoxetine in?
SSRI Antidepressant
48
What are the indications for Fluoxetine?
Bipolar Major Depression, Major Depressive Disorder,
OCD, Panic Disorder, Premenstrual Dysphoric Disorder,
Bulimea nervosa
49
What is the mechanism of action of Fluoxetine?
Bicyclic antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI)
50
What are the major contraindications for Fluoxetine?
Hypersensitivity to the drug, Concomitant pimozide, thioridazine, or MAOIs
51
What are the black box warnings for Fluoxetine?
Suicidality, Approved in children (>7 years of age, OCD; 8 years of age, MDD)
52
What are the common adverse drug reactions for Fluoxetine?
Diarrhea, Headache, Insomnia, Nausea, Somnolence, Tremor,
Xerostomia
53
What are the rare but serious adverse drug reactions for Fluoxetine?
Prolonged QTc Interval, Serotonin Syndrome, Suicidal Thoughts, Torsade de Pointes (Fatal Heart Rhythm), *SIADH*
54
What are the key counseling points for Fluoxetine?
Take without meals and in the morning. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks, while adverse effects often present in the 1st week of therapy. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. **Do not drink alcohol or use NSAIDs or aspirin while taking this drug.**
55
What are the brand names of Paroxetine?
Paxil, Paxil CR
56
What drug class is Paroxetine in?
SSRI Antidepressant
57
What are the indications for Paroxetine?
Depression, Generalized Anxiety Disorder, Social Anxiety Disorder, OCD, Panic Disorder, Post traumatic Stress Disorder (PTSD), Premenstrual Syndrome, Vasomotor Symptoms of Menopause
58
What is the mechanism of action of Paroxetine?
Highly selective and potent
inhibitor of serotonin reuptake (SSRI)
59
What are the major contraindications for Paroxetine?
Hypersensitivity to the drug, Concomitant use of thioridazine or MAOIs, Pregnancy
60
What are the black box warnings for Paroxetine?
Suicidality
61
What are the common adverse drug reactions for Paroxetine?
Abnormal Ejaculation, Asthenia, Constipation, Diarrhea, Headache, Insomnia, Nausea, Somnolence
62
What are the rare but serious adverse drug reactions for Paroxetine?
Serotonin Syndrome, Suicidal Thoughts
63
What are the key counseling points for Paroxetine
Do not chew or crush controlled-release tablet. **Shake suspension well before using**. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Avoid abrupt discontinuation. Do not drink alcohol. **Use caution with NSAIDs or aspirin while taking this drug.**
64
What is the brand name of Sertraline?
Zoloft
65
What drug class is Sertraline in?
SSRI antidepressant
66
What are the indications for Sertraline?
Depression, OCD, Panic Disorder, PTSD, Social Phobia Disorder, Premenstrual Dysphoric Disorder
67
What is the mechanism of action of Sertraline?
**SSRI that indirectly results in a down regulation of Beta-adrenergic receptors**. It has no clinically important effect on noradrenergic or histamine receptors and no effect on MAO. It lacks stimulant, cardiovascular, anticholinergic, and convulsant effects.
68
What are the major contraindications for Sertraline?
Hypersensitivity to the drug, Concomitant use of pimozide, thioridazine, or MAOIs
69
What are the black box warnings for Sertraline?
Suicidality
70
What are the common adverse drug reactions for Sertraline?
Diarrhea, Fatigue
Headache, Insomnia, Nausea
71
What are the rare but serious adverse drug reactions for Sertraline?
Serotonin Syndrome,
Suicidal Thoughts
72
What are the key counseling points for Sertraline?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation; may precipitate withdrawal symptoms. **Do not drink alcohol or use NSAIDs or aspirin while taking this drug.**
73
What are the brand names of Desvenlafaxine?
Pristiq, Khedezla
74
What drug class is Desvenlafaxine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
75
What are the indications for Desvenlafaxine?
Depression
76
What is the mechanism of action of Desvenlafaxine?
Potent reuptake inhibitor of serotonin and norepinephrine but lacks effects on muscarinic, a-adrenergic, or histamine receptors.
77
What are the major contraindications for Desvenlafaxine?
Hypersensitivity to the drug
or venlafaxine, MAOI use
78
What are the black box warnings for Desvenlafaxine?
Suicidality, Not for use in children, Not for bipolar disorder
79
What are the common adverse drug reactions for Desvenlafaxine?
Diaphoresis (excessive sweating), Dizziness
Headache, Nausea, Xerostomia
80
What are the rare but serious adverse drug reactions for Desvenlafaxine?
GI hemorrhage, Serotonin syndrome, Suicidal thoughts
81
What are the key counseling points for Desvenlafaxine?
Take with or without food. Avoid alcohol. Symptomatic improvement may not be evident for a few weeks. Do not discontinue drug abruptly as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Avoid activities requiring mental alertness or coordination until drug effects are realized, as this medicine may cause dizziness or somnolence.
82
What is the brand name of Duloxetine?
Cymbalta
83
What drug class is Duloxetine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
84
What are the indications for Duloxetine?
Anxiety, Depression, Diabetic Peripheral Neuropathy Pain, Fibromyalgia, Musculoskeletal Pain
85
What is the mechanism of action of Duloxetine?
Selective serotonin norepinephrine reuptake inhibitor that **exerts its antidepressant and pain inhibitory actions by potentiating the serotonergic and noradrenergic activity in the CNS**. It has no significant affinity for adrenergic, dopaminergic, cholinergic, opioid, glutamate, or histaminergic receptors in vitro and does not inhibit monoamine oxidase.
86
What are the major contraindications for Duloxetine?
Hypersensitivity to the drug, Concurrent MAOI use, Concurrent TCA use, Linezolid use, *Uncontrolled Glaucoma*
87
What are the black box warnings for Duloxetine?
Suicidality, Not approved for children
88
What are the common adverse drug reactions for Duloxetine?
Headache, Nausea
89
What are the rare but serious adverse drug reactions for Duloxetine?
Hepatotoxicity, Serotonin Syndrome, Suicidal Thoughts
90
What are the key counseling points for Duloxetine?
Report withdrawal symptoms (e.g., dysphoric mood, irritability, agitation, sensory disturbances), especially during abrupt discontinuation of therapy. Drug may cause hepatotoxicity and increased risk of bleeding (GI, ecchymosis, epistaxis, petechiae). **May require 1-4 week for improvement of depression symptoms**. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. **Children at higher risk for these effects during the first few months of therapy**. Patient should watch for signs/symptoms of bleeding events and hepatotoxicity. Avoid alcohol. Monitor carefully if on concurrent medications that alter coagulation. If discontinuing therapy, **taper dose downward slowly and do not discontinue abruptly**.
91
What are the brand names of Venlafaxine?
Effexor, Effexor XR
92
What drug class is Venlafaxine in?
Serotonin/Norepinephrine Reuptake Inhibitor (SNRI)
93
What are the indications for Venlafaxine?
Generalized Anxiety Disorder, Depression, Panic Disorder, Social Anxiety Disorder
94
What is the mechanism of action of Venlafaxine?
Potent reuptake inhibitor of serotonin and norepinephrine but lacks effects on muscarinic, ±- adrenergic, or
histamine receptors
95
What are the major contraindications of Venlafaxine?
Hypersensitivity, MAOIs
96
What are the black box warnings for Venlafaxine?
Suicidal Ideation, Not approved in children
97
What are the common adverse drug reactions for Venlafaxine?
Dizziness, Headache, Insomnia, Nausea, Somnolence, Xerostomia, Weakness
98
What are the rare but serious adverse drug reactions for Venlafaxine?
GI Hemorrhage, Hepatotoxicity, Serotonin Syndrome, Suicidal Thoughts
99
What are the key counseling points for Venlafaxine?
Take with food, but avoid alcohol. Extended-release capsules and tablets should be swallowed whole. Contents of extended-release capsules may be sprinkled on food and swallowed without chewing, followed by water. Symptomatic improvement may not be evident
for weeks. Do not discontinue drug abruptly, as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Avoid activities requiring mental alertness; may cause dizziness or somnolence.
100
What are the brand names of Bupropion?
Aplensin, Forfivo XL, Wellbutrin, SR/XL, Zyban
101
What drug class is Bupropion in?
Monocyclic Antidepressant
102
What are the indications for Bupropion?
Depression, Season Affective Disorder (SAD), Smoking Cessation Assistance
103
What is the mechanism of action of Bupropion?
Monocyclic antidepressant, unique as a mild dopamine and norepinephrine uptake inhibitor with no direct effect on serotonin receptors or MAO.
104
What are the major contraindications for Bupropion?
Seizure Disorder, History of Anorexia/Bulimia, Use of MAOI within 14d, Patients undergoing abrupt discontinuation of ethanol, benzodiazepines, barbiturates, or antiepileptics
105
What are the black box warnings for Bupropion?
Suicidality, Neuropsychiatric Reactions
106
What are the common adverse drug reactions for Bupropion?
Agitation, Constipation, Dizziness, Headache,
Insomnia, Nausea, Tachyarrhythmia, Tremor, Xerostomia
107
What are the rare but serious adverse drug reactions for Bupropion?
Cardiac Dysrhythmia,
Mania, Seizure, Suicidal Thoughts, Wide QRS Complex
108
What are the key counseling points for Bupropion?
Avoid alcohol, CNS depressants, and activities requiring mental alertness. Take at the same time each day and at bedtime if possible. If taking the extended-release tablet, the tablet shell may remain intact and be visible in the stool.
109
What is the brand name of Mirtazapine?
Remeron
110
What drug class is Mirtazapine in?
Antidepressant, ±2- Antagonist
111
What are the indications for Mirtazapine?
Headache, Panic Disorder
112
What is the mechanism of action of Mirtazapine?
Antidepressant that an-
tagonizes presynaptic ±2- adrenergic auto- and heteroreceptors that are responsible for controlling the release of norepinephrine and serotonin (5-HT). It is also a potent antagonist of postsynaptic 5-HT2 and 5-HT3 receptors. The net outcome of these effects is increased noradrenergic activity and enhanced 5-HT activity, especially at 5-HT1a receptors. This unique mechanism of action preserves antidepressant efficacy but minimizes many of the adverse effects common to heterocyclic antidepressants and SSRIs.
113
What are the major contraindications for Mirtazapine?
Hypersensitivity to
the drug, Concurrent use or use within 14d of MAOI, linezolid, IV methylene blue use
114
What are the black box warnings for Mirtazapine?
Suicidality, Not for use in children
115
What are the common adverse drug reactions for Mirtazapine?
Constipation, Increased Appetite, Somnolence,
Xerostomia, Increased Serum Cholesterol, Weight Gain
116
What are the rare but serious adverse drug reactions for Mirtazapine?
Neutropenia, Suicidal Thoughts, QTc Prolongation,
Torsades de Pointes (Fatal Heart Rhythm)
117
What are the key counseling points for Mirtazapine?
Orally disintegrating tablet blister pack should be opened with dry hands and placed on tongue; no water is needed; tablet should be used immediately after removal from package; once removed, it cannot be stored. Avoid activities requiring mental alertness until drug effects are realized. Report worsening depression, suicidal ideation, or unusual changes in behavior. Do not drink alcohol while taking this drug. Take in the evening prior to sleep.
118
What is the brand name of Vilazodone?
Viibryd
119
What drug class is Vilazodone in?
Antidepressant, SSRI/5-HT1A Receptor, Partial Agonist
120
What is the indication for Vilazodone?
Depression
121
What is the mechanism of action of Vilazodone?
Inhibits CNS neuron sero-
tonin uptake, with minimal or no effect on reuptake of norepinephrine or dopamine. It binds selectively with high affinity to 5-HT1A receptors (altered in depression and
anxiety patients) and is a 5-HT1A receptor partial agonist.
122
What are the major contraindications for Vilazodone?
Hypersensitivity, Concurrent use of MAOI
123
What are the black box warnings for Vilazodone?
Suicidal Thinking, Suicidal Behavior, Not approved for children
124
What are the common adverse drug reactions for Vilazodone?
Diarrhea, Nausea, Headache
125
What are the rare but serious adverse drug reactions for Vilazodone?
Hyponatremia, Serotonin Syndrome, Suicidal Ideation
126
What are the key counseling points for Vilazodone?
Patients should avoid
activities requiring mental alertness or coordination until drug effects are realized. Advise patient that symptomatic improvement may not be seen for a few weeks. Advise patients against sudden discontinuation of drug. Patient may take with or without food but should always take drug consistently. Patient should not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant use with MAOIs.
127
What is the brand name of Aripiprazole?
Abilify
128
What drug class is Aripiprazole in?
Second Generation Antipsychotic (SGA)
129
What are the indications for Aripiprazole?
Bipolar Disorder, manic or mixed episodes, Schizophrenia, Depression, Tourette Syndrome, Irritability with Autistic Disorder
130
What is the mechanism of action of Aripiprazole?
Atypical antipsychotic
agent (quinoline derivative). It exhibits partial agonist activity at dopamine D2 and
D3 receptors and serotonin 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
131
What are the major contraindications for Aripiprazole?
Hypersensitivity
132
What are the black box warnings for Aripiprazole?
Suicidality, Dementia
133
What are the common adverse drug reactions for Aripiprazole?
Akathisia, Anxiety, Extrapyramidal Effects, Headache, Increased Appetite, Somnolence,
Weight Gain, Hyperglycemia
134
What are the rare but serious adverse drug reactions for Aripiprazole?
Slowed or difficult breathing when used in combination with opioids,
Compulsive Behaviors, Neuroleptic Malignant Syndrome, Pancytopenia, QTc Prolongation, Seizures, Suicidal Thoughts,
Dyskinesia
135
What are the key counseling points for Aripiprazole?
Avoid activities requiring mental alertness or coordination until drug effects are realized. Drug may impair heat regulation. Drug may also lower seizure threshold. Patients with history
of seizures or conditions that lower seizure threshold should report increased seizure activity. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children, adolescents, and young adults are at higher risk for these effects during the first few months of therapy. Report signs/symptoms of hyperglycemia, extrapyramidal effects, and neuroleptic malignant syndrome. Avoid sudden discontinuation. Avoid alcohol.
136
What is the brand name of Lurasidone?
Latuda
137
What drug class is Lurasidone in?
Second Generation Antipsychotic (SGA)
138
What are the indications for Lurasidone?
Depressive episodes associated with Bipolar Disorder, Schizophrenia
139
What is the mechanism of action of Lurasidone?
Atypical antipsychotic
agent (benzisothiazole-derivative). Exhibits relatively high affinity for dopamine D2
receptor and serotonin 5-HT7 and 5-HT2A receptors.
140
What are the major contraindications for Lurasidone?
Hypersensitivity
Concurrent strong CYP3A4/5 inducers and inhibitors
141
What are the black box warnings for Lurasidone?
Dementia (increased
mortality), Suicidality
142
What are the common adverse drug reactions for Lurasidone?
Akathisia, Extrapyramidal Effects, Headache, Nausea, Somnolence
143
What are the rare but serious adverse drug reactions for Lurasidone?
Abnormal Dreams, Angioedema, Bradycardia, Neuroleptic Malignancy Syndrome, Pancytopenia, Seizures, Suicidal Thoughts, Stroke, Tardive Dyskinesia
144
What are the key counseling points for Lurasidone?
Take with food. Avoid activities requiring mental alertness or coordination until drug effects are realized. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children, adolescents, and young adults are at higher risk for these effects during the first few months of therapy. Report signs/symptoms of hyperglycemia, extrapyramidal effects, and neuroleptic malignant syndrome. Avoid sudden discontinuation. Avoid alcohol.
145
What is the brand name of Olanzapine?
Zyprexa
146
What drug class is Olanzapine in?
Second Generation Antipsychotic (SGA),
Thienobenzodiazepine
147
What are the indications for Olanzapine?
Bipolar Disorder, acute mixed or manic episodes, and maintenance therapy
Schizophrenia, Depression (treatment resistant)
148
What is the mechanism of action of Olanzapine?
Atypical antipsychotic agent that is a potent serotonin-5-HT2 and dopamine-D2 antagonist. Antipsychotic effect is most likely related to blockade of postsynaptic dopaminergic receptors in
the mesolimbic and prefrontal cortexes of the brain, although other neurotransmitter systems also are involved.
149
What are the major contraindications for Olanzapine?
Hypersensitivity
150
What are the black box warnings for Olanzapine?
Mortality in elderly patients with dementia-related psychosis, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)
151
What are the common adverse drug reactions for Olanzapine?
Akathisia, Asthenia, Dizziness, Hypercholesterolemia,
Hyperglycemia, Increased appetite, Increased prolactin levels, Increased triglycerides, Somnolence, Tremor, Weight gain, Xerostomia, Orthostatic hypotension, Increased LFTs
152
What are the rare but serious adverse drug reactions for Olanzapine?
Neuroleptic malignant syndrome, Pancreatitis, Sudden cardiac death, Suicidal thoughts, Tardive dyskinesia, DRESS, Slowed or difficult breathing when used in combination with opioids
153
What are the key counseling points for Olanzapine?
Avoid activities requir-
ing mental alertness or coordination until drug effects are realized. Drug may impair heat regulation. Rise from a sitting/lying-down position slowly. Report symptoms of tardive dyskinesia, neuroleptic malignant syndrome of DRESS syndrome. Diabetic
patients should monitor for hyperglycemia and report difficulties with glycemic
control. Avoid alcohol while taking this drug.
153
What are the brand names of Quetiapine?
Seroquel, Seroquel XR
153
What drug class is Quetiapine in?
Second Generation Antipsychotic (SGA)
154
What are the indications for Quetiapine?
Bipolar Disorder, Schizophrenia, Major Depressive Disorder
155
What is the mechanism of action of Quetiapine?
Antagonist at multiple neurotransmitter receptors in the brain. It antagonizes serotonin 5-HT1A and 5-HT2,
dopamine D1 and D2, histamine H1, and adrenergic ±1 and ±2 receptors. Efficacy in schizophrenia and bipolar disorder is due to the antagonism of a combination of D2 and 5-HT2 receptors
156
What are the major contraindications for Quetiapine?
Hypersensitivity
157
What are the black box warnings for Quetiapine?
Mortality in elderly with dementia, Suicidality, Not approved for children <10 y of age
158
What are the common adverse drug reactions for Quetiapine?
Agitation, Headache, Hypertension, Somnolence, Weight Gain, Xerostomia
159
What are the rare but serious adverse drug reactions for Quetiapine?
Neuroleptic Malignant Syndrome, Neutropenia, Pancreatitis, Sudden Cardiac Death, Syncope, Tardive Dyskinesia, Slowed or difficult breathing when used in combination with opioids
160
What are the key counseling points for Quetiapine?
Take with food but avoid alcohol. Avoid activities requiring mental alertness or coordination. Use caution with activities leading to an increased core temperature. Rise slowly from sitting/lying
down position. Report signs/symptoms of hyperglycemia, bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome
161
What is the brand name for Risperidone?
Risperdal
162
What drug class is Risperidone in?
Second Generation Antipsychotic
(SGA), Benzisoxazole
163
What are the indications for Risperidone?
Autistic Disorder, Irritability, Acute Manic or Mixed Episodes of Bipolar I Disorder, Schizophrenia
164
What is the mechanism of action of Risperidone?
Potent serotonin 5-HT2 antagonist with weaker dopamine-D2 antagonism. Whereas typical antipsychotics are dopamine antagonists, the additional serotonin antagonism increases efficacy
for negative symptoms of schizophrenia and reduces the likelihood of extrapyramidal symptoms
165
What are the major contraindications for Risperidone?
Hypersensitivity, Agents that increase QTc interval
166
What are the black box warnings for Risperidone?
Mortality in elderly with
dementia
167
What are the common adverse drug reactions for Risperidone?
Extrapyramidal Symptoms, Insomnia, Anxiety, Fatigue, Metabolic Changes, (Hyperglycemia, Dyslipidemia, Weight Gain, DM)
168
What are the rare but serious adverse drug reactions for Risperidone?
Neuroleptic Malignant Syndrome, Pancreatitis, Stroke, Pancytopenia, Sudden cardiac death, Syncope,
Tardive Dyskinesia, Priapism,
Slowed or difficult breathing when used in combination with opioids, Seizure, Suicidal ideation or behavior
169
What are the key counseling points for Risperidone?
Take with food. Avoid alcohol or other CNS depressants. Avoid activities requiring mental alertness or coordination until drug effects are realized. Use caution during activities leading to an increased core temperature. Rise slowly from a sitting/lying down position. Report signs/symptoms of hyperglycemia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome. Keep dispersible tablet in blister pack until use. Place on tongue and swallow after dissolved. Oral solution may be mixed with water, coffee, orange juice, or low-fat milk but should not be mixed with cola or tea.
170
What is the brand name of Ziprasidone?
Geodon Oral
171
What drug class is Ziprasidone in?
Second Generation Antipsychotic (SGA)
172
What are the indications for Ziprasidone?
Bipolar Disorder, acute manic or mixed episodes, Schizophrenia
173
What is the mechanism of action of Ziprasidone?
Atypical antipsychotic
drug with a very high ratio of 5-HT2A to dopamine-2 blockage, suggesting a very low risk of extrapyramidal effects. In addition, it is a 5-HT1A agonist and inhibits reuptake of both serotonin and norepinephrin-like antidepressants. The clinical value of the latter 2 effects is not established.
174
What are the major contraindications for Ziprasidone?
Hypersensitivity, Acute or recent AMI, Uncompensated heart failure, QTc prolongation, including congenital long QTc syndrome, Concomitant administration of other drugs that cause QTc prolongation
175
What are the black box warnings for Ziprasidone?
Elderly patients with dementia are at increased risk of death, Not approved for dementia related psychosis
176
What are the common adverse drug reactions for Ziprasidone?
Dizziness, Extrapyramidal disease, Headache
Nausea, Somnolence
177
What are the rare but serious adverse drug reactions for Ziprasidone?
Bone marrow depression, Diabetes, Neuroleptic malignant syndrome, Prolonged
QTc interval, Syncope, Tardive dyskinesia, Torsades de Pointes (Fatal Heart Rhythm), DRESS, Slowed or difficult breathing when used in combination with
opioids.
178
What are the key counseling points for Ziprasidone?
Take with food to increase absorption, but avoid alcohol. Avoid activities requiring mental alertness or coordination, as this medicine may cause dizziness and somnolence. Use caution with activities leading to an increased core temperature, such as strenuous exercise, exposure to extreme heat, or dehydration. Rise slowly from a sitting/lying down position, as drug may cause orthostatic hypotension. Report signs/symptoms of bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome.
Patient with diabetes should report worsening glycemic control
179
What is the brand name of Clonazepam?
Klonopin
180
What drug class is Clonazepam in?
Benzodiazepine (C-IV)
181
What is the indication for Clonazepam?
Seizure
182
What is the mechanism of action of Clonazepam?
Enhances the postsynaptic effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
183
What are the major contraindications for Clonazepam?
Hypersensitivity to
benzodiazepines, Narrow-angle glaucoma, Liver disease
184
What are the black box warnings for Clonazepam?
Concurrent use with opioids, Abuse, misude, and addiction, dependence and withdrawal reactions
185
What are the common adverse drug reactions for Clonazepam?
Ataxia, Lethargy, Somnolence, Weight gain
186
What are the rare but serious adverse drug reactions for Clonazepam?
Seizures, Mania, Depression, Withdrawal symptoms
187
What are the key counseling points for Clonazepam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Allow orally disintegrating tablet to dissolve on your tongue.
188
What is the brand name of Alprazolam?
Xanax
189
What drug class is Alprazolam in?
Benzodiazepine, Short or Intermediate Acting (C-IV)
190
What are the indications for Alprazolam?
Anxiety, Panic disorder, with or without Agoraphobia
191
What is the mechanism of action of Alprazolam?
Enhances the postsynap-
tic effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
192
What are the major contraindications for Alprazolam?
Hypersensitivity to
benzodiazepines
Narrow-angle glaucoma
Concurrent ketoconazole, or itraconazole
193
What are the black box warnings for Alprazolam?
Concurrent use with
opioids, Abuse potential,
Withdrawal reactions
194
What are the common adverse drug reactions of Alprazolam?
Ataxia, Lethargy, Retrograde amnesia, Somnolence, Weight gain, Change in appetite, Constipation,
Fatigue, Cognitive dysfunction, Decreased libido
195
What are the rare but serious adverse drug reactions for Alprazolam?
Seizures, Mania, Depression, Liver failure, Stevens-Johnson syndrome
196
What are the key counseling points for Alprazolam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Do not
crush or break extended-release product. Oral disintegrating tablet may be divided but are unstable after breaking. May mix solution in liquid or semi-solid food for administration. If only 1/2 tablet taken, discard the other half. Allow oral disintegrating tablet to dissolve on your tongue. Do not self-increase or abruptly discontinue use.
197
What is the brand name for Diazepam?
Valium
198
What drug class is Diazepam in?
Benzodiazepine (C-IV)
199
What are the indications for Diazepam?
Substance abuse withdrawal syndrome, Anxiety, Seizure
200
What is the mechanism of action of Diazepam?
Enhanced postsynaptic
effect of the inhibitory neurotransmitter, y-aminobutyric acid (GABA)
201
What are the major contraindications for Diazepam?
Hypersensitivity to benzodiazepines, Narrow-angle glaucoma, Severe liver disease, Myasthenia gravis,
Sleep apnea, Respiratory insufficiency, Children <6 mo
202
What are the black box warnings for Diazepam?
Concurrent use with
opioids, Addiction, dependence, and withdrawal reactions
203
What are the common adverse drug reactions for Diazepam?
Drowsiness, Impaired motor coordination
204
What are the rare but serious adverse drug reactions for Diazepam?
Seizures, Mania, Depression, Withdrawal symptoms, Elevated LFTs
205
What are the key counseling points for Diazepam?
May cause drowsiness;
avoid driving or other tasks requiring motor coordination. Avoid alcohol.
206
What is the brand name of Lorazepam?
Ativan
206
What drug class is Lorazepam in?
Benzodiazepine, Short or Intermediate
Acting (C-IV)
206
What are the indications for Lorazepam?
Anxiety, Insomnia, due to anxiety or situational stress
207
What is the mechanism of action of Lorazepam?
Enhance the postsynaptic
effect of the inhibitory neurotransmitter, GABA
208
What are the major contraindications for Lorazepam?
Hypersensitivity to benzodiazepines, Narrow-angle glaucoma
209
What are the black box warnings for Lorazepam?
Concurrent use with
opioids, Abuse, misuse, addiction, Dependence and withdrawal symptoms
210
What are the common adverse drug reactions for Lorazepam?
Drowsiness, Impaired motor coordination
Retrograde amnesia
211
What are the rare but serious adverse drug reactions for Lorazepam?
Seizures, Mania, Depression, Withdrawal symptoms
212
What are the key counseling points for Lorazepam?
May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
213
What is the brand name of Temazepam?
Restoril
214
What drug class is Temazepam in?
Benzodiazepine (C-IV)
214
What is the indication for Temazepam?
Insomnia
215
What is the mechanism of action of Temazepam?
Minor metabolite of
diazepam. Enhances the postsynaptic effect of the inhibitory neurotransmitter,
y-aminobutyric acid (GABA)
216
What are the major contraindications for Temazepam?
Hypersensitivity to
benzodiazepines, Narrow-angle glaucoma, Pregnancy
217
What are the black box warnings for Temazepam?
Concurrent use with
opioids, Abuse and dependence
218
What are the common adverse drug reactions for Temazepam
Drowsiness, Somnolence,
Impaired motor coordination
219
What are the rare but serious adverse drug reactions for Temazepam
Complex behavior, Anaphylaxis, Worsening of depression, Angioedema, Drug dependence
220
What are the key counseling points for Temazepam?
May cause drowsi-
ness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Take 30 mins prior to bedtime. Hazardous activites (eg., driving, cooking) and unusual
activities (eg., making phone calls) while asleep has been reported while taking triazolam; use with caution, especially if living alone and discontinue use if activities occur.
221
What is the brand name of Triazolam?
Halcion
222
What drug class is Triazolam in?
Benzodiazepine, Short or Intermediate
Acting (C-IV)
223
What is the indication of Triazolam?
Insomnia
224
What is the mechanism of action of Triazolam?
Enhances the postsynaptic
effect of the inhibitory neurotransmitter, GABA
225
What are the major contraindications for Triazolam?
Hypersensitivity to
benzodiazepines, Concurrent strong CYP3A4/5 inhibitors
226
What are black box warnings for Triazolam?
Concurrent use with opioids, Abuse, misuse, and addiction, which can lead to overdose or death
Dependence, which can lead to withdrawal reactions
227
What are the common adverse drug reactions for Triazolam?
Ataxia, Lethargy, Retrograde amnesia, Somnolence, Weight gain, Change in appetite,
Constipation, Fatigue, Cognitive dysfunction, Decreased libido
228
What are the rare but serious adverse drug reactions for Triazolam?
Seizures, Mania, Depression, Liver failure, Stevens-Johnson syndrome
229
What are the key counseling points for Triazolam?
May cause drowsiness;
avoid driving or other tasks requiring motor coordination. Avoid alcohol. Do not increase dose or use longer than 7 d without consult HCP. Hazardous activities (e.g., driving, cooking) and unusual activities (e.g., making phone calls) while asleep has been reported while taking triazolam; use with caution, especially if living alone and discontinue use if activities occur.
230
What are the brand names of Clobazam?
Onfi, Sympazan
231
What drug class is Clobazam in?
Benzodiazepine, Anticonvulsant (C-IV)
232
What is the indication for Clobazam?
Lennox-Gastaut Syndrome
233
What is the mechanism of action of Clobazam?
Thought to involve potentiation of neurotransmission resulting from binding at the benzodiazepine site of the GABAa receptor.
234
What are the major contraindications of Clobazam?
Hypersensitivity to the
drug
235
What are the black box warnings for Clobazam?
Concurrent use with
opioids, Abuse and addiction, Dependence and withdrawal reactions
236
What are the common adverse drug reactions for Clobazam?
Constipation, Drooling, Ataxia, Lethargy, Respiratory infections, Somnolence, Fever
237
What are the rare but serious adverse drug reactions for Clobazam?
Depression, Stevens-Johnson syndrome, Suicidal attempts, Toxic epidermal necrolysis, DRESS syndrome
238
What are the key counseling points for Clobazam?
Often causes lethargy
and somnolence. Avoid alcohol and opioids while using. Avoid activities requiring mental alertness. Do not discontinue abruptly.
239
What is the brand name of Atomoxetine?
Strattera
240
What drug class is Atomoxetine in?
Norepinephrine Reuptake Inhibitor, CNS Stimulant
241
What is the indication for Atomoxetine?
ADHD
242
What is the mechanism of action of Atomoxetine?
Selective norepinephrine reuptake inhibitor that produces therapeutic effects in patients with ADHD.
243
What are the major contraindications for Atomoxetine?
Hypersensitivity to the drug, Concomitant sue of MAOIs or use within 2 wk, Narrow-angle glaucoma, Pheochromocytoma,
Severe cardiac or vascular disorders in which condition would be expected to deteriorate with clinically important increases in BP or HR
244
What are the black box warnings for Atomoxetine?
Suicidality in children
and adolescents
245
What are the common adverse drug reactions for Atomoxetine?
Abdominal pain, Headache,
Insomnia, Loss of appetite, Nausea, Weight loss, Xerostomia
246
What are the rare but serious adverse drug reactions for Atomoxetine?
Dyskinesia, Mania,
Prolonged QTc interval, Psychotic disorders, Seizure, Suicidal thoughts, Sudden cardiac death,
Tachycardia, Hepatotoxicity
247
What are the key counseling points for Atomoxetine?
Avoid activities
requiring mental alertness or coordination until drug effects are realized. Growth rate and weight may need to be monitored more frequently in children. Report new or worsened psychiatric problems, chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmias, MI, or cerebrovascular accident. Do not open cap-
sules as atomoxetine is an ocular irritant.
248
What is the brand name for Buspirone?
BuSpar
249
What drug class is Buspirone in?
Antianxiety
250
What is the indication for Buspirone?
Anxiety
251
What is the mechanism of action of Buspirone?
Selective serotonin
5-HT1A receptor partial agonists. It also has some effect on dopamine-D2 auto-receptors and, like antidepressants, can downregulate ²- adrenergic receptors. Unlike
benzodiazepines, it lacks amnestic, anticonvulsant, muscle relaxant, and hypnotic effects.
252
What are the major contraindications for Buspirone?
Hypersensitivity
253
What are the black box warnings for Buspirone?
None
254
What are the common adverse drug reactions for Buspirone?
Dizziness
255
What are the rare but serious adverse drug reactions for Buspirone?
Mania, Psychiatric disorder
256
What are the key counseling points for Buspirone?
Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Advise patient that symptomatic improvement may not be seen for a few weeks. Advise patient against sudden discontinuation of drug. Patient may take with or without food but should always take drug consistently. Patient should not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant
use with MAOI.
257
What are the brand names for Lithium?
Eskalith, Eskalith-CR, Lithobid
258
What drug class is Lithium in?
Antimanic
259
What is the indication for Lithium?
Bipolar Disorder
260
What is the mechanism of action of Lithium?
Alters the actions of several
second-messenger systems (e.g., adenylate cyclase and phosphoinositol). Alters
cation transport across cell membrane in nerve and muscle cells and influences reuptake of serotonin and/or norepinephrine; second-messenger systems involving
phosphatidylinositol cycle are inhibited.
261
What are the major contraindications for Lithium?
Severe debilitation, dehydration, or sodium depletion, Significant cardiovascular disease, Significant renal impairment, Concomitant diuretic therapy
262
What are the black box warnings for Lithium?
Lithium level monitoring required
263
What are the common adverse drug reactions for Lithium?
Cardiac dysrhythmias, Fine tremor, Hypothyroidism, Leukocytosis, Thrombocytosis, Xerostomia
264
What are the rare but serious adverse drug reactions for Lithium?
Hypotension, Nephrotoxicity, Seizure, Hypercalcemia, Hyperparathyroidism
265
What are the key counseling points for Lithium?
An FDA-approved patient
medication guide must be dispensed with this medication. Swallow extended-re-
lease tablets whole; do not crush or chew. Avoid activities requiring mental alertness
or coordination until drug effects are realized. Report signs/symptoms of toxicity,
which may vary depending on the degree of toxicity. These may include diarrhea,
vomiting, tremor, ataxia, drowsiness, muscle weakness, lack of coordination, gid-
diness, blurred vision, tinnitus, or large volumes of dilute urine. Maintain adequate
fluid intake and normal salt intake.
