Psych Review Rx Flashcards

(38 cards)

1
Q

Classes of Medications

A

Antidepressants

Anxiolytics

Antipsychotics

Mood Stabilizers

Stimulants

Dementia Medications

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2
Q

Classes of Antidepressants

A

Selective Serotonin Reuptake Inhibitor (SSRI)

Serotonin Norepinephrine Reuptake Inhibitor (SNRI)

Tricyclic Antidepressants (TCA)

Dopamine

Other

MAOI

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3
Q

SSRIs

Special Considerations

A
Fluoxetine (Prozac)
 - PMDD
 - Longest Half Life
Sertraline (Zoloft)
 - *OCD (high doses)
Citalopram (Celexa)
Escitalopram (Lexapro)
Paroxetine (Paxil)
 - Weight gain more likely
 - Discontinuation syndrome likely
 - Teratogenic
Fluvoxamine (Luvox)
 - Shortest Half life
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4
Q

SNRIs

A

Venlafaxine (Effexor)

Desvenlafaxine (Pristiq)

Duloxetine (Cymbalta)

Milnacipran (Savella)

Levomilnacipran (Fetzima)

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5
Q

Appropriate Diagnosis

SNRI

A

Major Depressive Disorder

Anxiety Disorders

Adjustment Disorder

Neuropathic Pain

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6
Q

SNRIs

Special Considerations

A

Venlafaxine (Effexor)

  • Withdrawal Syndrome
  • Hypertension
  • Hyperkalemia

Desvenlafaxine (Pristiq)

Duloxetine (Cymbalta)

  • Diabetic Peripheral Neuropathy
  • Fibromyalgia
  • Musculoskeletal pain
  • Osteoarthritis

Milnacipran
- Fibromyalgia

Levomilnacipran
- Major Depressive Disorder

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7
Q

TCA’s

A
Amitriptyline
Amoxapine
Clomipramine
Desipramine
Doxepin
Imipramine
Nortriptyline
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8
Q

Appropriate Diagnosis

SNRI

A

Major Depressive Disorder

Obsessive Compulsive Disorder

Anxiety Disorders

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9
Q

TCA Special Considerations

A

Amitriptyline

  • Sleep
  • Migraines

Amoxapine

Clomipramine
- OCD

Desipramine

Doxepin
- Puritis

Imipramine
- Enuresis

Nortriptyline

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10
Q

Dopamine Acting Antidepressants

A

Bupropion (Wellbutrin)

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11
Q

Appropriate Diagnosis

Bupropion

A

Major Depressive Disorder

Nicotine Addiction*

Bipolar Depression

Sexual Dysfunction*

Adult ADHD

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12
Q

Bupropion Special Considerations

A

Avoid in seizure disorder

Avoid in eating disorders

Can add to other serotonergic antidepressants

Also has action on norepinephrine

Not associated with weight gain

Helpful to treat multiple problems at once

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13
Q

Other Antidepressants

A

Mirtazapine (Remeron)

Trazodone (Deseryl)

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14
Q

Appropriate Diagnosis

Other Antidepressants

A

Major Depressive Disorder

Anxiety Disorders

Insomnia

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15
Q

Other Antidepressants Special Considerations

A

Mirtazapine

  • Appetite Stimulant
  • Antiemetic
  • More sedating at lower doses

Trazodone

  • At doses required for depression, very sedating
  • Priapism
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16
Q

MAOI

A

MAOI is never the answer

17
Q

Classes of Anxiolytics

A

Antidepressants

Benzodiazepines

Beta-blockers
Propranolol (Non-selective)

Antihistamines
Hydroxyzine (Non-addictive)

Other
Buspirone

18
Q

Benzodiazepines

A
Diazepam (Valium)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Alprazolam (Xanax)
Chlordiazepoxide (Librium)
Oxazepam (Serax)
Temazepam (Restoril)
Midazolam (Versed)
Triazolam (Halcion)
19
Q

Benzodiazepines Special Considerations

A

Clonazepam

  • Longest half life
  • Best for long term prophylaxis

Alprazolam

  • Best for infrequent prn use
  • Addicting

REVERSAL AGENT: Flumazenil

Chlordiazepoxide

  • Etoh Withdrawal
  • Liver impairment

Midazolam

  • No Clinical psychiatric use
  • Shortest half life
20
Q

Classes of Antipsychotics

A

1st Generation (Typical)

2nd Generation (Atypical)

21
Q

1st Generation Antipsychotics

A

*Chlorpromazine (Thorazine)
*Haloperidol (Haldol)
Thioridazine (Mellaril)
Fluphenazine (Prolixin)
Trifluoperazine (Stelazine)
Thiothixene (Navane)
Perphenazine (Trilafon)
Loxapine (Loxitane)
Pimozide (Orap)

22
Q

Appropriate Diagnosis

1st Generation Antipsychotics

A

Schizophrenia

Schizoaffective Disorder

Substance Induced Psychosis

Brief Psychotic Disorder

Psychotic Agitation

BEST for Positive Symptoms

23
Q

2nd Generation Antipsychotics

A
Aripiprazole (Abilify)
Clozapine (Clozaril)
Lurasidone (Latuda)
Paliperidone (Invega)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
24
Q

Appropriate Diagnosis

2nd Generation Antipsychotics

A

Schizophrenia

Schizoaffective Disorder

Substance Induced Psychosis

Mood Stabilizer (mania and depression)

Brief Psychotic Disorder

Psychotic Agitation

25
Second Generation AntipsychoticsSpecial Considerations
Clozapine (Clozaril) - Agranulocystois Risperidone (Risperdal) - Gynocomastia - Galactorhea Olanzapine (Zyprexa) - Weight Gain/Sedation Best for Negative Symptoms ``` Quetiapine (Seroquel) - Sedation Ziprasidone (Geodon) - Weight Neutral - QT Prolongation ``` Aripiprazole (Abilify) - Akesthesia
26
Antipsychotics Side Effects
1st Generation - Neurologic = Tardive Dyskinesia, Dystonia etc. = Often Use Benztropine for side effects 2nd Generation - Metabolic = Weight gain, Diabetes, Hypertension, Hyperlipidemia
27
Mood Stabilizers
Lithium Lamotrigine Valproic Acid Carbamazepine
28
Mood Stabilizers Special Considerations
Lithium - Renal Impairment - Interactions Valproic Acid - Weight Gain - Hepatotoxicity - Teratogenic Lamotragine - Stevens-Johnson Syndrome Carbamazepine - Agranulyocytosis - Induces own metabolism
29
Appropriate Diagnosis | Mood Stabalizers
Bipolar Disorders
30
Sedatives
Zolpidem (Ambien) Zaleplon (Sonata) Ramelteon (Rozerem) Eszopiclone (Lunesta)
31
Appropriate Diagnosis | Sedatives
Insomnia
32
Sedatives Special Considerations
Zolpidem - Odd Behaviors - Addictive Ramelteon - Melatonin based
33
Stimulants
Amphetamine (Adderall) Modafinil (Provigil) Dextroamphetamine (Dexedrine) Methylphenidate (Ritalin, Concerta) Dexmethylphenidate (Focalin) Lisdexamfetamine (Vyvanse) Atomoxetine (Strattera)
34
Appropriate Diagnosis | Stimulants
ADHD Narcolepsy
35
Stimulants Special Considerations
Amphetamine - Addictive - Stunts Growth Modafinil - Addictive - Nacrolepsy Atomoxetine - Not Addictive
36
Neurocognitive Agents
Donepezil (Aricept) Rivastigmine (Exelon) Memantine (Namenda) Galantamine (Razadyne)
37
Appropriate Diagnosis | Neurocognitive Agents
Dementia Mild Cognitive Impairment
38
Neurocognitive Agents Special Considerations
Does not reverse, slows progression