Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm II > Test 4- Cara > Flashcards

Test 4- Cara Flashcards

(48 cards)

Start Studying
1
Q

receptors for this monoamine NT are found in the gut, blood vessel walls, and brain

A

Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when concentrations of this NT are lowered, concentration and focus can be decreased

A

Norepinephrine (NE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

this NT plays a role in cognition and alertness

A

dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can NT deficits result?

A
  1. ) not enough made
  2. ) chemical precursors (ingredients) are in short supply
  3. ) not enough receptor sites
  4. ) NT being taken up too quickly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GOLD STANDARD of antidepressants due to decreased SE’s and increased safety

A

SSRI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

increased availability of serotonin is available where?

A

to post synaptic serotonin receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Do SSRI’s affect histamine and Ach like TCA’s?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

All SSRI’s are pregnancy category C except….

A

Paroxetine (Paxil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Neonatal complications due to an SSRI include…

A
  • cardiac issues/pulmonary HTN
  • LOW birth weight
  • premature delivery
  • poor neonatal adjustment
  • risks of developmental issues
  • SSRIs are NOT safe in nursing moms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some SE’s of SSRIs?

A
  • weight gain (5 lbs. in a year)
  • nausea
  • vertigo
  • sexual dysfunction
  • suicidal risk
  • sleep disturbance
  • dry mouth and other anti-Ach SE’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient Treatment on an SSRI

A
  • follow up at 4 weeks
  • goal is 70% better in the first month
  • tell patient that treatment is for 6 mo. to 1 year
  • March/April from Sept/October is the best time to taper
  • don’t taper on anniversary of tough event
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

used for bulimia, panic disorder, depression, and OCD (give Sarafem)

first SSRI on the market

long half life

10-60mg daily

A

(Fluozetine) Prozac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

used for depression

results in QT prolongation at 40mg

don’t give more than 20mg to the elderly/OCP/PPI patients (increased arrhythmias)

*stronger anti-cholinergic properties

10-40 mg

A

(Citalopram) Celexa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

used for general anxiety anxiety and depression

less of a tapering, start on 10mg and go with it

may notice relief of symptoms within 1 week

works faster than other SSRIs

dosed 10-20mg daily

A

Escitalopram (Lexapro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

used for depression, PMDD, OCD (high doses), panic/social anxiety, and PTSD

dosing can be difficult

dosed 25-200mg daily

A

Sertraline (Zoloft)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

dosed 10-40 daily

A

Parozetine (Paxil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

used for depression, PMDD, panic disorder, social anxiety, OCD, GAD, PTSD

very sedating and causes weight gain

dosed 12.5-37.5mg daily

A

Paxil CR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

used for OCD

minimial anti-Ach side effects

dosed 100-300mg daily

A

Fluvoxamine (Luvox)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What drugs do SSRIs interact with?

A

other drugs that increase serotonin

St. John’s Wort

drugs that affect QT intervals

warfarin/digoxin

drugs with CNS affects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SSRI + diuretics =

Study These Flashcards
A

HYPOnatremia

**older patients on an SSRI need to get a sodium reading

21
Q

What drugs result in QT prolongation?

Study These Flashcards
A

Macrolides/Quinolones

Sulfa agents

TCA’s

anti-fungals

anti-arrhythmics

anti-psychotics

22
Q

What are the symptoms of serotonin syndrome?

Study These Flashcards
A

agitation

hyperthermia

hyperactivity

delirium

seizures

HTN

myoclonus

23
Q

How do you treat a patient who is experiencing serotonin syndrome?

Study These Flashcards
A

fluids, hydration, and educate patients on these symptoms

24
Q

an SNRI that is used for depression and GAD

Serotonin affect in low doses, NE affect in high doses

dose from 37.5-300mg

Pregnancy category C and works after 2 weeks

Study These Flashcards
A

Venlafaxine (Effexor, Effexor XR)

25
What are the warning/precautions/SE's associated with Effexor?
**associated with sustained HTN may lower seizure threshold suicide risk in teens overall benefits>risks in patients (especially with recent MI) Adverse Reactions: dizzy, bad dreams, tremor, nervousness, weight changes
26
All SSRI/SNRI patients need to be careful with _______ intake and not be on a __________
alcohol MAOI
27
What special issues must be considered with a patient on Effexor?
take with or w/o food caution with alcohol ***monitor BP regularly titrate up and down
28
SNRI dosed 20mg (60 max) PO BID often used for Fibromyalgia too
Cymbalta (Duloxetine)
29
a newer and more costly SNRI that does NOT need titration taken as 50mg daily
Pristiq (Desvenlafaxine)
30
Venlafaxine off label is used for....
1. ) hot flashes 2. ) neuropathy 3. ) insomnia
31
SNRI for FIBROMYALGIA, not depression CI in HTN, liver/renal patients, alcohol abuse, suicidality, seizures, and bleeding disorders nausea is the MC side effects, increased HR and palpitations too interacts with diuretics, NSAIDs, and other anti-depressants
Milnacipran (Savella)
32
indicated for depression and SAD **inhibitor of NE and dopamine reuptake pregnancy category C that takes greater than 2 weeks via a tablet, sustained, or extended release tablet Zyban is used for smoking cessation
(Buproprion) Wellbutrin
33
What are the contraindications for Wellbutrin?
***seizure disorder use with MAOIs prior diagnosis of bulimia or anorexia
34
What are the SE's associated with Wellbutrin?
agitation/insomnia N/V/C weight loss tremor/hallucinations/fatigue
35
the effect of Wellbutrin is increased with __________
Levodopa
36
What special issues go along with Wellbutrin?
do not D/C drug without calling provider no excessive alcohol monitor body weight used in same doses for smoking cessation (caution if on nicotine)
37
What are the benefits of Wellbutrin?
weight loss no anti-Ach SE's no sexual SE's no orthostasis/BP problems more elevating that sedating
38
a tetracyclic that is dosed 15-45 mg at BEDTIME impacts Histamine, Serotonin/NE receptors Preg Cat. C SEs: weight gain, fatigue, dizziness (worry about falls), dry mouth, constipation, BP changes
Mirtazapine (Remeron)
39
serotonin modulator that acts PREsynaptically indicated for depression and commonly used for insomnia SE: hypotension, N/V, mild anti-Ach, sedation, nightmares warnings regarding suicidality in teens and post MI **ADVERSE RXN: arrhythmias and priapism
Trazodone
40
approved for major depression has a duel mechanism less sexual SE's, more GI SE's, weight neutral tapering schedule of 10mg, 20mg, and 40mg
Vilazodone (Viibryd)
41
serotonergic antidepressant with an unclear MOA may work pre and post synaptically warning for suicidality under age 24 and serotonin syndrome risk
Vortiozetine (Brintellix)
42
known as heterocyclics inhibit a nerves ability to reuptake a neurotransmitter some histamine and serotonin impact HUGE anti-Ach SE's (dry mouth, blurred vision, sedation) adverse reaction of ORTHOSTATIC HYPOTENSION, palpitations, and lowering of the seizure threshold
Tricyclic Antidepressants TCA's
43
(Amitriptyline) Elavil and (Imipramine) Tofranil are both examples of...
TCA's
44
injection or tablet Preg. Cat. D take 7-21 for MOA to kick in CI's: narrow angle glaucoma alternatively used for: migraine prophylaxis, IBS, chronic pain, sleep
TCA's
45
What are warnings associated with TCA's?
cardiac disturbances renal/hepatic impairment ***may give pronounced HYPOtension (fatal) ***arrhythmia (may be fatal) try to avoid in elderly
46
Adverse Reactions of TCA's
drowsiness dizziness HA HYPOtension/palpitations constipation weight gain weakness
47
What drugs should TCA's never be combined with due to increased toxicity?
Clonidine Warfarin ***AntiAch Drugs CNS Depressants SSRI's
48
Special Issues of TCA's
avoid alcohol and caffeine may turn urine blue-green photosensitivity can occur altered sex drive or ability (reversible) ***NEVER ABRUPTLY DISCONTINUE

Pharm II (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions