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Drug Effects

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oeshnoeugo123's version from 2018-01-09 06:41

Antidepressants

Question Answer
TCAantidepressant drug/category that inhibits the reuptake of NE and 5- HT nonselectively
MAOIantidepressant that interferes with the intraneuronal catabolism of NE and 5-HT by MAO
TCAantidepressant class that interacts the worst with epinephrine
SSRIantidepressant/class that inhibits the reuptake of 5-HT selectively
Fluoxetine (Prozac)relabeled as Serafem and used for PMDD (premenstrual dysphoric disorder)
TCA's In particular Imipramineuseful for the treatment of bedwetting
Mirtazepine (Remeron) - possesses anxiolytic effect. May Improve sleep patterns associated with depressionalpha2, 5HT2 (blocking this - reduce serotonergic side effects of insomnia, agitation, sexual dysfunction), 5HT3 (blocking of this thought to decrease nausea) receptor blocker, NO effect on reuptake of NE or 5-HT.
St. John’s Wortherbal antidepressant
MAOIs - Tranylcypromine (Parnate), isocarboxizid (Marplan), selegilene, Phenelzineantidepressant associated with wine and cheese syndrome
MAOIs - Phenylzine (Nardil)antidepressant which has dangerous interaction with meperidine (aka Demerol - opioid analgesic) - can lead to hyperpyrexia, hypertensive crisis
Lithium, but also - Depakote, carbamazepine (Tegretol)used for the treatment of mania or bipolar affective disorder syndrome
Prozac (Fluoxetine) , Paxil (Paroxetine)SSRI that inhibits cytochrome P450 2D6
Fluoxetine (Prozac)don’t give codeine to someone taking this drug – codeine won’t work
Paroxetine (Paxil)tx social anxiety/panic disorder
LithiumPatty Duke may have been prescribed this for her Bipolar disorder
Valproate Sodium & CARBAMAZAPINEANTICONVULSANT drug used to treat manic depression (bipolar disorder)
Paroxetine (Paxil)approved for social anxiety/panic disorder (SAD)
Sertraline (Zoloft) - atypical 2nd gen antidepressant - SSRIapproved for post traumatic stress disorder (PTSD)
Carbamazepine (Tegretol)antimanic drugs that interacts adversely with erythromycin
Valproate Sodium (Depakote)antimanic agent that can alter blood coagulation
Buproprion (Wellbutrin, Zyban)of the 2nd generation antidepressants this produces the least sexual dysfunction also used for smoking cessation
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Sedation

Question Answer
Oxygenshould be given at end of nitrous procedure to reduce risk of diffusion hypoxia
Zolpidem (Ambien)non-BDZ of imadazopyridine class – short-acting – promoted as sleep aid
BenzodiazepinesEnhances the binding of GABA to its receptor, opens Cl- channel
Lorazepam (Ativan)Benzodiazepine with long duration of effect and profound amnestic effects
Nitrous oxideabsolutely contraindicated in patient with middle ear/inner ear surgery
Midazolam (Versed)Water soluble BDZ with short duration of action
Diazepam (Valium)BDZ that has active metabolites; metabolism through p450 3a4 enzyme
KetamineInduces dissociative anesthesia and weird dreams (emergence phenomena); provides analgesia as well as anesthesia; helps respiration, does NOT depress CV system. Increase HR & SBP
Nitrous oxidegas that should never be given in concentrations of more than 70%, typical effective range 20-50%
Triazolam (Halcion); midazolam (versed) - clinical effect = 1-3hrsvery short acting BDZ
FlumazenilReversal agent for BDZ overdose
SevofluraneGeneral anesthetic gas used to maintain unconsciousness
Methohexitalultra-short acting IV barbiturate agent used to induce unconsciousness in oral surgery
Propofolnewer non-barbiturate IV sedative agent that has the beneficial property of not accumulating in body no matter how long it is given – thus always rapid offset of action – does not cause analgesia
Benzodiazepinesmost frequently used class of drugs for oral sedation and anxiolysis
Benzodiazepines Nitrous oxideContraindicated for patients with severe copd
Ketaminesedative/anesthetic agent that works as a non-competitive NMDA receptor antagonist
Nitrous oxideanesthetic gas that has the highest MAC – minimum alveolar concentration
Nitrous oxideconscious sedation agent that may cause diffusion hypoxia
Nitrous oxidechronic exposure associated with increased rate of spontaneous abortions
Naloxoneused to reverse opioid overdose
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Antipsychotics

 

Question Answer
Haloperidol (Haldol)a selective D2 blocker with weak anticholinergic properties used to treat schizophrenia – Most EPS (due to weak anticholnergic effects) - tardive dyskinesia, Pseudoparkinsonism, Akathisia
Chlorpromazine (Thorazine)a phenothiazine nonselective D1 and D2 blocker used to treat schizophrenia, blocks alpha 1
Dibenzapines -
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Quetipine (Seroquel)
an antipsychotic drug that is a D4 blocker, in addition to D2, 5-HT2, alpha-2 and muscarinic receptors
Clozapine (Clozaril), Olanzapine (Zyprexa)an antipsychotic agent with strong anticholinergic activity; reduced extrapyramidal symptoms
Chlorpromazine (Thorazine)antiemetic agent for chemotherapy
Clozapine (Clozaril)an antipsychotic agent with the dangerous side effect of agranulocytosis
Benztropineanticholinergic agent often combined with antipsychotic therapy to reduce incidence of extrapyramidal symptoms
Clozapine (Clozaril)causes “sialorrhea” or excessive salivation
Risperidone (Risperidal)agents less likely to produce tardive dyskinesia
Atypical antipsychotics - Dibenzapines & Benzisoxazole (Risperidone [Risperidol])antipsychotic agent which antagonizes D2 and 5-HT2 receptors
Olanzapine (Zyprexa)new clozapine-like drug that doesn’t cause excessive salivation or agranulocytosis
Aripipazole (abilify)3rd generation antipsychotic – works as a dopamine receptor partial agonist in addition to antagonist action at 5-HT2A receptors
Mesolimbicdopaminergic tract that is the desired target for antipsychotic drugs to alleviate positive symptoms
nigrostriataldopaminergic tract from which blocking DA receptors causes EPS symptoms
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Drug Facts

Question Answer
Aripiprazole (Abilify) - 3rd gen antipsychoticNew atypical antipsychotic acts as dopamine partial agonist. Net increase in stimulation of dopamine receptors in low dopamine level areas. Reduces dopamine effects in areas of brain with high dopamine levels.
BenztropineAnticholinergic drug given with haloperidol to reduce eps
Bupropion (Wellbutrin)DARI antidepressant – less sexual dysfunction – also sold as ZYBAN for smoking cessation
Carbamazepine (Tegretol)Anticonvulsant sodium channel inactivator (partial seizures), antimanic, trigeminal neuralgia, induces liver enzymes (3A4)
Chlorpromazine1st generation antipsychotic, non-specific D1, D2 blocker. Lots of side effects due to alpha-1 block, antihistaminergic activity and action in all three dopaminergic tracts
Citalopram (Celexa)One of the first SSRIs – new improved version is Lexapro
Clozapine (Clozaril)1st atypical antipsychotic: D2, D4 and 5-HT2 blocker; drooling, agranulocytosis, much less TD and EPS; treats both positive and negative symptoms
Diazepam (Valium, Diastat)BDZ sedative, anti-anxiety, status epilepticus (IV or Diastat rectal gel) – GABA facilitator
Duloxetine (Cymbalta)Newest SNRI
Fluoxetine (Prozac)Original SSRI – 2D6 inhibitor, reduces effect of codeine also sold as Serafem for PMDD
Haloperidol (Haldol)1st generation antipsychotic, lots of EPS tardive dyskinesia; D2 selective blocker; epi reversal
Olanzapine (Zyprexa)Atypical antipsychotic – causes diabetes, excessive weight gain and suicide as side effects; D2, D4 and 5-HT2 blocker; much less TD; treats both positive and negative symptoms
Paroxetine (Paxil)SSRI for depression and social anxiety disorder – 2D6 blocker
PhenobarbitalGABA facilitator; Barbiturate for febrile seizures in kids; induces liver enzymes
Both types of atypical antipsychotics - quetipine &
Risperidone (Risperidal)
Atypical antipsychotic; D2, D4 and 5-HT2 blocker; much less tardive dyskinesia; treats both positive and negative symptoms
Valproate sodiumAntimanic form of valproic acid for rapid cyclers – birth
Venlafaxine (Effexor)SNRI for depression and anxiety – caution with epi
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