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Medications

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kannanmon's version from 2017-05-10 12:33

antidepressants

Question Answer
SSRI1ST line antidepressant Selective seratonin reuptake inhibitor- serotonin syndrome - increased temp muscle rigidity diarrhea,.(when mixed with MAOI)- BLACK BOX warning (due to more energy - mania violent behavior or suicidal behavior especially children)not for preggers or older people - high level of toxicity - diarrhea, tachy cardia, fever seizure, many interactions st john wart. PREFERABLY EVENING (drowsiness )few anticholinergic and sedating effects. GI dysfunction and cns dysfunction. - lorapam, - tine
TCAanother 1st line antidepressant - start low go slow on old people,lots of side effects, most dangerous side effects are cardiovascular, risk in those with cardiac disease. AT NIGHT, -pramine
MAOITyramine diet - avocado, fish, ginseng tea, smoked meat, cheese except cotage, raisins, fermented stuff, yougurt,figs. etc causes hypertensive crisis,
dry mouth, nausea headache - side fx
selegiline patch - 6mg over 24 hrs no tyramine control- 9-12 mg - need tyramine diet. -GIVEN IN THE MORNING can cause insomnia -ine
THERAPEUTIC EFFECT1-3 weeks for EFFECTS
SSRI TO MAOIWAIT 5 WEEKS SSRI - MAOI due to serotonin syndrome
common SSRIfluoxitine ( prozac) setraline ( zoloft)
common MAOISELEGILINE (PATCH)
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Mood stabilizer

Question Answer
Mood stabilizersbipolar - LITHIUM - 1st choice- small therapeutic window - take with meals = prevent nausea, maintain sodium = lower toxicity, toxicity = muscle weakness, slurred speech, diaphoresis, weakness, tremors NO DIURETICS OR NSAIDS = INCREASED TOXICITY- therapeutic range 0.5-1.5, maintenance - .4-1.3, NO PREGGERS. CAFFEINE, increase fluid intake 1-3 weeks to work, weight gain , fine tremors, polyuria etc are common expected side effects
atypical anti-psychotic 2nd generation, can be used with lithium, 1st choice for antipsychotic can be bipolar and schizophrenia - risperidone - orthostatic hypotension decreased seizure threshold anticholinergic effects
lithium is for manic or hypomanic levels
anxiolytics benzodiazepines - zepam - pram and benadryl because addictive, weight gain drowsiness anticholinergic effects, CLONAZEPAM, mood stabilizer, benadryl.
Anticonvulsants "mood stabilizer" - used for rapid cycling paranoid mania(2 mania 2 depression in an year), LAMOTRIGINE - can replace lithium - can cause STEVEN JOHNSON'S syndrome, aseptic meningitis. GABAPENTIN - well known
NON BENZO anxioletic busperone - for anxiety
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antipsychotics

Question Answer
atypical antipsychotic ***bipolar and schizophrenia - 1st line - 2nd generation. treats negative(social withdrawal etc) and positive symptoms (hallucinations, delusions etc) of schizophrenia has metabolic syndrome, weight gain, dyslipidimia, diabetes, atherosclerosis, increase heart disease physique problems, = $$$ less pt adherence can take months for effects, fewer disturbing extra pyramidal effects not with older adults with dementia , anticholinergic effects - sympathetic -fight or flight. risperidone - orthostatic hypotension decreased seizure threshold anticholinergic effects
conventional anti psychotictreats ONLY POSITIVE, have EXTRA PYRAMIDAL SIDE EFFECTS, most cost effective, stop if neuroleptic malignant syndrome occurs, not with older adults with dementia , has anticholinergic effects- sympathetic - fight or flight
clozapine- causes agranulocytosis. atypical antipsychotics
EPS agranulocytosis ( low wbc) pseudo parkinsions, tardive dyskinesia (irreversible - cause social isolation)r, akinesia akasthisia(restless), acute dystonic reaction (drooling and contracture), etc
NMSneuroleptic malignant syndrome characterized by hyperpyrexia (fever), muscular rigidity, altered mental status, and autonomic dysfunction
sedative hypnotics zolperam? - barbituate
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alzehiemer's

Question Answer
nemenda antagonistalzehiemers - nmda receptors - memantine - 1st line for moderate to severe, time limited effect
cholinesterace inhibitor- alzehiemers, delays symptoms - 3ish months, mild to moderate, donapezil - arecept.
namzaricdonepezil and memantine combo
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eating disorder drugs

Question Answer
olanzapine- anorexia - 2nd gen antipsychotic positive for weight gain, and body image, improves cognition - GOLD STANDARD
fluoxitine - has been used for anorexia nervosa but negative effect - SSRI
bulemia nervosa- fluoxitine - GOLD STANDARD FOR bulemia - SSRI
binge eating disorderSSRI - shows some efficiency - topriemate - antiepileptic - causes weight loss and reduce binge eating.
ptsdSSRI
SOMATIC DISORDERSSRI AND benzos
gamblingopioid antagonist - nalmefene
kleptomania, trichotillomania and pathological gamblingSSRI, antidepressant - bupropion AND opioid antagonist - naltrexone
autism spectrumatypical antipsychotics - respidone- resperidal SSRI OR BETA BLOCKER
ADHDnonstimulant - atomoxetine ;;;;; STIMULANT - METHYLPHENIDATE
motor disorder haloperidol - haldol - lower tics,
anxietyssri antidepressant, beta blocker, antihistamines.
ocd relatedssri, SNRI, antidepresent,
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substance abuse any addiction but now for opioid

 

Question Answer
opioid abuse 1st choice narcan(naloxone) - antidote for opioid respiratory distress. short acting
nelmefenesame as narcan - longer half life. prolonged withdrawl
methadoneopioid adiction, long acting, ease withdrawal symptoms for heroine most effective need daily clinical visits
buprenorphinesame as methadone but weaker opioid effects = less likely od
naltraxone USED FOR BOTH - after detox, blocks euphoric effects - causes nausea with alcohol intake
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substance abuse now for alcohol

Question Answer
naltraxone USED FOR BOTH - after detox, blocks euphoric effects - causes nausea with alcohol intake
disulfiranmotivational aid to stay sober - mixing with alcohol causes violent side effects
acamprosatereduces unpleasent symptoms of abstinence of alcohol and cuts cravings
gabapentin treats dependence and relapse of alcohol
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