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44 Cards in this Set
- Front
- Back
Least anticholinergic TCA's
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Desipramine
Nortriptyline |
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TCA with least orthostatic hypotension
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Nortriptyline
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Tertiary amine preferentially work on which amine
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Serotonin (esp clomipramine)
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Secondary amine act more on?
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NE (es desipramine)
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Mechanism of Action for Venlafaxine
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SSNRI
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Advantage of Venlafaxine
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10% greater rate of full reminission
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Duloxetine
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Like venalafaxine but more balanced effect on seritonin and norepi
Can be given at full dose initially |
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Uses for Buproprion
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Bipolar Depression
ADHD Smoking Cessation Slightly higher seizure risk than TCA's |
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Use for Buspirone
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Generalized anxiety disorder
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DOC for generalized anxiety disorder
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Buspirone
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Trazadone
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Sedative
Useful in agitated dementia No real side effect issues |
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Nefazodone
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Like traz but with less sedation and REM sleep supression
May cause liver failure so being removed from the market |
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Anti-Depressant with less sedative effects than other.
May have serious side effect |
Nefazodone
Liver failure |
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Carbamazepine
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Mood stabilizer and broad spectrum anti-convulsant. Also works for neuralgia.
Better than Li for mixed states |
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Better than Li for Bipolar with mixed episodes or rapid cycling
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Carbamazepine
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Note as good of a anti-depressant as Li but as good for manic states
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Valproate
Rare side effect of fatal hepatotoxicity, hemorrhagic pancreatitis and agranulocytosis in those under two years of age with other anticonvulsants |
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Don't give this drug to kids under 2 years old, especially if they are on other anticonvulsants
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Valproate
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First approved mantenance tx for bipolar disorder since lithium
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Lamotrigine
may cause rash, Steve-Johnson syndrome Go low and slow |
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Indication for ECT
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Refractory to TX
Need for rapid correction Catatonia Refractory Schizophrenia Pregnant |
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Benzodiazapine antagonist
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Flumazenil
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Flumazenil
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Benzo anatagonist
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Zolpidem
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BZ1 selective
Sedation with little disruption of REM sleep Good for initial insomnia |
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Good for initial insomnia
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Triazolam
Zolpidem |
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Benzo's given IV
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Lorazepam and Midazolam
Lorazepam more reliable for acute anxiety, aggitation Midazolam has shorter half-life, better for anesthesia |
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For actuately agitated patients
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Lorazepam IV
can be given with haldol |
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Rapid Onset Benzo's
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Flurazepam, Tempazepam, Quazepam and Triazolam
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Good for middle insomnia
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Flurazepam
Long half life, some residual sedation |
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Best for inital insomnia
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Triazolam
not associated with amnesia dn behavioral changes |
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Bezo'w without active metabolites (for elderly or liver compromised)
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Lorazepam
Oxazepam Tempazepam |
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Best benzo's for routine use
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Lorazepam
Chlordiazepoxide Clonazepam |
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TX for generalized anxiety disorder
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Buspirone (low and slow)
Benzo's TCA's and venalafaxine esp. if previously treated with benzo's |
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Tx for Panic Disorder
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Bezon's acutely, but not monotherapy
Use SSRI or TCA for prophylaxis |
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Tx for Phobic Disorder
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Behavioral Therapy
Benzo for acute Benzo for public speaking SSRI's and MAOI's for Generalized Social Phobia |
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Tx for PTSD
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TCA's and MAOI's 1st Line
Clondine, Naltrxone or Propranolol Lithium and Carbamazepine No Benzo's SSRI's are good, but may induce arousal and anxiety |
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Tx for OCD
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SSRI's
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Best Benzo for Detox
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Clonazepam
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Greatest risk for addiction
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Alprazolam (Xanax)
Short half-life, rapid onset |
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Risk for amnesia
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Triazolam
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Secondary Amines preferentially act on what receptors
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NE more than 5_HT
Desipramine, Nortriptyline |
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Clomipramine preferentially acts on which receptor
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Serotonin
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Venlafaxine preferential action
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SSRI at low dose
More NE action at high dose |
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Duloxetine preferntial action
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5HT, NE equally
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Buspirone MOA
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Pre and Post synaptic Serotonin partial agonist/antagonist
For GAD |
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Trazodone Preference
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Serotonin anatgonist only
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