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Mood Altering Meds
| Question | Answer |
|---|---|
| What is recommended for chronic anxiety? | SSRI's |
| What are the short-acting Benzodiazepines? | Alprazolam (Xanax), 3A4 subs. Oxazepam (Serax) |
| Which Benzos can be used by the elderly patients? | Lorazepam (Ativan) Oxazepam (Serax) Temazepam (Restoril) |
| What is Librium? | Chlordiazepoxide, for alcohol withdrawal |
| What is Buspar? Dosing? Max? | Buspirone Dose: 15mg/day, titrate by 5mg Max: 60mg/day |
| What drug interactions would you look out for with Buspirone? | Avoid use with MAOi & inhibitors (3A4 substrate) |
| What is Celexa? Dose? | Citalopram, 10-60mg/day |
| What is Lexapro? | Escitalopram |
| What is Flouxetine? Dosing? | Prozac, Sarafem 10-80mg QAM |
| What is Luvox? Dosing? | Fluvoxamine, for OCD QHS |
| What is Paxil? Dosing? | Paroxetine 10-80mg QAM Don't DC abruptly = severe anger |
| What is Zoloft? Dose? | Sertraline Max: 200mg QD |
| Major SE for SNRI's? | Hypertension |
| What is Venlafaxine? | Effexor |
| What is Pristiq? Max dose? | Desvelanfaxine Max: 400mg |
| What is the Pristiq dose for renal patients (CrCl <30mL/min)? | 50mg QOD |
| What is Cymbalta? Dose? | Duloxetine Dose: 60mg QD/BID |
| What is the dose for Cymbalta for renal patients (CrCl<30mL/min)? | Avoid in patients with renal, hepatic & high alcohol use. |
| What is Savella? Indication? | Milnacipram, for fibromyalgia |
| List the meds approved for fibromyalgia (3) | Savella (milnacipram) Cymbalta (duloxetine) Lyrica (pregabalin) |
| What is the max dose for regular Bupropion? Bupropion ER? | 450mg/day ER: 300mg/day |
| What is Desyrel? | Trazodone |
| What is Desyrel indicated for and dose? | MDD Sleep: 25-50mg |
| What does Bupropion work on? | Dopamine agonist Norepinephrine agonist |
| What is Serzone? | Nefazodone |
| What is Remeron? | Mirtazipine |
| Remeron SE? | Weight gain Somnolence |
| What is Tofranil? | Imipramine (TCA) |
| What is Elavil? | Amitriptylline (TCA) |
| What is Sinequan? | Doxepin (TCA) |
| What is Anafranil? Indication? | Clomipramine (TCA), for OCD |
| What is Norpramine? Indication? | Desipramine, for ADHD |
| What is Nortriptyline? | Pamelor Aventyl |
| SE of TCA's? | Anti-cholinergic effects CV effects Arrythmia |
| What is Parnate? | Tranylcylpramine (MAOi) |
| What is Nardil? | Phenelzine (MAOi) |
| What is Marplan? | Isocarboxazid (MAOi) |
| Why should Tyramine be avoided when on MAOi meds? | Tyramine releases catecholamines (NE) which results to HTN crisis when combined with MAOi's. |
| What is Emsam? | Selegiline (MAOi) patch, QD |
| What are the anti-psychotics approved for MDD (3)? | Abilify: <15mg Symbyax (Olanzapine + Fluoxetine) Lithium |
| Dosing for Symbyax? | QHS, very sedating |
| What is Bipolar? | Characterized by alternating episodes of Mania (euphoria) and Depression |
| What is Depakote? | Indication?VaLProic acid Indications: migraine, seizure, bipolar |
| What is Zyprexa? | Indication? Max dose?Olanzapine, for bipolar Max: 20mg QD, very long acting |
| What is Equeto? | Carbamazepine, for bipolar & seizure |
| What is Lamictal? Monitor what? | Lamotrigine Monitor liver and watch out for rash! |
| What is Topamax? Indication? | Topiramate, used for seizure and unapproved for bipolar |
| What is Risperdal? | Risperidone |
| What is Ziprasidone? Dose? | Geodon, 80mg BID with food |
| What is Abilify? | Aripiprazole |
| What is Saphris? | Asenaphine, ODT |
| What is the dose of Olanzapine for acute mania? | 10mg IM |
| What is Stavzor? | Valproic Acid |
| Production of _______ goes up with the use of Lithium. | WBC, similar in action to steroids |
| Lithium serum concentrations should be between _________ | 0.6 - 1.2 mmol/L |
| What is the Lithium dose? | 900 - 1800mg div into 3 doses |
| What is the Lithium dose for the Elderly and renally impaired? Serum concentration? | Start: 300mg QD Serum: 0.4 - 0.6mmol/L |
| Therapeutic levels for Lithium? | Acute: 0.8 - 1.5 meq/L Maintenance: 0.6 - 1.2 meq/L |
| Lithium Toxicity S/S? | >1.5 meq/L = tremor, vomiting, ataxia,slurred speech, confusion >2 meq/L = arrhythmias, seizures, coma |
| Monitoring parameters for Lithium | Bun & CrCl Urine specific gravity CBC Electrolytes TSH EKG Glucose |
| What is schizophrenia? | There is too much Dopamine which results to a mental disorder. |
| Diagnostic criteria for Schizophrenia | 2 of the following 5 symptoms - hallucinations - delusions - disorganized speech - disorganized behavior - negative symptoms (symptoms you can see) |
| SE of Anti-psychotics? | Weight gain Anti-cholinergic effects Sedation Hypotension Movement disorders (Tardive Dyskenisia) EPSE Neuroleptic Malignant Syndrome (NMS) |
| What are the EPS? | Dystonia Akathisia Pseudoparkinsonism |
| What is Dystonia? Treatment? | Painful muscle spasm - laryngospasm Benadryl IV 25-50mg |
| What is Akathisia? Treatment? | Restlessness Tx: propranolol 30-100mg |
| What is the treatment for Pseudoparkinsonim? | Increase dopamine or decrease acetylcholine |
| What is Tardive Dyskinesia? | Hypersensitivity due to prolonged blockage of dopamine. Characterized by tongue, lip, jaw & extremity movement |
| What is Neuroleptic Malignant Syndrome? | Depletion of DA in the CNS resulting to RIGIDITY, FEVER, DIAPHORESIS, altered consciousness, INCREASE IN BP & HR |
| What labs do you monitor with NMS? | inc. CPK (muscle breakdown) LFT inc. WBC (CBC) |
| What is Dantrolene? | A muscle relaxant to treat malignant hyperthermia in NMS Tx: 1mg/kg rapid IV push |
| What is Thorazine? | Chlorpromazine |
| What is Mellaril? | Thioridazine |
| That is Trilafon? | Perphenazine |
| What is Stelazine? | Triflouperazine |
Created by:
oparaMK
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