Podcast
Questions and Answers
What potential cardiac risk is associated with certain antidepressants?
What potential cardiac risk is associated with certain antidepressants?
Which dietary consideration is essential for patients taking MAO inhibitors?
Which dietary consideration is essential for patients taking MAO inhibitors?
Which mechanism of action characterizes atypical antidepressants like Bupropion?
Which mechanism of action characterizes atypical antidepressants like Bupropion?
What adverse effect is commonly associated with first-generation antipsychotics?
What adverse effect is commonly associated with first-generation antipsychotics?
Signup and view all the answers
What is a primary reason MAO inhibitors are not commonly prescribed as a first-line treatment for depression?
What is a primary reason MAO inhibitors are not commonly prescribed as a first-line treatment for depression?
Signup and view all the answers
Which of the following statements about Ketamine is correct?
Which of the following statements about Ketamine is correct?
Signup and view all the answers
What is a significant consideration when prescribing Bupropion?
What is a significant consideration when prescribing Bupropion?
Signup and view all the answers
What is a primary concern when using stimulants like methylphenidate?
What is a primary concern when using stimulants like methylphenidate?
Signup and view all the answers
What is a common desired effect of Trazodone when used in mildly depressed clients?
What is a common desired effect of Trazodone when used in mildly depressed clients?
Signup and view all the answers
Which of the following is a contraindication for levodopa/carbidopa use?
Which of the following is a contraindication for levodopa/carbidopa use?
Signup and view all the answers
What is a significant risk associated with chronic use of methylphenidate?
What is a significant risk associated with chronic use of methylphenidate?
Signup and view all the answers
Which medication is recognized for its potential to increase norepinephrine in treating ADHD?
Which medication is recognized for its potential to increase norepinephrine in treating ADHD?
Signup and view all the answers
What adverse effect is commonly associated with non-stimulant treatments for ADHD?
What adverse effect is commonly associated with non-stimulant treatments for ADHD?
Signup and view all the answers
Which of the following conditions does levodopa/carbidopa primarily treat?
Which of the following conditions does levodopa/carbidopa primarily treat?
Signup and view all the answers
What is a known side effect of stimulant medications that can impact overall health?
What is a known side effect of stimulant medications that can impact overall health?
Signup and view all the answers
Which medication class has a small risk of severe liver injury?
Which medication class has a small risk of severe liver injury?
Signup and view all the answers
What significant risk is associated with Clozapine that necessitates careful monitoring?
What significant risk is associated with Clozapine that necessitates careful monitoring?
Signup and view all the answers
Which of the following atypical antipsychotics is associated with the lowest risk of cardiometabolic side effects?
Which of the following atypical antipsychotics is associated with the lowest risk of cardiometabolic side effects?
Signup and view all the answers
What is a major contraindication for using certain antipsychotics in patients?
What is a major contraindication for using certain antipsychotics in patients?
Signup and view all the answers
Which mechanism of action is shared by Clozapine and other second-generation antipsychotics?
Which mechanism of action is shared by Clozapine and other second-generation antipsychotics?
Signup and view all the answers
In prescribing carbamazepine, screening for which genetic variant is essential to avoid severe skin reactions?
In prescribing carbamazepine, screening for which genetic variant is essential to avoid severe skin reactions?
Signup and view all the answers
What is a common adverse effect associated with many second-generation antipsychotics?
What is a common adverse effect associated with many second-generation antipsychotics?
Signup and view all the answers
What condition does Phenytoin primarily treat?
What condition does Phenytoin primarily treat?
Signup and view all the answers
Which of the following is NOT a common side effect of second-generation antipsychotics?
Which of the following is NOT a common side effect of second-generation antipsychotics?
Signup and view all the answers
Study Notes
Benzodiazepines
- Alprazolam (Xanax) works quickly with a moderate half-life. It's often the most addictive.
- Lorazepam (Ativan) is commonly used for anxiety, but has a slower onset and shorter half-life.
- Diazepam (Valium) has a longer half-life and is used to help reduce spasms and decrease seizure activity.
- Indications include anxiety, seizures, and PD. Used for immediate relief from acute anxiety attacks.
- MOA: Boosts the effect of the neurotransmitter GABA.
- Safety/Contraindications/D2D: Contraindicated in pregnancy. Caution in those with sleep apnea or a history of alcohol or substance abuse. Combining benzos with opioids or alcohol can cause severe respiratory depression and death.
- Special: Schedule IV drugs. Routine daily use leads to physical dependence & is discouraged. Discontinuing use should be tapered over many weeks, as abrupt discontinuation can lead to seizures.
SSRIs
- Escitalopram (Lexapro), paroxetine (Paxil), citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft) are used to treat anxiety and depression.
- Indications: GAD, SAD, PTSD, PD, OCD
- MOA: Block serotonin reuptake, increasing serotonin concentration in the synapse and increasing activation of postsynaptic serotonin receptors.
- Safety/Contraindications/D2D: Abrupt discontinuation may cause withdrawal symptoms. Serotonin syndrome (rare but serious) can occur. Increased suicidal ideation in first 2-3 weeks.
- Special: Zoloft, Paxil, Fluvoxamine are safe during breastfeeding. Avoid Paxil during pregnancy; Prozac is the most studied for use in children.
SNRIs
- Venlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine SR (Pristiq) are all treatments for depression and anxiety.
- Indications: AD, PD, PTSD
- MOA: Increase serotonin and norepinephrine levels.
- Safety/Contraindications/D2D: Venlafaxine should be avoided with MAOIs.
- Special: Venlafaxine can be used for post-menopausal hot flashes.
Anxiolytic
- Buspirone (BuSpar) is used to treat anxiety.
- MOA: Not a CNS depressant; unknown mechanism of action.
- Safety/Contraindications/D2D: Takes several weeks to work. Not for PRN (as needed) use. No abuse potential. Interactions with other medications include Erythromycin, Ketoconazole, and grapefruit juice.
- Side effects: Dizziness, nausea, headache, drowsiness.
Antihistamine
- Hydroxyzine (Atarax, Vistaril) is an antihistamine used to treat anxiety and insomnia.
- MOA: Antihistamine
- Safety/Contraindications/D2D: Anticholinergic side effects. Use with caution in the elderly. It does not have abuse or addiction concerns.
Beta Blocker
- Propranolol (Inderal) is used to treat performance anxiety.
- MOA: Decreases symptoms caused by autonomic hyperactivity, such as tremors, sweating, tachycardia, and palpitations.
- Safety/Contraindications/D2D: Should not be used in patients already taking beta-blockers or other cardiac medications.
St. John's Wort
- Used to treat sleep, anxiety, and improve mood.
- Safety/Contraindications/D2D: Many drug interactions, including triptans, benzos, contraceptives, digoxin, SSRIs, and antibiotics.
- There is a risk of severe phototoxic skin reactions.
Sedative Benzodiazepines
- Estaizolam (ProSom), flurazepam (Dalmane), temazepam (Restoril).
- Indications: Sleep
- Safety/Contraindications/D2D: Short-term use only (10 days maximum). Risk for dependence. Contraindicated in elderly due to increased risk of cognitive impairments, falls and fractures. Rapid dose decreases can cause withdrawal symptoms.
Non-benzodiazepines
- Eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).
- Indication: Sleep.
- Special Use: Lunesta is the only one recommended for long-term use.
Melatonin Agonist
- Ramelteon (Rozerem).
- Indications: Sleep
- MOA: Activates melatonin receptors
- Safety/Contraindications/D2D: May increase prolactin levels and decrease testosterone. Interactions with fluvoxamine and hepatic impairment. Contraindicated in pregnancy and lactation.
Other considerations
- TCAs (Tricyclic antidepressants): Amitriptyline, Clomipramine, Doxepin, Imipramine.
- MAO Inhibitors: Isocarboxazid, Phenelzine.
- Atypical antidepressants: Bupropion (Wellbutrin), Trazodone.
- Ketamine.
- Brexanolone (Zulresso).
- First-generation/Conventional Antipsychotics: Haloperidol (Haldol), Chlorpromazine.
- Second-generation/Atypical Antipsychotics: Clozapine, Olanzapine, Ziprasidone, and Aripiprazole.
- Iminostilbenes: Carbamazepine (Tegretol).
- Hydantoins: Phenytoin (Dilantin).
- Succinimides: Ethosuximide (Zarontin), Valproic acid (Depakote), lamotrigine (Lamictal)
- Cholinesterase Inhibitors: Donepezil (Aricept)
- NMDA receptor antagonists: Memantine (Namenda)
- Stimulants: Methylphenidate (Ritalin, Concerta), Dextroamphetamine, (Dexedrine).
- Non Stimulants: Atomoxetine (Strattera), Clonidine (Kapvay).
- Dopamine replacement: Levodopa/Carbidopa.
- Dopamine agonists: Nonergot Derivatives and Egot Derivatives.
Anticholinergic Drug
- Benztropine (Cogentin).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers key information on Benzodiazepines, including their effects, indications, and safety measures, as well as an introduction to SSRIs. Test your knowledge on these important classes of medications that are commonly used for treating anxiety and other disorders.
