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58 Cards in this Set
- Front
- Back
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what is the most important neurotranmitter when it comes to depression?
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serotonin 5ht...also other catecholamines (dopamin, Nepi, epi)
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There is no way to measure the levels of NT so treatment is mainly a good assessmnte ant trial and error
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k
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4 classes of drugs that can cause or worsen depression (important)
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CV (BB, clonidine, methyldopa, procainamide, reserpine), hormonal (anabolic steroids, corticosteroids, estrogen or prog), cns (barbs, benzos, ethanol), other (indomethacin, interferon, narcotics)
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If a patient is having suicidal ideation how do we deal with them?
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ER
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which SSRI has thelongest Half life and CAN be stopped suddenly?
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fluoxetine
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what is the SE pneumogram for paroxetine?
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flat and fat (flat affect and weight gainO...anticholinergic
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what are other SE of SSRI's
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decreased libido, ejaculation diff, anorgasmia, GI effects, restless legs, HA
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what is the dose conversion of paroxeting IR to ER?
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10 ir is 12.5 CR
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citalopram brand
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celexa
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escitalopram brand
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lexapro
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MAOI inh and ssri inxn, how long washout for going to maoi FROM fluoxetin?...ho wlong if going from maoi to fluoxetine?)
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5 weeks...2 weeks
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ssri inxn with warf?
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increase bleeding risk
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Venlafaxine brand
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effexor
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typical dosing of fluox
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10-40
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typical dosing of paroxeting IR, CR
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10-40...25-62.5
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typical dosing of sert and citaloprma and escital?
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50-200...20-40...10
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which SNRI is good if pt also has pain?
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duloxetine (cyumbalta)
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Venlafaxin SE
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GI, increase in BP, insomnia
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what is the SE profile of duloxetine related to?
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antichol
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brand of desvenlafaxine?
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pristiq
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common SE to all SNRI's
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sexual SE, increased Sweating, restless leg
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washout period for maoi?
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2 weeks going both ways
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what is the major cyp for the ssri and snri?
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2d6 (duloxetine..
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tricyclics moa?
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sert and NE and ACH and histamin inh
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the 2 main teriarty amines? seconaray amines?
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amitrypt, doxepin, nortripytline
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amitriptyline brand, doxepin, nortrypt
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elavil, sinequan, pamelor
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SE of the tricyclics?
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prolonged QT interval (can be used for suicide)..orthohypo...antichol...vividreams
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inxn with maoi?
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hypertensive crisis...2 week washout either way
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Cyps for tricyclics..and ssri and snri?
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2d6
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general practitioner would rarely prescribe moais, only psychiatrist
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k
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name the 3 moai's
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isocarboxazid (marplan), phenelzine (nardil), tranylcypromide (parnate)
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SE of the moa
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htn crisis with inxns, antichol, ortho hypo, sedation, sexual dysfunction
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WAtch tyramine and mao
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k
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what does bupropion do to weight?
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neutral
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what is the brand for bupropion when used for smoking?
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zyban...as opposued to wellbutrin
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What main risk does bupropion carry?
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seizure at high doses
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what is the max dose for buproion?
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450mg/day
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what property does mirtaz have that makes it great for the elderly who have depressoin?
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SEDATION and WEIGHT GAIN
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what SE for trazodone
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emergency pripaism, SEDATION
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what is the unique SE of nefazodone?
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hepatoxicity
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when is aripiprazole and olanzapin/fluoxetine indicated?
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treatment resistant depression and suicidal ideation pts
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what are the major se with aripip and olanzapine?
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metabolic issues
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brand of aripiprazole?
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abilify
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what is the treatment timeline for alzheimers pts?
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progression regardless of treamtne
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pathophys of alzhe
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neuritic plaques and tangles in brain tissue, alter NT (lower acetylcholinelacetylcholinesterase inh donepezil)) amyloid
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other meds for alz
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Vit E sometime tried, but carries a risk, ginkgo for memory, no benefit, do not recommend (increased bleeding risk)
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drugs that can worsen dementia?
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antichol, anti histamine, antiemetcis, antipsych, barbs, benzos, muscle relaxants, tricyclic antidep
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donepezil moa
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acetylcholinesterase inh
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donepezil brand?
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aricept
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donepezil se
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bradycardia, fainting, GI, make sure you titrate dose upward
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what sort of medications are rivastigmine (exelon) and galantamine (razadyne)?
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acetylcholinesterase inh
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why is tacrine not used? its an acethylcholinesterase inh
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hepatotoxic
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MOA of memantine?
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blocks nmda (which inh glutamine
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when is memantin indicated?
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mod to severe ADqdo
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dosing consideratoien for memantine
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CrCl
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donepezile is taken at night to help wthe nausea
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k
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all the alz meds will be gradually increased
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k
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