-
Symbyax
Olanzapine and fluoxetine
-
-
-
Marplan
Isocarboxazid - non selective MAO inhibitor
-
Parnate
Tranylcypromine - non-selective MAO inhibitor
-
Nardil
Phenylzine - non selective MAO inhibitor
-
-
-
Depakene
Valproic acid capsules and solution
-
-
Stavzor
Valproic Acid delayed release capsules
-
-
Sinemet
- Carbidopa/levodopa
- Carbidopa inhibits dopa decarboxylase preventing peripheral metabolism of levo
- 70 to 100 mg of carb required to be effective and decrease nausea
- Nausea, dizziness, orthostasis, dyskinesias, dark urine, unusual sexual urges, used mostly in older adults
- Iron and protein-rich foods can decrease absorption
-
Comtan
- Entacapone
- COMT InhibitorÂ
- Inhibits COMT to prevent peripheral conversion of levodopa, only use with levodopa
-
Stalevo
Levo/carbi/entacapone
-
Mirapex
- Pramipexol - DA agonist
- Start 0.125 mg TID, titrate weekly to 0.5 to 1.5 mg TID
- Drowsiness, nausea, dizziness, orthostasis, hallucinations, dyskinesias, decrease dose if CrCl less than 60
-
Requip
- Ropinorole - DA agonist
- 0.25 mg TID, titrate weekly to 1 to 4 mg TID
-
Neupro
- Rotigotine - patch formulation
- DA agonist
- 1 mg / 24 hours
- Remove prior to MRI
-
Apokyn
- Apomorphine
- DA agonist injection for advanced disease: a "rescue" movement agent for OFF periods
- CI with 5HT-receptor antagonists (like zofran)
- Severe N/V, hypotension (use trimethobenzamide for nausea at least 3 days prior to initial dose)
-
Tigan
- Trimethobenzamide
- For use with apomorphine - start 3 days before and continued for at least first 3 monhts of therapy
-
Symmetrel
- Amantadine
- Dopamine reuptake inhibitor - used in mild disease or for dyskinesias in advanced disease
- 100 mg BID to TID
- Decrease dose in renal impairment
- Nausea, dizzy, lightheaded
-
Eldepreyl
- Selegiline - selective MAO-B inhibitor
- Only has benefit when used WITH levo
- Ensam is a selegiline transdermal patch which is the only formulation used for depression
- 5 to 10 mg daily
-
Ensam
Selegiline transdermal patch for depression
-
Zelepar
- Selegiline ODT formulation for PD
- 1.25 to 5 mg daily
-
Azilect
- Rasagiline
- MAO-B inhibitor
- Rasagiline can used as initial monotherapy or adjunctive with levo
- 0.5 to 1 mg daily in am, can be activating
- When used as monotherapy, can cause HA, joint pain, and indigestion.
- More risk than selegiline for drug and food interactions.
- Drug interactions: meperidine, tramadol, methodone, propoxyphene, dextromethorphan, st jon's wort, mirtazapine, cyclobenzaprine
-
Cogentin
- Benztropine
- Centrally acting anticholinergic
- 0.5 to 2 mg TID
- Used for tremor - avoid in elderly
-
Artane
- Trihexphenidyl
- Centrally acting anticholinergic
- 1 to 2 mg TID
-
Drugs that worsen dementia
Peripheral and central anticholinergics, antihistamines, antiemetics, antipsychotics, barbiturates, benzos, skeltal muscle relaxants
-
Drugs that cause or worsen PD
phenothiazines, FGAs, SGAs, Reglan, cholinesterase inhibitors used for dementia
-
Aricept
- Donepezil
- Acetylcholinesterease inhibitor
- Available ODT
- 5 to 10 mg QHS, new formula is 23 mg daily but this provides little benefit
- GI side effects, given QHS to help with nausea,
-
Exelon
- Rivastigmine
- Available as a patch
- Acetylcholinesterase inhibitor
- 1.5 to 6 mg BID
- 4.6 and 9.5 mg / 24 hour patch
- With food
-
Razadyne
- Galantamine
- Acetylcholinesterase inhibitor
- 4 to 12 mg BID
- ER: start at 8 mg daily, then increase to 16 to 24 mg daily
-
Cognex
- Tacrine
- Acetylcholinesterase inhibitor
- Hepatotoxicity - do not give with hx of tacrine induced jaundice or bilirubin
- 10 to 20 mg bid
-
Namenda
- Memantine
- Blocks NMDA which inhibits glutamate from binding to NMDA receptors, decreases abnormal activation
- 5 to 10 mg BIDÂ or 28 mg daily if XR (start at 7 and titrate weekly)
- GI, HA
- Rare: flu like sx, arthralgia, UTI, urinary retention, small risk of seizures
-
Ritalin
- Methylphenidate IR
- 2.5 to 20 mg tabs
-
Methylin
- Methylphenidate IR
- 2.5 mg to 20 mg tabs
-
Ritalin LA
- Methylphenidate long acting
- 1/2 IR and 1/2 SR
- 10 to 40 mg tabs
-
Ritalin SR
- Methylphenidate sustained release
- 20 mg SR tabs
-
Metadate ER
- Methylphenidate EXt Release
- 10 to 20 mg ER tabs
-
Quillivant XR
Methylphenidate XR oral suspension
-
Concerta
Methylphenidate IR with OROS system
-
Metadate CD
Methylphenidate IR with beads that dissolve at different rates
-
Daytrana
Methylphenidate transdermal patch
-
Focalin
- Dexmethylphenidate
- 2.5 to 10 mg tabs for IR
- 5 to 20 mg caps for ER
-
Adderall
Dextroamphetamine and amphetamine mixed salts
-
Dexedrine and dextrostat, ProCentra
- dextroamphetamine IR
- Available as dexedrine spansules
-
-
ADHD meds that can be mixed with apple sauce
Focalin XF, Ritalin LA, Metadate CD, Adderall XR
-
Strattera
- Atomoxetine
- 40 to 80 mg capsules, occassionally up to 100 mg
- Black Box, suicide, liver injury, CV problems, glaucoma
- GI fatigue
-
Intuniv
- Guanfacine XR
- Daily start at 1mg, go up to 4
-
Kapvay
- Clondine XR
- Start at 0.1 mg QHS, titrate weekly
- Rebound HTN is stopped abruptly, extended Release formula is supposed to have fewer SE
-
Provigil
- Modafinil
- 200 mg daily
- HA, dizzy, anxiety, agitation, rash
-
Nuvigil
- Armodafanil
- 150 to 250 mg daily
-
Medications that can cause or worsen depression
- Beta blockers, especially propranolol
- Clonidine
- Steroids
- Cyclosporine
- Ethanol
- Isotretinoin
- Indomethacin
- Interferons
- Methadone
- Methyldopa
- Oral contraceptives
- Stimulants
- Procainamide
- Reserpine
- Statins
- Varenicline
-
Meds that can worsen anxiety
- Albuterol if swallowed
- Abilify
- Caffeine
- Stimulants
- Decongestants
- Bupropion
- Fluoxetine
- Illicit drugs
-
Inderal
- Propranolol for stage fright
- 10 to 40 mg 1 hour prior to event
- Non selective beta blocker so avoid with asthma and COPD
-
-
Xanax
- Alprazolam
- 0.25 o 2 mg prn
-
-
Klonopin
- Clonazepam
- 0.125 to 2 mg prn
-
-
Valium
- Diazepam
- 3.75 to 15 mg prn
-
-
-
Buspar
- Buspirone
- 5HT1 Partial Agonist
- Start 7.5 mg BID can increase by 5 mg / day every 2 to 3 days until 30 mg / day
- Decrease dose with dilt, verap, erythro
-
Ambien
- Zolpidem
- 5 to 10 mg QHS
- Do not take with fatty foods, a heavy meal
- May cause parasomnias
-
-
-
Rozerem
- Ramelteon
- Melatonin Receptor Agonist
- Do not take with fatty food
- 8 mg QHS
-
Silenor
- Doxepin ER
- 6 mg QHS or 3 mg if greater than 65 years
- Used for difficulty staying asleep
-
Edluar SL and Intermezzo SL
- Zolpidem SL
- Intermezzo SL for night time awakening
-
Antacids
- Aluminum causes constipation
- Magnesium causes diarrhea - think magnesium citrate
- Al and Mg can accumulate with CrCl less than 30
-
Duexis
Famotidine and Ibuprofen
-
Pepcid
- Famotidine
- 10 and 20 OTC strength 20 and 40 RX strength
-
Zantac
- Ranitidine
- OTC 75 and 150
- RX 300
-
Axid
- Nizatadine
- OTC 75
- RX 150 and 300
-
Tagamet
- Cimetidine
- OTC 200
- RX 300 400 and 800
-
PPIs
- Prilosec
- Zegerid
- Protonix
- Prevacid
- Dexilant
- Nexium
- Vimovo
- Aciphex
- Do not crush or chew pantoprazole or rabeprazole tablets or capsules
- Esomeprazole and Pantoprazole available as injection
-
Cytotec
- Misoprostol
- 100 mcg after dinner, then 100 mcg or 200 mcg QID
- Preg cat X
- Diarrhea, ab pain
-
Carafate
- Sucralafate
- 1 g tab QID before meals and at bedtime
- Avoid in severe renal disease
- May cause constipation
-
Reglan
- Metoclopramide
- 10 mg QID before meals and at bedtime
- Decrease dose when CrCl less than 40
-
Citrucel
- Methylcellulose
- Bulk laxative
-
FiberCon
- Calcium Polycarbophil
- Bulk laxative
-
-
-
-
-
Relistor
- Methylnaltrexone
- Blocks opioid receptors in the gut to relieve constipation - only for use with opioids after failure with colace and stimulant
-
Milk of Magnesia
- Magnesium salts
- Salts retain fluid in the bowel lumen with net increase of fluid secretions in the small intesting
-
Golytely, Miralax, Carbowax
- Polyethylene glycol
- Hyperosmotic
-
Amitiza
- Lubiprostone
- Activates chloride channels in the gut leading to increased fluid in gut and movement
- 24 mcg capsule BID with food
-
Pepto Bismol
- Bismuth subsalicylate
- DOn't give to children
- SE include black tongiue, rarely tinnitus
-
-
Lomitil
- Diphenoxylate 2.5 mg withatropine 0.025 mg
- mac 20 mg / day
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