DL - Final 2

  1. The first time that you fill an antidepressant, you should ask the patient what?
    • “Are you thinking about harming or killing yourself?”
    • If the risk is significant, the patient should be referred immediately to an appropriate health care professional.
    • You can continue to ask in future situations
    • Document interactions
  2. What are the SSRIs?
    • Citalopram (Celexa®)
    • Escitalopram (Lexapro®)
    • Fluoxetine (Prozac®)
    • Paroxetine (Paxil®)
    • Sertraline (Zoloft®)
  3. How should you instruct patients about antidepressant use?
    • 4 weeks or longer for effect
    • Continue taking even if not feeling better right away
    • Watch for worsening or changes in feelings
    • Do not suddenly stop – talk to doc first
    • Drowsiness or dizziness
    • Avoid alcohol
    • Black Box Warning and Med Guide
  4. How do SSRIs compare to TCAs?
    • Less:
    • Sedation
    • Anticholinergic
    • Cardiovascular
  5. When given with what other drugs can SSRIs cause Seratonin Syndrome?
    • Triptans
    • St. John's Wort
    • Amphetamines
    • MAO inhibitors
    • sibutramine
    • dextromethorphan
    • cocaine
    • Meperidine
    • buspirone
    • lithium
    • Nefazodone
    • Taking SSRIs alongside many similar drugs can make new bad listeners
  6. What are the general Disadvantages of SSRIs?
    • Serotonin Syndrome
    • CYP interactions
    • GI
    • HA/ Tremor
    • (Last two are transient)
  7. What are the dosages forms available for Zoloft?
    • 25, 50, 100 mg
    • 20 mg/mL oral concentrate
  8. How many active metabolites does Zoloft have?
    One less active metabolite
  9. What DDIs does Zoloft have?
    2D6 (less than Fluoxetine or Paroxetine)
  10. What is Zoloft approved to treat?
    • Major Depression
    • OCD
    • Panic disorder
    • PMDD
    • PTSD
    • Social anxiety
  11. What special information should you tell a patient about Zoloft?
    • QAM
    • Take w/ food to decrease GI upset
    • Oral solution: dilute right before admin in >4 oz beverage
    • Beverage must be: Ginger ale, water, lemon lime soda, lemonade, orange juice
  12. What should you know about the pharmacokinetics of Zoloft?
    • Elderly clear it 40% less
    • Dose reduce in liver failure due lengthened t1/2
    • Unchanged kinetics in moderate – severe renal impairment
  13. What are the dosage forms available for Celexa?
    • 10, 20, 40 mg tabs
    • Oral solution 10mg/5 mL
  14. How/When should Celexa be given?
    Morning or evening w/ or without food
  15. What are the dosage forms available for Lexapro
    5,10,20 mg, 5mg/5ml solution
  16. How/When should Lexapro be given?
    • QD
    • with or without food
    • morning or night
    • Nausea is problematic = take after a meal
    • Take with a full glass of water
  17. What special information should you counsel a patient on regarding Lexapro?
    Tablets are scored and may be cut in half if needed
Card Set
DL - Final 2
DL - Final