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dxc358
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Diazepam (Valium)
- Benzodiazepine Muscle relaxant, antispasmodic, sedative (enhances GABA)
- Treats anxiety disorders, muscle spasms, alcohol withdrawal
- Side effects: CNS depression, amnesia,, respiratory depressionPhysical dependence - do not d/c abruptly
- Avoid other CNS depressants
- Antidote: flumazenil (Romazicon)Taper dose to d/c
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Amitriptyline (Elavil)
- Tricyclic antidepressant (TCA)Blocks NE, serotonin reuptake
- Used for depression, migraines
- Can cause orthostatic hypotension, anticholinergic effects, sedation, cardiac toxicity, decreased seizure threshold, sweating
- Avoid St. John's wort (serotonin syndrome, antihistamines, anticholinergics, alcohol, CNS depressants, MAOIs
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Fluoxetine (Prozac)
- SSRI (depression)
- Can cause sexual dysfunction, CNS stimulation, weight loss/gain, serotonin syndrome, withdrawal syndrome, hyponatremia, bruxism, rash, fatigue, GI bleeding
- Do not take w/ MAOIs or TCAs, St. John's wort, lithium
- Caution w/ Coumadin, NSAIDs (suppresses platelet aggregation)
- Take in the morning, takes several weeks for full effects, take w/ food for GI effects
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Lithium
- Mood stabilizer
- Used for bipolar disorder
- Blocks serotonin receptors, decreases neuronal atrophy/increases neuronal growth
- Can cause GI distress, fine hand tremors, polyuria and thirst, weight gain, renal toxicity, goiter and hypothyroidism, bradydysrhythmias, hypotension, electrolyte imbalance
- Early toxicity: N/V/D, thirst, polyuria, muscle weakness, slurred speechLow Na increases toxicity
- NSAIDs increase toxicity
- Avoid anticholinergics
- Normal level 0.4-1.0mEq/L (toxicity > 1.5)
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Valproic acid (Depakote)
- Antiepileptic (also bipolar)
- Can use for absence seizures
- Can cause N/V, hepatotoxicity, pancreatitis, thrombocytopeniaIncreases levels of phenytoin and phenobarbital
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Chlorpromazine (Thorazine)Haloperidol (Haldol)
- Conventional antipsychotic (positive symptoms)
- Block dopamine, ACh, NE, histamine
- Can cause:Acute dystonia (treat w/ anticholinergics - benztropine/Cogentin or Benadryl) - EARLYParkinsonism (treat w/ antcholinergics or amantadine)
- Akathisia (beta blocker, benzodiazepine, anticholinergic)
- EPS or tardive dyskinesia - LATE Neuroleptic malignant syndrome (d/c, antipyretics, Valium, dantrolene)
- Anticholinergic effects, orthostatic hypotension, sedation, gynecomastia, seizures, sexual dysfunction, photosensitivity, agranulocytosis, dysrhythmias
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