Pscy Meds II

  1. TCAs block which NT(s)?
    Serotonin and Norepinephrine
  2. What class of med is Maprotilin?
    TCA (antidepressant)
  3. This class of drug blocks reuptake of serotonin
  4. Which NTs do MAOIs effect?
    Decrease MAO (which removes norepinephrine, serotonin, dopamine)
  5. What class is Amitriptyline (Elavil)?
    TCA antidepressant
  6. What class is Amoxapine?
    TCA antidepressant
  7. What class is Desipramine (Norpramin)?
    TCA antidepressant
  8. What class is Doxepin (Sinequan)?
    TCA antidepressant
  9. What class is Imipramine (Tofranil)?
    TCA antidepressant
  10. What class is Nortriptyline (Pamelor)?
    TCA antidepressant
  11. What class is Protriptyline (Vivactil)?
    TCA antidepressant
  12. What class is Trimipramine (Surmontil)?
    TCA antidepressant
  13. T or F: It is safe to take TCAs and MAOIs together.
  14. What are cardiac side effects of TCAs?
    Tachycardia/irregular heart rate, orthostatic Hypotennsion
  15. What are sexual side effects of TCAs?
    Impotence, delayed orgasm, low libido
  16. What are GI and urinary side effects of TCAs?
    Dry mouth, constipation, urinary retention, increased appetite (increased weight gain)
  17. What are neurological side effects of TCAs?
    Tremors, increased seizures
  18. Which is less expensive? Which is more effective?

    a. TCAs
    b. SSRIs
    • TCAs less expensive
    • SSRIs more effective
  19. How long does it take for TCAs to work?
    2-4 weeks
  20. What will you assess for early with TCAs?
  21. What are the therapeutic effects of TCAs? (3)
    • 1. Mood elevation
    • 2. Increased interest in daily living
    • 3. Decreased insomnia
  22. Which kinds of Rx drugs will you avoid with someone who is taking TCAs.
    Hypnotics, sedatives, barbiturates d/t increased CNS depression

    MAOIs, PCU d/t increased cardiac dysrhythmias
  23. What class of drug is Citalopram (Celexa)?
    SSRI antidepressant
  24. What class is Escitalopram (Lexapro)?
    SSRI antidepressant
  25. What class is Fluoxetine (Prozac)?
    SSRI antidepressant
  26. What class is Paroxetine (Paxil, Pexeva)?
    SSRI antidepressant
  27. What class is Sertraline (Zoloft)?
    SSRI antidepressant
  28. Will you take SSRIs with or without food? AM or HS? Why?
    With food or at HS if possible d/t neasea
  29. What mental disorders can SSRIs be used for?
    Anxiety, eating disorders, and selected drug use disorders
  30. This class of antidepressant can be used for PMS
  31. This class of antidepressant can be used to prevent headaches
  32. What are cardia symptoms of Serotonin syndrome?
    HTN, tachycardia
  33. What are observable symptoms of Serotonin syndrome?
    sweating, tremors, restlessness, seizures
  34. What are some behavioral symptoms of Serotonin syndrome?
    Anxiety, agitation, confusion, restlessness, lack of coordination
  35. What class is Bupropion (Wellbutrin)?
    Atypical antidepressant
  36. What class is Mirtazapine (Remeron)?
    Atypical antidepressant
  37. What class is Nefazodone?
    Atypical antidepressant
  38. What class is Trazodone (Oleptro)?
    Atypical antidepressant
  39. What are common side effects of atypical antidepressants? (3)
    • 1. dry mouth
    • 2. constipation
    • 3. dizziness
  40. This atypical antidepressant has been linked to seizures and might not be good for those with eating disorders
  41. This atypical antidepressant can ease nicotine cravings and have a loss of appetite.
  42. Ths atypical antidepressant can increase appetite and cholesterol.
    Mirtazapine: the increased cholesterol might need labs
  43. This atypical antidepressant is linked to liver failure
  44. This Atypical antidepressant is linked to priapism and cardiac arrhythmias
  45. What class is Isocarboxazid (Marplan)?
    MAOIs antidepressant
  46. What class is Phenelzine (Nardil)?
    MAOIs antidepressant
  47. What class is Selegiline (Emsam)?
    MAOIs antidepressant
  48. What class is Tranylcypromine (Parnate)?
    MAOIs antidepressant
  49. What are cardiac s/e of MAOIs?
  50. What GI and urinary s/e of MAOIs?
    • Nausea
    • Diarrhea
    • constipation
    • Difficulty starting urine flow
  51. What class of antidepressants were first used?
  52. What is a dangerous side effect of MAOIs and what are its triggers?
    • Dangerous HTN and HA can occur when taken with specific foods or meds:
    • Foods: cheeses, pickled foods, alcohol, chocolate, coffee, bananas, liver, yeast

    Drugs: Amphetamines, Methyldopa, Levodopa, Dopamine, Epinephrine
  53. What is the Tx of MAOI overdose?
    Induce vomiting or gastric lavage
  54. List the things you will monitor during MAOI tx (6)
    • 1. SI
    • 2. BP/P
    • 3. I/O 
    • 4. daily weight and fasting BG
    • 5. Cholesterol (in beginning)
    • 6. Liver fxn
  55. What are mood stabilizers used to treat?
    • Bipolar disorder
    • Also controls hyperactivity and flight of ideas
  56. What class is Lithium?
    Mood stabilizer
  57. What values will you monitor during lithium tx?
    • 1. Lithium levels
    • 2. Fluids
    • 3. Sodium
  58. How often will you monitor Lithium levels? What are ideal levels?
    • Every two weeks, then every 2-3 months (drawn in AM prior to next dose)
    • 0.6-1.2mmol/L
  59. Why should you avoid caffeine when taking lithium
    Caffeine can decrease serum lithium levels
  60. T or F: You want to avoid large sodium intake when taking lithium
  61. What class is Valproic acid (Depakote)?
    Sedating AED (Mood stabilizer)
  62. What class is Carbamazepine?
    Sedatin AED (Mood stabilizer)
  63. What are other uses for AEDs?
    • Anxiolytic
    • Antimannc
    • Sleep promoting
  64. What class is Felbamate?
    Activating AED (mood stabilizer)
  65. What class is Lamotrigine?
    Activating AED (mood stabilizer)
  66. Fill in: Some pts with a seizure disorder might be on ____.
  67. What class is Phenytoin?
  68. What class is Zonisamide?
  69. What class is Topiramate?
  70. What class is Gabapentin?
  71. Phenytoin MIGHT help with ____?
  72. Zonisamide MIGHT help with ____
  73. Toiramate MAY improve ______
    mania, might help with eating disorders, PTSD, social phobia
  74. What are uses for gabapentin?
    Great for anxiety and might be effective for mood disorders
  75. What class is Carbamazepine?
  76. What is Carbamazepine indicated for?
    • Effective for mania and bipolar
    • possibly some borderline personality and impulse control
  77. What are metabolic considerations for Carbamazepine?
    Completely absorbed in blood stream, metabolized in liver, crosses BBB
  78. What labs will you lookf or with Carbamazepine?
    • CBC weekly for first two months
    • BUN
    • liver/thyroid
    • Cholesterol
    • Electrolytes and possible ECG
    • Serum levels (4-12mg/L)
  79. What symptoms will you watch for with Carbamazepine?
    • fever
    • sore throat
    • mouth ulcers
    • bruising
Card Set
Pscy Meds II
lecture notes