-
phenylzine
MOA:
1) inhibits the enzyme responsible for the breakdown of NE & 5-HT
2) results in increased NE, 5-HT, & Dopamine (DA)
Monoamine Oxidase Inhibitor (MAOI)
-
tranylcypromine
MOA:
1) inhibits the enzyme responsible for the breakdown of NE & 5-HT
2) results in increased NE, 5-HT, & Dopamine (DA)
Monoamine Oxidase Inhibitor (MAOI)
-
Sinequan
MOA:
1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings
(results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
doxepin
Tricyclic Antidepressants (TCAs)
* not 1st line due to toxicity
-
Tofranil
MOA:
1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings
(results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
imipramine
Tricyclic Antidepressants (TCAs)
* not 1st line due to toxicity
-
Pamelor
MOA:
1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings
(results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
nortipyline
Tricyclic Antidepressants (TCAs)
* not 1st line due to toxicity
-
Ascendin
MOA:
1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings
(results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
amoxapine
Tricyclic Antidepressants (TCAs)
* not 1st line due to toxicity
-
Elavil
MOA:works on neuropathic pain
1) inhibit the reuptake of NE & h-HT into the neuronal nerve endings
(results upone admin, peaking @ 4-6 weeks, lasting through 2 wks after d/c)
amitriptyline
Tricyclic Antidepressants (TCAs)
* not 1st line due to toxicity
-
Prozac
MOA: selective only to 5-HT
1) inhibits the reuptake of serotonin
fluoxetine
Selective Serotonin Reuptake Inhibitors (SSRIs)
*1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
-
Paxil
MOA: selective only to 5-HT
1) inhibits the reuptake of serotonin
paroxetine
Selective Serotonin Reuptake Inhibitors (SSRIs)
*1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
-
Zoloft
MOA: selective only to 5-HT
1) inhibits the reuptake of serotonin
sertaline
Selective Serotonin Reuptake Inhibitors (SSRIs)
*1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
-
Celexa
MOA: selective only to 5-HT
1) inhibits the reuptake of serotonin
citalopram
Selective Serotonin Reuptake Inhibitors (SSRIs)
*1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
-
Lexapro
MOA: selective only to 5-HT
1) inhibits the reuptake of serotonin
escitalopram
Selective Serotonin Reuptake Inhibitors (SSRIs)
*1st line for MDD & anxiety due to efficacy, tolerability (safer than TCA in OD)
-
Effexor
MOA:
1) inhibits both 5-HT & NE reuptake
venlafaxine
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
-
Prestiq
MOA:
1) inhibits both 5-HT & NE reuptake
desvenlafaxine
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
-
Cymbalta
MOA:
1) inhibits both 5-HT & NE reuptake
*indicated for fibromyalgia, but still prescribed for depression*
dulocetine
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
*FDA approved to treat Fibromyalgia (1/3)
-
Sevella
MOA: 1) inhibits both 5-HT & NE reuptake
*indicated for fibromyalgia, not depression, but still prescribed for depression*
milnacipran
Serotonin & Norepinephrine Reuptake Inhibitors (SNRIs)
*FDA approved to treat Fibromyalgia (1/3)
-
Lyrica
MOA:
1) unknown, but modifies ionic factors
Neuropathic Pain Agent
*FDA approved to treat Fibromyalgia (1/3)
-
Wellbutrin
MOA:
1) inhibits NE & Dopamine (DA) reuptake
2) lowers seizure threshold
*also used for smoking cessation
buproprion
Atypical Antidepressant
-
Remeron
MOA:
1) Alpha2-Adrenergic Antagonist
2) increases 5-HT & NE release
*used for sedation @ low dose
mirtazapine
Atypical Antidepressant
*avoid use with clonidine to avoid rebound HTN
-
Serzone
MOA: unkown
1) inhibits serotonin & NE reuptake
2) also acts on 5-HT receptor
nefazadone
Atypical Antidepressant
* BBW: liver failure
-
Desyrel
MOA: unknown
1) potentiates serotenergic activity in CNS
2) Adjunct to AD for insomnia
trazodone
Atypical Antidepressant
*may cause prolonged priapism
-
St. John's Wart
MOA:
1) natural antidepressant activity
Herbal Suppliment
- DDIs:
- 1) Warfarin
- 2) SSRIs
- 3) TCAs
-
lithium
MOA:
1) decreases excitability of nerve tissue
2) decreases release of NE @ nerve endings
2) increases reuptake of NE & 5-HT
Antimanic
*similar to Na (sodium), so body uses Lithium instead of Sodium - increase NA intake
-
Lithium: 0.6 - 0.8 Meq/L
normal levels
-
Litium: <1.5 Meq/L
- fine hand tremors
- GI upset
- polydipsia
- muscle weakness
-
Lithium: 1.5 - 1.5 Meq/L
- slurred speech
- confusion
- sedation
- dizziness
-
Lithium: >2.5 Meq/L
- seizures
- coma
- cardiovascular collapse
- DEATH
-
divalproex sodium
MOA: unkown
1) works with GABA
Class: Valporic Acid
- anti-convulsant
- anti-migrain
- eanti-manic
* BBW: hepatotoxicity
-
Tegretol
MOA: unknown for mania
1) sodium channel blocker
2) auto-induction & enzyme INDUCER
carbamazepine
- Antiepileptic (AED) & Antimanic
- --> complex partial seizures
- --> partial seizures secondarily generalized
- --> tonic-clonic seizures
*BBW: Steven Johnson Syndrome
-
Lamictal
MOA:
1) bloacks Na (sodium) dependant channels
2) unknown for mania, but may decrease glutamate release
lamotrigene
Anticonvulsant & Antimanic
*start slow & low
-
Thorazine
MOA: based on dopamine hypothesis
1) bloackade of CNS dopamine receptors
2) results in inhibition of dopamine-mediated effects associated with schizophrenia
chlorpromazine
1st generation (Typical) Antipsychotics
-
Mellaril
MOA: based on dopamine hypothesis
1) bloackade of CNS dopamine receptors
2) results in inhibition of dopamine-mediated effects associated with schizophrenia
thioridazine
1st generation (Typical) Antipsychotics
-
Haldol
MOA: based on dopamine hypothesis
1) bloackade of CNS dopamine receptors
2) results in inhibition of dopamine-mediated effects associated with schizophrenia
haloperidol
1st generation (Typical) Antipsychotics
-
Navane
MOA: based on dopamine hypothesis
1) bloackade of CNS dopamine receptors
2) results in inhibition of dopamine-mediated effects associated with schizophrenia
thiothixene
1st generation (Typical) Antipsychotics
-
clozapine
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
-
Risperidone
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
-
Olanzapine
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
-
Quetiapine
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)3) Also affects other receptors to work
on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
-
Ziprasidone
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
-
Aripiprazole *
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
Effective as monotherapy/adjuct with lithium/valporic acid in txof acute mania*
-
Paliperidone
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
-
Iloperidone
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
-
Safrus
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
asenapine
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
-
Lurasidone *
MOA:
1) Moderate - high D2 antagonist (blocker)
2) High 5-HT2a antagonist (blocker)
3) Also affects other receptors to work on the negative sxs of schizophrenia
2nd Generation Antipsychotics
*1st line agents in tx of schizophrenia
-
Xanax
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
alprazolam
Benzodiazepine: SHORT-ACTING
-
Ativan
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
lorazepam
Benzodiazepine: SHORT-ACTING
-
Restoril
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
temazepam
Benzodiazepine: SHORT-ACTING
-
Halcion
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
triazolam
Benzodiazepine: SHORT-ACTING
-
Librium
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
chlordiazepoxide
Benzodiazepine: LONG-ACTING
-
Klonopin
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
clonazepam
Benzodiazepine: LONG-ACTING
-
Valium
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
diazepam
Benzodiazepine: LONG-ACTING
-
Dalmane
MOA:
1) inhibits enzyme responsible for GABA breakdown
2) reduces neuronal excitability
flurazepam
Benzodiazepine: LONG-ACTING
-
Buspar
MOA:
1) supresses serotonergic activity
2) enhances noradrenergi & dopaminergic cell firing
3) relieves sxs associated with GAD (motor tension, autonomic hyperactivity)
buspirone
- Azapirone
- -similar in efficacy to benzodiazepines
-
Valerian
MOA: similar to benzodiazepine
1) inhibits the breakdown of GABA
herbal supplement
TX: insomnia & anxiety
DDIs: MAOIs
-
TCA - OTC
MOA:
1) atagonists (blocker) at histamine receptor sites
amitriptyline & doxepine
OTC Antipressants
Histamine Antagonist (Blocker)
-
mirtazapine
MOA:
1) atagonists (blocker) at histamine receptor sites
OTC Antipressants
Histamine Antagonist (Blocker)
-
trazodone
MOA:
1) atagonists (blocker) at histamine receptor sites
OTC Antipressants
Histamine Antagonist (Blocker)
-
Rozerem
MOA:
1) stimulates melatonin receptor to normalize physiologic & behavioral sleep patterns
ramelton - RX only
Melatonin Recpetor Agonist
-
Melatonin
MOA:
1) normalizes physiologic & behavioral sleep patterns
OTC supplement
Melatonin Receptor Agonist
-
Ambien
MOA:
1) binds to GABA receptor complex sites
2) enhances GABA activity in CNS
zolpidem
- GABA Agonist: Nonbenzodiazepine
- "Z drugs"
-
Lunesta
MOA:
1) binds to GABA receptor complex sites
2) enhances GABA activity in CNS
eszopiclone
- GABA Agonist: Nonbenzodiazepine
- "Z drugs"
-
Sonata
MOA:
1) binds to GABA receptor complex sites
2) enhances GABA activity in CNS
zaleplon
- GABA Agonist: Nonbenzodiazepine
- "Z drugs"
-
Adderall
MOA:
1) effective in tx of ADHD
stimulant
-
Concerta
MOA:
1) effective in tx of ADHD
Ritalin
stimulant
-
Focalin
MOA:
1) effective in tx of ADHD
stimulant
-
Vyvanse
MOA:
1) effective in tx of ADHD
stimulant
-
Daytrana - patch
MOA:
1) effective in tx of ADHD
topical (trasdermal) stimulant
* total wear time should not exceed 9 hrs
-
Strattera
MOA:
1) non-stimulant tx for ADHD
NRI (norepinephrine reuptake inhibitor)
-
Dilantin
MOA:
1) Inhibits Na (sodium) channels
2) decreases hyperexcitability of the nerve cells
*enzyme inducer
phenytoin
- Hydantoins (AEDs)
- --> complex partial seizures
- --> patial
seizures 2ndarily generalized- --> tonic-clonic seizures
-
Zarontin
MOA:
1) antiepilectic action with very narrow spectrum
ethosuximide
- Antiepileptic Drug (Misc AED)
- --> absence seizures
-
Depakene
MOA:
1) unknown, but elevates GABA
Side Effects:
- Thrombocytopenia
- Weight gain & GI Upset
BBW: Hepatic Failure*
valporic acid
- Antiepileptic Drug (Misc AED)
- --> tonic-clonic seizures
- --> absence seizures
-
Neurontin
MOA:
1) inhibit Ca (calcium) channel
2) increases GABA
gabapentin
- Antiepileptic Drug (Misc AED)
- --> complex partial seizures
-
Topamax
MOA:
1) Affects voltage dependent Na (sodium)
2) effects GABA receptors
topiramate
- Antiepileptic Drug (Misc AED)
- --> complex partial seizures
- --> tonic-clonic seizures
-
Vimpat
MOA:
1) decreases hyperexcitability of neurons
lacosamide
Antiepileptic Drug (Misc AED)
-
Trileptal
MOA:
1) antiepileptic activity
Side Effects:
- Ocular (diplopia, nystagmus)
- N/V
oxcabazepine
Antiepileptic Drug (Misc AED)
* suspension only good for 7 weeks once opened
-
Keppra
MOA:
1) antiepileptic activity
Side Effects:
- Sedation; fatigue
levetiracetam
Antiepileptic Drug (Misc AED)
-
Sabril
MOA:
1) inhibits enzyme responsible for the breakdown of GABA
*enzyme inhibitor*
vigabatrin
- Antiepileptic Drug (Misc AED)
- --> complex partial seizures
-
Zonegran
MOA:
1) Na (sodium) channel, T-type Ca inhibitor
* enzyme inhibitor*
zonisamide
- Antiepileptic Drug (Misc AED)
- --> absence seizures
-
L-Dopa
MOA:
1) Precurser to Dopamine (DA)
2) Crosses Blood/Brain Barrier
3) Carbidopa adjunct: prevents peripheral conversion of L-Dopa to dopamine (prevents peripheral effects of N&V) & allows L-Dopa to enter CNS
levodopa (&carbidopa)
Antiparkinsonian
-
Cogentin
MOA:
1) antichiloinergic activity similar to atropine
benztropine
Antiparkinsonian: ANTI-CHOLINERGIC
-
Artane
MOA:
1) antichiloinergic activity similar to atropine
trihexphenidyl
Antiparkinsonian: ANTI-CHOLINERGIC
-
Symmetrel
MOA:
1) interferes with viral trasmission into cell
amantadine
Antiparkinsonian: ANTI-VIRAL
-
Benadryl
MOA:
1) competes at Histamine receptors
diphenydramine
Antiparkinsonian: ANTI-HISTAMINE
-
Eldepryl
MOA:
1) inhibits the MAOB enzyme, which is responsible for Dopamine (DA) metabolism/breakdown
selegeline
- Antiparkinsonian: DOPAMINE CONSERVER
- -->MAOB Inhibitor*
-
Azilect
MOA:
1) inhibits the MAOB enzyme, which is responsible for Dopamine (DA) metabolism/breakdown
rasagiline
- Antiparkinsonian: DOPAMINE CONSERVER
- -->MAOB Inhibitor*
-
Parlodel
MOA:
1) binds to & stimulates dopamine receptors
bromocriptine
- Antiparkinsonian: DOPAMINE AGONIST- less fluctuation & dyskinesia
-
Mirapex
MOA:
1) binds to & stimulates dopamine receptors
pramipexole
- Antiparkinsonian: DOPAMINE AGONIST- less fluctuation & dyskinesia
-
Requip
MOA:
1) binds to & stimulates dopamine receptors
ropinerole
- Antiparkinsonian: DOPAMINE AGONIST- less fluctuation & dyskinesia
-
Apokyn
MOA:
1) binds to & stimulates dopamine receptors
*USED FOR TEMP RELIEF DUR "OFF PERIODS"
apomorphine
- Antiparkinsonian: DOPAMINE AGONIST (potent)
- - less fluctuation & dyskinesia
-
Tasmar
MOA:
1) inhibits the enzyme primarily responsible for the metabolism of L-dopa
tolcapone
Antiparkinsonian: COMT INHIBITOR
BBW: liver toxicity
-
Comtan
MOA:
1) inhibits the enzyme primarily responsible for the metabolism of L-dopa
entacapone
Antiparkinsonian: COMT INHIBITOR
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