anti depressants

what are tricyclic antidepressants used for

depression, bipolar, ADHD, OCD

examples of tricyclic antidepressants

imipramine, doxepin, amitriptyline

what are possible drug interactions of tricyclic antidepressants

• MAOI: severe HTN

• epi and nor epi

• anticholinergic agents

  • intensifies response

what are toxic clinical manifestations of TCAs

prolonged PR, QRS, and EKG changes

when are MAOIs used

when nothing else works

what is an example of an MAOI

selegiline and phenelzine

what do MAOIs do

increase amount of nor epi and serotonin available

what are adverse effects of MAOIs

• orthostatic hypotension

• cheese reaction

  • massive vasoconstriction and cardiac stimulation

how is the cheese reaction caused by MAOIs treated

IV phentolamine

why do we like SSRIs

work as well at TCA but not HTN, sedation or anticholinergic effect and less risk of suicide

what are examples of SSRIs

fluoxetine, sertraline, escitalopram, citalopram

what are side effects of SSRIs

sexual dysfunction, N/V, headache, insomnia, anxiety, weight gain

what are possible drug interactions with SSRIs

MAOIs and St john’s wort: serotonin syndrome

what antidepressants may lead to poor compliance

MAOIs bc of all the stuff they cant eat

what do SNRIs do?

block reuptake of norepi and serotonin with minimal effects on other transmitters

what is an example of a SNRIs

venlafaxine

what is an important teaching regarding SNRIs

no grapefruit

what are examples of an atypical antidepressant

bupropion and trazodone

what does bupropion do

block dopamine uptake

what does trazodone do

selectively block norepi reuptake

what is used to treat anxiety

benzos, antidepressants, barbituates,

side effects of benzos

CNS and resp depression, antegrade amnesia, interacts with alc

what is the first line tx of GAD

buspirone

what is used to treat ADHD

Adderall, Ritalin, and modafinil

what meds are used to treat the manic phases of bipolar

Zyprexa ad Risperdal

what is used to treat mood disorders

lithium, divalproex, carbamazepine, SSRIs, SNRIs

what are examples of 1st gen antipsychotics

Thorazine, haloperidol, and chlorpromazine

what are examples of 2nd gen antipsychotics

risperidone, clozapine

what treatment for bipolar may lead to birth defects? what are those defects

lithium, can cause cardiac defects

what is a therapeutic and desired level for lithium

therapeutic: 0.6-1.2

desired: 0.8

what are s/s of therapeutic levels of lithium

GI upset, fatigue, constipation, polyuria

what are s/s of toxic levels of lithium

ataxia, blurred vision, twitching, hypotension, seizures

what can drastically increase lithium levels

NSAIDs

when should lithium be avoided

1st trimester of pregnancy

what are cognitive s/s of schizophrenia

disordered thinking, memory issues,

what are examples of NMS

rigidity, high fever, sweating

what are examples of EPS

dystonia, joint dislocation, impaired respirations

what are NSM s/s treated

benzos, dantrolene, and bromocriptine

drugs that react badly with 1st gen antipsychotic

anticholinergic, CNS depressants, and direct dopamine receptor agonists

what is an example of an atypical antipsychotic and what does it treat

Abilify: treats psychosis