cns 2 exam 1 top 300

clozapine brand

clozaril, fazaclo, versacloz

clozapine class

antipsychotic; atypical, second generation

clozapine use

treatment-resistant schizophrenia
schizophrenia associated w/ suicidality

clozapine MOA

dibenzodiazepine, primary action through antagonism of dopamine type 2 (D2) receptor and serotonin type 2A (5-HT2A) receptors

clozapine dose

PO: 12.5mg daily or twice daily increased to 300-450 mg/day (max dose 900mg.day)

clozapine contraindications

none listed

clozapine bbw

orthostatic hypotension
bradycardia
syncope
cardiac arrest
myocarditis
cardiomyopathy
severe hepatotoxicity
severe neutropenia
(absolute neutrophil count < 500/mm3)
seizures
increased risk of death in elderly pts with dementia-related psychosis

haloperidol brand

haldol

haloperidol class

antipsychotic, first generation

haloperidol use

schizophrenia, psychosis

haloperidol MOA

butyrophenone antipsychotic that non-selectively blocks post synaptic dopamine (D2) receptors in the brain

haloperidol dose

Psychosis PO: 0.5 to 5 mg in divided doses Schizophrenia IM: 2 to 5 mg in divided doses (20 mg/day)

haloperidol contraindications

none listed

haloperidol bbw

increased morality in elderly patients with dementia-related psychosis

varenicline brand

chantix

varenicline class

smoking cessation aid

varenicline use

nicotine addiction

varenicline MOA

partial α4 β2 nicotinic receptor agonist, also binds 5-HT3 receptors, small stimulation of dopamine activity

varenicline dose

Days 1-3: PO: 0.5 mg daily Days 4-7: PO: 0.5 mg twice daily Maintenance (week 2- 12) PO: 1 mg twice daily

varenicline contraindications

Caution: in individuals with history of seizures Caution: as it can increase intoxicating effects of alcohol

varenicline bbw

none

quetiapine brand

seroquel

quetiapine class

antipsychotic, dibenzothiazepine atypical

quetiapine use

schizophrenia, bipolar disorder

quetiapine MOA

antagonizes multiple neurotransmitter receptors in the brain (serotonin 5HT2, dopamine D1 & 2, H1, alpha 1 & 2)

quetiapine dose

IR: 150-750 mg PO/day given BID-TID
ER: 400-800 mg PO qPM

quetiapine contraindications

electrolyte abnormalities, hypokalemia, long QT syndrome, arrythmias

quetiapine BBW

may cause suicidal thoughts in children and young adults
increases mortality in elderly patients with dementia-related psychosis

aripiprazole brand

abilify, abilify maintena, abilfy MyCite

aripiprazole class

antipsychotics, 2nd generation

aripiprazole use

schizophrenia, bipolar I, major depressive disorder

aripiprazole MOA

partially agonizes dopamine D2 and serotonin 5-HT1A receptors, antagonizes serotonin 5-HT2A receptors

aripiprazole dose

10-15 mg po qd

aripiprazole contraindications

none listed

aripiprazole BBW

increased mortality in elderly patients with dementia-related psychosis

risperidone brand

risperdal, risperdal consta

risperidone class

antipsychotic, 2nd generation

risperidone uses

schizophrenia, bipolar I

risperidone MOA

antagonizes dopamine D2, serotonin 5-HT2, and other receptors

risperidone dose

1-4 mg/day PO divided qd-BID
INJ: 25mg IM q 2 weeks

risperidone contraindications

hypersensitivity to paliperidone

risperidone BBW

increased mortality in elderly patients with dementia-related psychosis
increased suicidality in children, adolescents, and young adults

olanzapine brand

zyprexa, zyprexa relprevv, zyprexa zydis

olanzapine class

antipsychotic, 2nd generation (thienobenzodiazepine)

olanzapine use

schizophrenia, bipolar I

olanzapine MOA

antagonizes dopamine, serotonin 5-HT2, and other receptors

olanzapine dose

10-20 mg PO qd

olanzapine contraindications

alcohol use, CNS depressant use

olanzapine BBW

increased mortality in elderly patients with dementia-related psychosis

lithium brand

lithobid

lithium class

bipolar disorder agents

lithium uses

bipolar disorder, mania and maintenance

lithium MOA

alters neuronal sodium transport

lithium dose

IR: 600-1800 mg/day divided BID-TID
ER: 900-1200 mg/day divided BID-TID

lithium contraindications

brugada syndrome, CV arrhythmias

lithium BBW

NTI drug - start tx only if facility available for prompt accurate lithium levels

lamotrigine brand

lamictal

lamotrigine class

anticonvulsant, anti-mania

lamotrigine uses

bipolar disorder, partial seizures

lamotrigine MOA

inhibits voltage dependent sodium channels, decreasing presynaptic glutamate and aspartate release

lamotrigine dose

varies by disease

lamotrigine contraindications

avoid abrupt withdrawal

lamotrigine bbw

serious rashes requiring hospitalization may develop