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- mech and use TCA (incl specific uses of 2)
- mech: block reuptake NE, serotonin
- use: depression, bedwet (imipramine), OCD (clomipramine)
- SE phenytoin
- nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, anemias, teratogen, peripheral neuro, rare malignant hyperthermia
- Lithium, mech and use
- mech: ? inhibits phosphoinositol cascade
- use: bipolar, acute/relapse mania
- Brimonidine
- alpha agonist used in glaucoma to decr aq humor syn (no SE)
- cholinomimetics used tx glaucoma: names, mech, SE
- pilocarpine, carbachol, physiostigmine, echothiophate
- SE: miosis, cyclospasm
- Chlordiazepoxide
- a benzo
- Neostigmine (3 uses)
- anti CE, used for post-op ileus and urinary retention, MG, reversal NMJ block
- SE valproic acid (3)
- measure LFT, rare but fatal hepatotoxicity
- NT defects (spina bifida), GI
- Thioridazine
- anti psych
- mech tardive dyskinesia
- oral facial mvmt due to D R sensitization long term anti-psych use
- evolution EPS SE
- 4h acute dystonia
- 4mo tradive dyskinesia (irrev)
- Thiopental
- barbituate used in induction anesth
- SE MAOI
- HTN crisis w tyramine and meperidine, CNS stim
- contraindicated w SSRI, b agonist!!!
- tx OD benzos
- flumazenil (competit antag at GABA R)
- 5 ex DA agents used in PD
- Ldopa/carbidopa, bromocriptine, pramipexole, ropinirole, amantadine
- what use for atropine OD
- physistigmine (anti CE)
- Doxepin
- TCA
- general toxicity of antipsych
- EPS, sedation, endo, SE from blocking muscarinic, alpha and His R
- Topiramate
- for partial sz only,
- mech: block Na channels, increase GABA action
- ex MAOI used in PD,
- selegiline, selective MAO B inhibitor
- SE Lithium (4)
- tremor, hypothyroid, polyuria (nephrogenic DI), teratogen.
- narrow therapeutic range requires close monitor serum levels
- serotonin syndrome
- SSRI + MAOI (hyperthermia, mscl rigidity, CVS collapse)
- advantages of atypical anti psych
- useful for + and - sx
- fewer EPS, antichol
- valproic acid
- used in t/c sz and absence sz,
- mech increase Na channel inactiv, incr GABA concentration
- selegiline, mech, use, SE
- used in PD as adjunct to Ldopa, inhibits MAO-B increasing availability of DA,
- SE: may enhance adverse effects of L-dopa
- Citalopram
- SSRI
- Nortriptyline
- 2 TCA (less anti-chol than 3TCA)
- SE ethosuximide
- anti-epileptic but only for general sz, works by blocking thalamic T type Ca channels
- GI distress, lethargy, HA, urticaria, Stevens-Johnson
- name 4 SSRIs
- Ethosuximide
- anti-epileptic but only for general sz, works by blocking thalamic T type Ca channels
- SE phenoxybenzamine
- (irrev alpha blocker, used for pheo) orthostatic HTN, reflex tachycardia
- SE topiramate
- sedation, mental dulling, kidney stones, weight loss
- Maprotiline
- heterocyclic blocks NE uptake use in depression
- and tx?
- 1) Neuroeleptic malignant syndrome-rigidity, auto instability, hyperpyrexia
- tx: dantrolene and D agonist
- SE Phenobarbital
- anti-epileptic for partial and general t/c, works by incr GABAa action
- sedation, induce P450, tolerance, dependence
- SE gabapentin
- sedation, mvmt
- mech: incr GABA release
- Phenobarbital
- anti-epileptic for partial and general t/c, works by incr GABAa action
- toxicity of TCAs
- convulsions, coma, cardiotoxicity (arrhythmias), respir depression, hyperpyrexia.
- elderly: confusion, hallucinations (2/2 anti chol)
- muscarinic cholinoR blockers include (4) (use)
- atropine, beztropine (PD), scopolamine (motion sickness), ipratropium (asthma, COPD)
- Lamotrigine
- used in partial sz and generalized tonic clonic,
- mech: blocks voltage gated Na
- Amitriptyline
- 3 TCA, with more anti chol than 2 TCA
- benzodiazepines: use, mech
- use: anxity, spasticity, status epilepticus (diazepam), detox (EtOH wdrawal DT)
- note: most have long t1/2 and active metabolites
- SE trazodone
- sedation, nausea, priapism, hypotension
- antipsychotics name 4
- thioridazine, haloperidol, fluphenazine, chlorpromazine
- 2 uses of phenytoin, mech
- 1) grand mal sz
- use-dependent blockade of Na channels
- phenytoin MOA
- increases Na channel inactivation--use dependent Na channels
- toxicity of SSRI
- CNS stim, anxiety, insomnia, tremor, anorexia, N/V
- -Serotonin syndrome w MAOI (hyperthermia, mscl rigidity, CVS collapse)
- name atypical antipsych
- clozapine, olanzapine, risperidone
- Desipramine
- TCA, least sedating
- SE atypical anti-psych
- fewer EPS and antichol, clozapine requires wkly WBC bc agranulocytosis
- Phentolamine
- reversible alpha blocker (like irrev phenoxybenzamine) used for pheo
- effect alpha 1 R
- -vasoconstriction GI
- -ejac
- Venlafaxine
- heterocyclic, inhibit serotonin, NE, and D reuptake, use depression and general anxiety disorder