Table Of Contents
Precursor
Precursor | |
Tryptophan | serotonin |
Glutamic acid | GABA |
Histidine | histamine |
Methionine | cysteine, carnitine, taurine, lecithin |
Tyrosine | thyroxine, dopamine, NE, epinephrine, melanin |
Antidepressant
Bupropion
Trazodone
Anti-epileptic
1st generation antihistamine
Cyproheptadine
1st gen antipsychotic
- MOA:
- Clinical Use:
- Low potency:
- Side effects:
- High potency:
- Side effects:
Chlorpromazine
Haloperidol
2nd gen antipsychotic
Clozapine
- Type:
- Clinical Use:
- Side effect:
Quetiapine
Risperidone
Bipolar medications
Lithium
- MOA:
- Clinical Use:
- Side effects:
- Toxicity:
- In pregnant patients:
- Notes:
- Interactions:
- Filtered/reabsorbed mostly by proximal tubules (acts like sodium) SO any decreased GFR will cause an increased sodium/lithium reabsorption
- Thiazide diuretics can potentiate lithium toxicity because of volume depletion in distal tubule –> stimulates proximal tubule to step up reabsorption
- ACE inhibitors, and NSAIDs also –> impaired lithium clearance/toxicity
- Filtered/reabsorbed mostly by proximal tubules (acts like sodium) SO any decreased GFR will cause an increased sodium/lithium reabsorption
- Lithium induced hypothyroidism:
Anticonvulsants
Antihistamine
Diphenhydramine
Anxiolytic
Buspirone
- Type:
- Clinical Use:
- Notes:
Baclofen
GABA receptor agonism
Barbiturates
- MOA:
Phenobarbital
Benzodiazepines
- MOA:
- Clinical Use:
Alprazolam
Clonazepam
- Brand name:
- Type:
- Anticonvulsant/antiepileptic
- Clinical Use:
- Treats panic attacks
Diazepam
- Brand name:
- Type:
- Clinical Use:
- Risk:
Flurazepam
Lorazepam
- Name brand:
- Type:
- Clinical Use:
Temazepam
Triazolam
Propofol
- Clinical Use:
Hypertensives
Hypnotic
Zolpidem
MAOI
Linezolid
- Type:
- MAOI
Phenelzine
- Type:
- MAOI
Prazosin
Psychostimulants
SNRI
Venlafaxine
SSRI
- Precursor for serotonin:
Citalopram
Paroxetine
Sertraline
- Brand Name:
- MOA:
Tricyclic antidepressants
Drug combinations
Meds to avoid in geriatric patients
- Avoid to treat insomnia:
Similar MOA
Medication induced syndrome
Neuroleptic malignant syndrome
Serotonin syndrome
- Path:
- When an MAOI is combined w/SSRI, SNRI, or TCA –> produce excessive synaptic serotonin levels due to decreased reuptake AND decreased serotonin degradation
- Presentation:
- Hyperthermia, confusion, myoclonus, cardiovascular instability, diaphoresis, flushing, diarrhea, seizures.
- 1. autonomic instability
- 2. altered mental status
- 3. neuromuscular hyperactivity
- Treatment:
- 2-week washout period after discontinuing an MAOI before initiating an SSRI to allow enough time for MAO generation
- OR cyproheptadine (antihistamine that functions as a serotonin antagonist when given as antidote)
Antidote for Overdose
Overdose | Antidote |
Benzo | FLUMAZENIL |
Narcotic | Naloxone |
Withdrawal
Alcohol withdrawal
- Presentation:
- Treatment: