Which SSRI is attributed to more frequent, rapid and pronounced weight gain than
other SSRIs?
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Paxil (paroxetine)
Classification of DRAs? Pharmacological classification?
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FIRST generation antipsychotic (LOW potency):
-chlorpromazine (Thorazine)
-Prochlorperazine (Compazine)-rarely used as antipsychotic
-Thioridazine (Mellaril)
FIRST generation antipsychotic (HIGH potency):
-Fluphenazine (Prolixin)
, -Pimozide (Orap)
-Thiothixene (Navane)
-Haloperidol (haldol)
Review factors that can influence the pharmacokinetics of antipsychotics.
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-Age (elderly may demonstrate reduced clearance rates)
-Medical condition (decreased hepatic blood flow can reduce clearance)
-Enzyme inducer (carbamazepine, phenytoin, ethambutol, barbituates)
-Clearance inhibitors (include SSRIs, TCAs, cimetidine, b-blockers,
isoniazid, methylphenidate, erthromycin, triazolobenzodiazepines, cipro,
ketoconazole)
-changes in binding protein (hypoalbuminemia can occur w/malnutrition or
hepatic failure)
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine
(Prozac)?
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when switching from an antidepressant to an irreversible MAOI-should wait
10-14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI
to avoid drug interactions
Why are SSRIs first choice among antidepressants?
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, -greater safety
-eliminating cardiovascular + anticholingergic effects
-still elevate levels of 5-HT
-SSRIs do NOT alter NE, histamine, or Ach
Although typical antipsychotics are associated w/ EPS syndromes, their use is still
considered as they differ from newer atypical agents in that they do not have what risk
associated with them?
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A reason to still consider DRAs is their lower risk of causing significant
metabolic abnormalities, such as weight gain, lipid elevations and diabetes
Indications for use of TCAs in children?
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indications: enuresis, insomnia, ADHD, MDD, obsessional d/o, panic d/o,
school phobia, separation anxiety d/o, bulimia and Tourette's syndrome
Monitor what lab d/t safety concerns with the use of nefazodone?
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serial hepatic function test
, What is the recommended monitoring for orthostatic hypotension when using IM
LOW potency DRAs?
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The clinician should measure the pts BP (lying + standing) before and after
the first dose and during the first few days of tx
What are the TWO characteristic SE of mirtazapine?
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INCREASED appetite and sedation
Paradoxical
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A response to a drug that represents the clinical effect opposite of what is
expected
Why would oral administration of DRAs need to continue if a patient is placed on a
depot parenteral formulation? How long should oral therapy be continued?
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It can take 6 months of tx with a depot formulation to reach steady-state
plasma levels, indicating that oral therapy should be continued during the
other SSRIs?
Give this one a try later!
Paxil (paroxetine)
Classification of DRAs? Pharmacological classification?
Give this one a try later!
FIRST generation antipsychotic (LOW potency):
-chlorpromazine (Thorazine)
-Prochlorperazine (Compazine)-rarely used as antipsychotic
-Thioridazine (Mellaril)
FIRST generation antipsychotic (HIGH potency):
-Fluphenazine (Prolixin)
, -Pimozide (Orap)
-Thiothixene (Navane)
-Haloperidol (haldol)
Review factors that can influence the pharmacokinetics of antipsychotics.
Give this one a try later!
-Age (elderly may demonstrate reduced clearance rates)
-Medical condition (decreased hepatic blood flow can reduce clearance)
-Enzyme inducer (carbamazepine, phenytoin, ethambutol, barbituates)
-Clearance inhibitors (include SSRIs, TCAs, cimetidine, b-blockers,
isoniazid, methylphenidate, erthromycin, triazolobenzodiazepines, cipro,
ketoconazole)
-changes in binding protein (hypoalbuminemia can occur w/malnutrition or
hepatic failure)
How long should the NP wait to begin an MAOI after d/c a pt from fluoxetine
(Prozac)?
Give this one a try later!
when switching from an antidepressant to an irreversible MAOI-should wait
10-14 days (or 5 weeks for fluoxetine (Prozac) before starting use of MAOI
to avoid drug interactions
Why are SSRIs first choice among antidepressants?
Give this one a try later!
, -greater safety
-eliminating cardiovascular + anticholingergic effects
-still elevate levels of 5-HT
-SSRIs do NOT alter NE, histamine, or Ach
Although typical antipsychotics are associated w/ EPS syndromes, their use is still
considered as they differ from newer atypical agents in that they do not have what risk
associated with them?
Give this one a try later!
A reason to still consider DRAs is their lower risk of causing significant
metabolic abnormalities, such as weight gain, lipid elevations and diabetes
Indications for use of TCAs in children?
Give this one a try later!
indications: enuresis, insomnia, ADHD, MDD, obsessional d/o, panic d/o,
school phobia, separation anxiety d/o, bulimia and Tourette's syndrome
Monitor what lab d/t safety concerns with the use of nefazodone?
Give this one a try later!
serial hepatic function test
, What is the recommended monitoring for orthostatic hypotension when using IM
LOW potency DRAs?
Give this one a try later!
The clinician should measure the pts BP (lying + standing) before and after
the first dose and during the first few days of tx
What are the TWO characteristic SE of mirtazapine?
Give this one a try later!
INCREASED appetite and sedation
Paradoxical
Give this one a try later!
A response to a drug that represents the clinical effect opposite of what is
expected
Why would oral administration of DRAs need to continue if a patient is placed on a
depot parenteral formulation? How long should oral therapy be continued?
Give this one a try later!
It can take 6 months of tx with a depot formulation to reach steady-state
plasma levels, indicating that oral therapy should be continued during the
