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Psychotropic Medications Study Guide, Study Guides, Projects, Research of Pharmacology

Virginia State University (VSU)Pharmacology

A comprehensive review of various psychotropic medications, including their mechanisms of action, indications, side effects, and drug interactions. It covers a wide range of drug classes such as ssris, snris, ndris, serotonin modulators, tcas, and maois, as well as mood stabilizers like lithium, valproic acid, carbamazepine, and lamotrigine. The document delves into the pharmacological properties, clinical applications, and monitoring requirements for these medications, making it a valuable resource for healthcare professionals and students interested in the field of psychopharmacology. The level of detail and the breadth of topics covered suggest that this document could be useful as study notes, lecture notes, or a summary for university-level courses related to psychiatry, pharmacology, or neuroscience.

Typology: Study Guides, Projects, Research

2024/2025

Available from 09/23/2024

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Pharm: Psychotropic meds study guide review notes
1.Serotonin (5H): *Chemical messenger in the CNS*
*Helps regulate*:
- Mood/happiness
- Anxiety
- Sleep cycle
2.Serotonin is found in the :
*GIT* (BM, Nausea)
3. *SSRIs* are the most prescribed
meds
Generally & : Most *commonly* prescribed
*anti-de- pression* meds
Generally *well tolerated* & *widely used*
4.*SSRI* examples:: - Citalopram (celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
5.Clinical effect of *SSRIs* can take how long?: *4* weeks
6.*SSRI* half life's: *Short*: Paxil
*Moderate*: Sertraline, Citalopram, Escitalopram
*Long*: Fluoxetine (Prozac) —> compliance
7.*Paroxetine* can lead to...: *Weight gain*
*Withdrawl* symtpoms with missed doses
8.*Citalopram* is indicated for...: *depression*
9.*Escitalopram* is indicated for...: *Anxiety* & *Depression*
10.*Fluoxetine* has significant interactions: *drug*
11.*Sertraline* is frequently used in the : Frequently used in the
*elderly*
(Available in low doses)
12.*Fluvoxamine* is indicated for :
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Pharm: Psychotropic meds study guide review notes

  1. Serotonin (5H): Chemical messenger in the CNS Helps regulate:
  • Mood/happiness
  • Anxiety
  • Sleep cycle
  1. Serotonin is found in the : GIT (BM, Nausea) 3. SSRIs are the most prescribed meds Generally & : Most commonly prescribed anti-de- pression meds Generally well tolerated & widely used
  2. SSRI examples:: - Citalopram (celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  1. Clinical effect of SSRIs can take how long?: 4 weeks
  2. SSRI half life's: Short: Paxil Moderate: Sertraline, Citalopram, Escitalopram Long: Fluoxetine (Prozac) —> compliance
  3. Paroxetine can lead to...: Weight gain Withdrawl symtpoms with missed doses
  4. Citalopram is indicated for...: depression
  5. Escitalopram is indicated for...: Anxiety & Depression
  6. Fluoxetine has significant interactions: drug
  7. Sertraline is frequently used in the : Frequently used in the elderly (Available in low doses)
  8. Fluvoxamine is indicated for :

OCD (Multiple drug interactions)

  • Meperidine
  • Sumatriptan
  • St. John's wart
  • MDMA
  • LSD
  • Tramadol
  1. SSRI contraindicated in use with : Concomitant use with MAOI
  2. SNRI SE:: - HTN
  • Increase suicide risk for adolescents (Similar to SSRI) 21. SNRIs have similar to Drug of choice depends on the : Similar efficacy to SSRI Drug choice depends on the patient
  1. What is the best tolerated antidepressant class?: SSRI
  2. SNRI examples:: - Venlafaxine; desvenlafaxine
  • Duloxetine
  1. Venlafaxine; desvenlafaxine are FDA approved for...: Anxiety, depression, social phobia, panic d/o
  2. What is an active metabolite of venlafaxine?: Desvenlafaxine
  3. Duloxetine is indicated for...: - Anxiety, depression
  • Diabetic peripheral neuropathy
  • Fibromyalgia
  • Chronic pain
  1. SSRI and SNRI indications:: FDA approved to treat depression
  • MDD and dysthymia
  • except Luvox (OCD)
  1. SSRI and SNRI are also approved to treat...: - Generalized anxiety
  • OCD
  • Panic disorder
  • PTSD
  • Eating disorder
  • PMDD
  • Social anxeity
  • Pain disorder
  1. Serotonin modulator SE:: - Sedation
  • Postural hypotension
  1. Trazodone is used most commonly for...: Insomnia (Off-label)
  2. TCA examples:: - Amitriptyline
  • Nortriptyline
  • Doxepin
  • Imipramine
  • Desipramine
  1. TCA indications:: Depression Anxiety (NOT first line) (Used in addition to SSRI, SNRI)
  2. TCA additional indications...: - Chronic pain
  • Insomnia
  • Migraine prophylaxis
  • Postherpetic neuralgia
  • Narcolepsy
  1. TCA interactions: Multiple major
  2. MAOI MOA:: Blocks degrative enzyme monoamine —> increases level of NE, serotonin, dopamine (Monoamine oxidase A and B)
  3. MAOI (non-selective) examples:: Inhibit A & B:
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)
  • Isocarboxazid (Marplan)
  1. MAOI (selective) examples:: MAO-B Inhibitors: Selegiline (Emsam) (used in Parkinson's)
  2. MAOI efficacy probably due to...: Inhibition of MAO-A
  3. MAOI SE:: - Drowsiness/fatigue
  • Low BP
  • Hypertensive crisis
  • Sexual dysfunction

aminobutyric

acid* Chemical messenger widely distributed in the brain cortex Neuron overstimulation associated with anxiety/fear

53. Dopamine is a involved in... Responsible for...: Neurotransmitter involved in executive function Responsible for motor control, motivation, arousal, reinforcement, reward

  1. Deficiency in dopamine leads to...: - Parkinson's
  • Addictions
  1. Excess dopamine leads to...: Schizophrenia
  2. Mood stabilizer (old) examples:: - Lithium
  • Carbamazepine (tegretol)
  • Valproic acid (Depakote)
  1. Mood stabilizer (new) examples:: - Lamotrigine (Lamictal)
  • Oxcarbazepine (Trileptal)
  • Topiramate (Toyama's)
  • Olanzapine/ fluoxetine combo (Symbyax)
  • Levatiracetam (Keppra)
  • Zonisamide (Zonegran)
  1. What else do we use mood stabilizers for?: - Seizure disorders
  • Migraines
  • Chronic pain syndromes
  • Aggression
  • Impulsivity
  • Augmentation of antidepressants and antipsychotics
  1. Lithium indications:: - Acute bipolar episode
  • Maintenance therapy
  1. Lithium MOA:: Unknown
  2. Lithium SE:: - Dizziness
  • Weight gain
  • Polydispasia
  • Polyuria
  • Fatigue

SE are related: Low therapeutic index Need to monitor serum levels SE are dose related Meds affecting kidney function

  • ACEI, ARB, NSAID
  • increased risk of Li tox BEERS list Monitor TFT
  • can cause THY dysfunction
  1. Don't use lithium with...: Meds affecting kidney function: ACEI, ARB, NSAID (Increased risk of Lithium toxicity)
  2. Lithium is contraindicated for use of : Con- comitant use of diuretics
  3. Valproic Acid (Depakote) indications:: - Bipolar
  • Seizure
  1. Valproic acid MOA:: Unknown Thought to increase brain concentrations of GABA
  2. Valproic acid SE:: - Alopecia
  • GI (abd pain, NVD, anorexia)
  • Weight gain
  • Tremor
  • Myelodysplastic syndrome
  • Thrombocytopenia
  1. Valproic acid monitoring:: Serum levels —> liver dysfunction, thrombocy- topenia CBC
  2. Valproic acid drug interactions:: Numerous 70. Carbamazepine (Tegretol) is first line for &

More effective than in cycling & states: First line in acute mania and bipolar maintenance More effective than lithium in rapid cycling and mixed states

  1. Carbamazepine monitoring...: Need to monitor serum levels for dosing Should be withdrawn SLOWLY to prevent relapse
  2. Carbamazepine (BP) MOA:: blockade of sodium channels stabilizes hyper excited nerve membranes
  3. Carbamazepine (antiepileptic) MOA:: Reduction of glutamate release Stabilization of neuronal membranes
  4. Carbamazepine (antidepressant) MOA:: Depressant effect on dopamine and noradrenaline turnover —> anti manic effect
  5. Carbamazepine SE:: - Nausea
  • Dizziness
  • Somnolence
  • Hematologic
  1. Hematologic SE of carbamazepine:: - Agranulocytosis
  • Aplastic anemia
  • Bone marrow depression
  • Eosinophilia
  • Leukopenia
  • Pancytopenia
  • Thrombocytopenia
  1. Carbamazepine monitoring:: Serum levels CBC (pre and during) LFT (pre and during)
  2. Carbamazine drug interactions:: Numerous
  3. Lamotrigine (Lamicatal) indications:: Bipolar (especially depression)

Stabilizes inactivated NA channels —> fewer left open

  1. Lamotrigine SE:: SJS/TEN (initiate therapy slowly to decrease risk)
  2. Lamotrigine drug interactions:: Valproate (increases Lamotrigine levels) Carbamazepine (decreases Lamotrigine levels) 83. Oxcarbazepine (Trileptal) is a modified , differ- ently Less and Primarily used in combo with...: Modified carbamazepine, metabolized dif- ferently Less SE and interactions Primarily used in combo with other mood stabilizers 84. Olanzapi ne/fluoxetine combo (Symbyax) is a drug Approved to treat & : Psy- chotherapeutic combo drug Approved to treat bipolar depression and resistant depressions
  3. What Anticonvulsants are used as mood stabilizers?: - Levatiracetam (Keppra)
  • Topiramate (Topamax)
  • Zonisamide (Zonegran) 86. Levatiracetam (Keppra) MOA: Interactions? Monitoring?: Unknown

(May inhibit firing of NT)

  • Minimal interaction