Skethcy Pharm
1. Benzodiazepines: GABA A; increase frequency of chloride ion channels
1.a.Short acting: end in “olam”
1.i. Oxazepam: fast ox so short acting
1.ii. Alprazolam and triazolam also
1.iii. Metabolized in liver
1.b. Long acting:
1.iv. Form active metabolites at liver. Half life of hundreds of hours
1.1. Diazepam or chlordiazepoxide
1.a. Good for withdrawal
1.c.IV benzos: general asthesia (muscle relaxation, amnesia); diazepam, lorazepam,
midazolam)used with other agents
1.v. And causes sedation for minor surgeries (that require being
conscious)
1.d. Contraindication: (barbituates and) alcohol “GABA A FOR ALCOHOL”
1.vi. Withdrawal of alcohol: anxiety, insomnia, tremor, autonomic
hyperactivity 8-12 after alcohol
1.2. Seizures 12-48 hours after (diazepam and lorazepam for
acute seizure (status epilepticus))
1.3. Delirium tremens is 48-96 hours (severe agitation,
disorientation, and fever)
2. SSRI/SNRI’s: (1-2 months for max effect)
1.vii. Withdrawal: flu like symptoms
1.viii. Can cause serotonin syndrome (same symptoms as malignant
neuroleptic syndrome like hyperthermia and hypertension (except get
hyperreflexia and clonus)
1.4. higher chance if take with TCA OR MAO’s
1.5. cure by stopping serotoniergic agents and take
CYPROHEPTADINE
1.ix. Benzo for gad and panic short term
1.e.SSRI’s:
1.x. Fluoxetine, paroxetine, sertraline, citalopram
1.xi. Adverse effects: hyponatremia (SIADH), sexual dysfunction,
drowsiness, weight gain, and insomnia
1.f. SNRI’s: (1-2 months for max effect)
1.xii. Venlafaxine and Duloxetine
1.6. Treats chronic pain and diabetic neuropathy
3. Tricyclic Antidepressants (TCA):
1.xiii. Inhibit presynaptic uptake of serotonin and norepinephrine
1.xiv. 2nd/ 3rd line for antidepressant; use when ssri/snri’s are not
effective
1.xv. Used for pain disorders (neuropathic, chronic pain conditions, and
migraines)
