Other drugs: Sertraline, fluoxetine (many end with ine).
Therapeutic use: Anxiety, depression, OCD, PTSD
Expected Pharmacological Action: Inhibits serotonin reuptake (i.e. increases serotonin).
SE: Sexual dysfunction, weight gain, INSOMNIA
Key points: WATCH FOR SEROTONIN SYNDROME! Symptoms: agitation, hallucinations, fever, diaphoresis, tremors. Do not take with St. John's wort, as this increases the risk for serotonin syndrome. Full effects not felt for up to a month.
Other drugs: Imipramine
Therapeutic use: Depression, neuropathy, fibromyalgia, anxiety, insomnia
SE: Sedation, orthostatic hypotension, ANTICHOLINERGIC SE (urinary retention, constipation, dry mouth, blurry vision, photophobia, tachycardia), sweating, seizures
Key points: To counteract anticholinergic se- chew gum, wear sunglasses, high fiber diet, increase fluid intake
Therapeutic use: Bipolar disorder
SE: GI upset, FINE HAND TREMORS, polyuria, weight gain, kidney toxicity, electrolyte imbalances
Key points: Monitor plasma levels! TOXICITY OVER 1.5 mEq/L. Symptoms of toxicity- COARSE TREMORS, confusion, hypotension, seizures, tinnitus. No diuretics, anticholinergics, or NSAIDS. Contraindicated for patients with renal disease. Closely monitor sodium levels. Need adequate fluid intake (2-3 liters) and sodium intake!
Therapeutic use: Schizophrenia, psychotic disorders. Mainly controls positive symptoms (i.e. delusions, hallucinations).
SE: EXTRAPYRAMIDAL SE (EPS): Dystonia, Parkinson's symptoms (shuffling gait, rigidity), tardive dyskinesia (lip smacking, tongue rolling), akathisia
NEUROLEPTIC MALIGNANT SYNDROME (NMS): Fever, BP fluctuations, dysrhythmias, muscle rigidity
Other: Agranulocytosis, anticholinergic effects, ortho hypotension, sedation, seizures
Key points: Monitor VS every 1-2 hours. Anticholinergics (ex: benztropine) can be used to control EPS symptoms. Muscle relaxant (ex dantrolene) can be used to treat NMS
Other drugs: Clozapine, olanzapine (many end in -done or -pine)
Therapeutic use: Schizophrenia. Controls pos. and neg. symptoms (anergia, anhedonia, social w/drawal)
SE: DIABETES, WEIGHT GAIN, INC. CHOLESTEROL, sedation, ortho HTN, anticholinergic effects, menorrhagia, decreased libido. CLOZAPINE CARRIES RISK FOR AGRANULOCYTOSIS!
Key points: Risperidone can be administered by IM injection q2wks (for non-compliant patients). Avoid alcohol.
Therapeutic use: Contraception, PMS symptoms, post-menopausal osteoporosis, dysmenorrhea, prostate cancer.
SE: Embolic events(DVT,PE,MI,Stroke), HTN, weight gain, edema, increased risk of some cancers.
Key points: Contraindicated in Pts. who smoke, have HTN, are at high risk for embolic events, or have estrogen-dependent cancer.
Therapeutic use: Delayed puberty in boys, hypogonadism, postmenopausal breast cancer
SE:Acne, hypercholesterolemia, edema, liver dysfunction, polycythemia(increase in Hct and Hgb), premature epiphyseal closure. In women, causes deepening of voice, baldness, hirsutism
Key Points: Contraindicated in patients with prostate cancer. High abuse potential
Therapeutic use: Solid tumors
Mode of action: Binds to DNA, Inhibiting DNA and RNA synthesis. Causes death of rapidly replicating cells
SE: GI Upset, alopecia, bone marrow suppression(anemia, neutropenia, thrombocytopenia), cardiac toxicity, RED DISCOLORATION OF URINE/SWEAT/TEARS
Key Points: Monitor for infection, administer antiemetics for n/v, monitor cardiac function, monitor CBC levels.
indications: pulmonary edema, edema (r/t heart failure, liver disease, and kidney disease), hypertension
mode of action: blocks reabsorption of Na, Cl, and water in the ascending loop of henle, causing RAPID diuresis
SE: dehydration, electrolyte imbalance, hyponatremia, HYPOKALEMIA, HYPOTENSION, OTOTOXICITY, hyperglycemia
key points: administer during the day vs. night, infuse IV at 20mg/min, weigh patients daily, monitor I&Os, monitor electrolytes, ENCOURAGE FOODS HIGH IN POTASSIUM
indications: hypertension, (often in combination with antihypertensive meds), edema (r/t heart failure, liver disease, and kidney disease)
mode of action: blocks reabsorption of Na, Cl, water at distal convoluted tubule
SE: dehydration, HYPOKALEMIA , hyperglycemia, NO ototoxicity, ORTHOSTATIC HYPOTENSION
key points: administer during the day vs. night, weigh patients daily, monitor I&Os, monitor electrolytes, ENCOURAGE FOODS HIGH IN POTASSIUM
indications: edema, increased intracranial pressure (ICP), increased intraocular pressure (IOP)
mode of action: reduces ICP and IOP by increasing serum osmolality, which draws fluid back into the interstitial fluid and plasma
SE: HF, pulmonary edema, renal failure , dehydration, electrolyte imbalances (Na, K)
key points: use filter needle and filter in IV tubing, monitor weight, I&Os, electrolytes
Therapeutic use: Bacterial infections, acne, lyme disease
Mode of Action: Prevents protein synthesis, inhibiting bacterial growth
SE: GI upset, TOOTH DISCOLORATION IN CHILDREN (AND FETUSES), hepatotoxicity, PHOTOSENSITIVITY, superinfection (CDIFF, yeast infection).
Key points: DO NOT GIVE TO PREGNANT WOMEN OR CHILDREN UNDER 8 YEARS OF AGE. Wear sunscreen . Should be taken on an empty stomach w/full glass of water. Decreases effectiveness of oral contraceptives. DAIRY PRODUCTS(SUCH AS MILK), FOODS HIGH IN CALCIUM, AND ANTACIDS DECREASE ABSORPTION.