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Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012. Main source, Stahl’s: The Prescribers Guide.2009

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Page 1: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Medications

Most of the medication questions are covered as part of specific Disorders. The following

are some outside Disorders.As of 15January2012. Main source, Stahl’s: The Prescribers Guide.2009

Page 2: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

This PowerPoint Section

This PowerPoint Section only addresses a few meds as most meds are covered in the psychiatric management parts of the PowerPoints devoted to specific Disorders.

Page 3: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Gabapentin

Q. Gabapentin is FDA approved for?

Page 4: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Benzodiazepines

Q. How do benzodiazepines work?

Page 5: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Benzodiazepines

Ans. Binds to benzodiazepine receptors at the GABA-A ligand-gated chloride channel complex.

Page 6: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Gabapentin

Ans.

1] partial seizures

2] post-herpetic neuralgia

[So, much as many of us have had good results with gabapentin, it will frequently be the wrong answer on exams where FDA approval is implied.]

Page 7: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine

Q. FDA approves clozapine for?

Page 8: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine

Ans.

1] “Resistant” schizophrenia

2] People with schizophrenia who are high suicide risk.

Page 9: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

SSRIs

Q. List the SSRIs.

Page 10: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

SSRIs

Ans.

Citalopram

Escitalopram

Fluoxetine

Fluvoxamine

Paroxetine

Sertraline

Page 11: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Flumazenil

Q. FDA approves flumzenil for?

Page 12: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Flumazenil

Ans. Reversal of sedative side effects of benzodiazepines, such as overdose, including such a need in children.

Page 13: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Risperidone

Q. Risperidone’s notable side effects?

Page 14: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Risperidone

Ans. Stahl lists four:

Increase risk for diabetes

Increase risk for dyslipidemia

Dose-related hyperprolactinemia

Page 15: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Modafinil

Q. Modafinil is FDA approved for?

Page 16: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Modafinil

Ans.

Reducing excessive sleepiness associated with:

-- narcolepsy

-- shift-work sleep disorder

-- obstructive sleep apnea

Page 17: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Acamprosate

Q. Acamprosate is thought to work on which receptor sites?

Page 18: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Acamprosate

Ans. Stabilize glutamatergic function.

Page 19: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Carbamazepine – lab tests

Q. What lab tests are needed when using carbamazepine?

Page 20: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Carbamazepine – lab tests

Ans.

Blood count: every two weeks for 2 months, then every three months.

Liver, kidney and thyroid function: every 6 to 12 months

Consider monitoring sodium

Page 21: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Carbamazepine – lifethreatening

Q. What are the life-threatening conditions to worry about when using carbamazepine?

Page 22: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Carbamazepine – lifethreatening

Ans.

1. Rare, aplastic anemia, agranulocytosis

2. Rare, Stevens-Johnson syndrome

3. Rare, SIADH = syndrome of inappropriate antidiuretic hormone secretion with hyponatremia

Page 23: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine – tests/monitoring

Q. What tests are to be run with clozapine?

What do you want to monitor in addition to the lab test and physical findings

Page 24: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine – tests - 1

Ans.Complete blood count:

-- before treatment-- weekly for 6 months-- then biweekly for months 6-12-- after one year, then every four weeks-- then 4 weeks after treatment discontinued

See next screen

Page 25: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine – tests - 2

Ans. Continued:Track:

weight, q 3 monthsBMI, q 3 monthswaist circumference, q 3 monthsfasting glucose, q 3 monthslipids, q 3 months

Page 26: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Clozapine – monitoring - 3

Ans. Vigilant for diabetic ketoacidosis by monitoring: rapid onset of polyuriarapid onset of polydipsiaweight lostnausea or vomitingdehydrationincreased Rweaknessclouding of sensorium, [including, of course, coma]

Page 27: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Valproate – tests and monitoring

Q. What to test and monitor for when prescribing valproate?

Page 28: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Valproate – tests andmonitoring

Ans. Lab tests before beginning treatment:

platelet countcoagulation testliver function tests

Also monitorweight

Follow above frequently, especially in first six months, then once or twice a year.

Page 29: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Prazosin

Q. Use of prazosin [Minipress] in psychiatry?

Page 30: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Prazosin

Ans: PTSD’s nightmares.

Page 31: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Bupropion’s use in anorexia nervosa

Q. Discuss bupropion’s use in anorexia nervosa.

Page 32: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Bupropion’s use in anorexia nervosa

Ans. Has FDA black box because of increased of seizures in pts with eating disorders.

Page 33: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Warfarin

Q. What should not be used with warfarin [Coumadin]?

Page 34: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Warfarin

Ans. bupropioncitalopramdisulfirammifeprestone [RU 486

[may not be complete][answer may be to use with caution, rather

than not at all]

Page 35: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Anticholinergic signs

Q. What are the untoward anticholinergic signs?

Page 36: Medications Most of the medication questions are covered as part of specific Disorders. The following are some outside Disorders. As of 15January2012

Anticholinergic signs

Ans.1. dry mouth2. blurred vision3. constipation4. tachycardia5. urinary retention6. hyperthermia 7. decreased cognition8. [also, bad for narrow-angle glaucoma]


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