Neuro Pharm 11
Terms
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- barb interactions
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- phenobarbital + cimetidine, erythromycin, clarithromycin, or fluconazole means increased phenobarb
– phenobarbital + rifampin means decreased phenobarb - long-acting benzos for anxiety
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- b/c long-lasting active metabolite Nordiazepam
- diazepam, flurazepam, chlordiazepoxide, cloraze-pate
- more daytime sleepiness - shorter-acting benzo's for anxiety
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- triazolam and midazolam (for unconcious sedation)
- more sever withdrawl - intermediate acting benzo's for anxiety
- lorazepam, alprazolam, temazepam
- what decreases benzo level
- rifampin, food, antacids
- what increases benzo level
- Cimetidine, disulfiram, isoniazid, and estrogen
- benzos increase the level of
- phenytoin, digoxin
- Panic Disorder tx
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– 1) TCA's (imipramine, clomipramine)
– 2) SSRI's (gold for PD and SAD)
– 3) SNRIs
– 4) benzo’s (alprazolam, clonazepam, lorazepam)
– 5) MAOI's for refractory cases due to SE profile
– initiate at low doses then titrate to avoid temporary worsening of panic sx - OCD tx
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– Only effective work w/ S
– Clomipramine (TCA)
- 4 SSRIs – fluoxetine, sertraline, paroxetine, and fluvoxamine - PTSD tx
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– SSRIs first-line
- sertraline and paroxetine have FDA approval - GAD tx
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- BZDs were used, now
– Buspirone
– The SNRI, venlafaxine
– SSRIs paroxetine and citalopram - Social Anxiety Disorder tx
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- MAOs OK, but SSRIs 1st line
– sertraline, paroxetine, venlafaxine
– Benzos or β-blockers sometimes uses (performance anxiety)