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Mirtazapine and Varenicline (Atypical Antidepressants)
Mirtazapine
α2-antagonist (Increased release of NE and 5-HT)
Potent 5-HT2 and 5-HT3 receptor antagonist and H1 antagonist
Toxicity: sedation (which may be desirable in depressed patients with insomnia), increased appetite, weight gain (which may be desirable in elderly or anorexic patients), dry mouth
Varenicline
Nicotinic ACh receptor partial agonist
Used for smoking cessation (decreases both cravings and decreasing the rewarding effects of nicotine)
Toxicity: sleep disturbance
Trazodone
Indications
Insomnia
Depression
Mechanism of Action
Inhibit Serotonin Reuptake
Alpha-1 Blocker
Histamine (H1) Blocker
Side Effects
Sedation
Orthostatic Hypotension
Dry Mouth
Priapism
Arrhythmias
2 mins
Monoamine Oxidase Inhibitors (MAO-Is)
Indications
Atypical Depression
Mechanism of Action
Increase Levels of Amine Neurotransmitters
Drugs
"Takes Pride In Shanghai"
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
1 min
Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome vs. Serotonin Syndrome
Autonomic Instability
Muscle Rigidity
Malignant Hyperthermia
Ryanodine Receptor 1 Mutation
Inhaled Anesthetics
Succinylcholine
Dantrolene
Neuroleptic Malignant Syndrome
Antidopaminergic Medications
Hyporeflexia
Myoglobinuria
Dantrolene
Serotonin Syndrome
Serotonergic Medications
Hyperreflexia
Clonus
Cyproheptadine
3 mins
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
2 mins
Bipolar Disorder Interventions
Drug Therapy
Lithium
Valproic Acid (Valproate)
Lamotrigine
Manic Episode
Hospitalization
Nutrition
Hygiene
Depressive Episode
Monitor for Vegetative Signs
Suicide Precautions
2 mins
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
59 secs
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
2 mins
Lamotrigine (Lamictal)
Mechanism
Blocks Na+ Channels
Indications
Seizures
Bipolar Disorder
Side Effects
Diplopia
Stevens-Johnson Syndrome
Headache
Aseptic Meningitis
Nausea and Vomiting
Considerations
Screen for Suicide Risk
2 mins
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