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What antidepressant category are: Amitriptyline, Despiramine, Doxepin, Imipramine, and Nortriptyline?
Tricyclic Antidepressants (TCAs)
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What antidepressant category is: Trazodone?
What is Trazodone's most common use?
Miscellaneous Antidepressant, Most often used as a sleep aid
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What antidepressant category are: Citalopram, Escitalopram, Fluoxetine, Paroxetine, and Sertaline?
Selective Serotonin Reuptake Inhibitor (SSRIs)
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What antidepressant category are: Duloxetine and Venlafaxine?
Selective Norepinephrine Reuptake Inhibitors (SNRIs)
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What antidepressant category are: Isocarboxazid, Phenelzine, Selegiline, and Tranylcypromine?
Monoamine Oxidase Inhibitor (MAOIs)
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What antidepressant categories are: Bupropion, Mirtazapine, and Lithium?
- Bupropion: Aminoketone Antidepressant
- Mirtazapine: Novel Alpha-2 Receptor Antagonist
- Lithium: Lithium
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What categories of drugs make up the Antidepressants?
TCAs, Misc. Antidep, SSRIs, SNRIs, MAOIs, and the individual agents - Aminoketone Antidep, Alpha-2 Rec. Antag., Lithium
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What anti-anxiety category are: Buspirone and Diphenhydramine?
"Other" Anti-anxiety agents
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What anti-anxiety category are: Eszopiclone, Ramelteon, Zaleplon and Zolpidem?
"Z" drugs
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What antipsychotic category is: Haloperidol?
Butyrophenone
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What antipsychotic category are: Aripiprazole, Clozapine, Olanzepine, Quetiapine, Risperidone, and Ziprasidone?
Atypicals
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What type of drugs are these: Carbamazepine, Clonazepam, Ethosuximide, Gabapentin, Lamotrigine, Levetiracetam, Pregabalin, Phenytoic, Sodium Valproate, and Topiramate?
Anticonvulsants
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What type of drugs are these: Carbidopa/Levodopa, Pramipexole, Ropinirole, Rasagiline, Selegiline, and Entacapone?
Antiparkinson's Drugs
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What type of drugs are these: Atomoxetine, Methylphenidate, Dexmethylphenidate, Dextroamphetamine, Lisdexamfetamine, and Amphetamine Mixtures?
ADD/ADHD
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Of the antidepressant categories which are the most dentally significant in terms of adverse effects?
TCAs, MAOIs, and Lithium
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What are the common dentally significant adverse effects of the TCAs?
- sedation
- *Most severe xerostomia
- orthostatic hypotension
- tachycardia
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What are the common dentally significant adverse effects of the SNRIs?
increased BP with venlafaxine
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What are the common dentally significant adverse effects of the SSRIs?
- bruxism
- nausea
- insomnia
- agitation
- sedation
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What are the common dentally significant adverse effects of the Mirtazapine?
- drowsiness
- dizziness
- weight gain
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What are the common dentally significant adverse effects of the Bupropion?
- seizures (rare but serious)
- agitation
- insomnia
- dry mouth
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What are the common dentally significant adverse effects of the Lithium?
- tremor
- taste disturbances
- abnormal facial movements
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What are the common dentally significant adverse effects of the MAOIs?
- orthostatic hypotension
- tachycardia
- HA
- restlessness
- insomnia
- dizziness
- overstimulation
- dry mouth
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What adverse effect do most anti-anxiety agents produce? Which drug is the exception?
Most are CNS Depressants except Buspirone
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What are the common dentally significant adverse effects of Buspirone?
- dizziness
- nausea
- HA
- nervousness
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What are the common dentally significant adverse effects of the "Z" Drugs?
CNS Depressants
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What are the common dentally significant adverse effects of Haloperidol?
Casuses the highest risk of movement disorders
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What are the common dentally significant adverse effects of the Atypical Antipsychotics?
- Weight gain
- Most are CNS Depressants; exception aripiprazole
- QT interval prolongation; risk highest w/Ziprasidone and Quetiapine
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What adverse effect do most anti-epilepsy agents (AEDs) produce?
All are CNS depressants and most predispose to blood dyscrasias and dermatologic/mucosal toxicity
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What are the common dentally significant adverse effects of Phenytoin?
- Gingival overgrowth
- Possible Osteomalacia
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What are the common dentally significant adverse effects of Sodium Valproate?
Possible bleeding caused by dec. platelets or platelet activity
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What are the common dentally significant adverse effects of Carbidopa/Levodopa?
Can cause excessive movements including bruxism
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What are the common dentally significant adverse effects of the Miscellaneous Antiparkinsonian Drugs?
Most side effects are not significant compared to dopaminergics
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What adverse effect do most ADD/ADHD have in common? Which drug is the exception?
- They are all Schedule II amphetamines
- CNS Stimulation: HA, Nervousness, dry mouth, insomnia, appetite suppression
- Can increase BP and heart Rate
- **EXCEPTION = Atomoxetine**
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What are the major treatment impacts for the Antidepressants?
- TCAs: Epi intx w/high-dose TCA, additive CNS dep. w/ opoids and anti-anxiety agents, MOST SEVERE XEROSTOMIA
- SNRIs: Additive CNS dep. w/Trazodone and opiods, LESS dry mouth, MOST LIKELY to INC BP, most likely to be used for neuropathic or chronic pain
- SSRIs: Less dry mouth, avoid combo w/BZDP
- Mirtazapine: BZDPs inc psychomotor impairment, min dry mouth
- MAOIs: Limit epi to .04mg, avoid Meperidine, avoid decongestants and amphetamines
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What are the major treatment impacts for the Anti-anxiety agents?
- BZDP: additive w/CNS depressants
- Others:
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What are the major treatment impacts for the Antipsychotic agents?
- Haloperidol: Little or no intx w/epi, xerostomia
- Atypicals: Clozapine + BZDP = resp dep & hypotension as well as red. effects of opoids
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What are the major treatment impacts for the Anticonvulsant medications?
- potentiated by CNS Dep
- Sodium Valproate: possible bleeding
- Phenytoin: Gingival overgrowth
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What are the major treatment impacts for the Antiparkinson's agents?
- Levodopa can inc effects of epi
- Pt mgmt is difficult due to movements and excessive saliva
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What are the major treatment impacts for the ADD/ADHD drugs?
Possible inc caries
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