DL - Final 3
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Does Lexapro or Celexa have a faster OOA?
Lexapro by 1-2 weeks
Is Lexapro or Celexa superior?
Lexapro has not been shown to be superior to Celexa or to have less side effects than Celexa.
How is Celexa metabolized?
Hepatic metabolism is primary
T1/2 of Celexa is increased by 50% in ___________.
The oral clearance of _________________ is decreased 37% in liver impairment and t1/2 is increased 50%.
The oral clearance of Celexa is decreased 37% in _____________________ and t1/2 is increased__________.
First approved SSRI in the US and the longest half life of all the SSRI’s is:
What is Prozac indicated for?
- Depression, OCD, bulimia nervosa, panic disorder, PTSD
- Geriatric depression
- Pediatric use in depression and OCD
- Sarafem – PMDD
Prozac weekly is used for what?
Maintenance treatment of depression
How/When should patients take Prozac?
- Morning or night based on how it effects them
- > 40 mg-divide in two doses- morning and afternoon
- Weekly-swallow whole, don’t crush, chew, or cut
How does Prozac compare to other SSRIs?
Slower onset of action
What are the pharmacokinetic parameters of Prozac?
- Potent Inhibitor of CYP 2D6
- Inhibits CYP 3A4
- Food can delay rate of absorption, but not bioavailability
- Elderly metabolize similarly to younger people
- Hepatic impairment can delay elimination
What are the dosage forms available for Paxil?
- CR = 12.5, 25, 37.5 mg
- IR = 10, 20, 30, or 40mg and 10mg/5ml suspension
How many active metabolites does Paxil have?
No active metabolites
What SSRI has the highest affinity for serotonin receptors?
What are the indications for Paxil?
Adults with depression, depression complicated by anxiety, and for all the major anxiety syndromes, OCD, panic disorders, social anxiety
Paxil has what DDIs?
Potent inhibitor of CYP 2D6
Should you take Paxil with food?
Bioavailability is not affected by food
What groups need lower doses of Paxil?
Elderly, renal, and liver impaired
When there are questionable drug interactions ______________________ should be first choice because they have lower risks of drug interactions.
Citalopram or Sertraline
In a patient who is prone to SSRI adverse effects do not give __________________ due to increased GI side effects.
Paroxetine - Paxil
____________________ is a good choice for patients who are poorly compliant or who have had trouble with discontinuation of antidepressants previously.
Fluoxetine – Prozac
What are the dosage forms available for Cymbalta?
20, 30 and 60 mg
_______________________ is effective in treating depression and improves the painful physical symptoms of depression. It can also be used to treat Generalized Anxiety Disorder.
Those with preexisting liver disease may have increasing liver damage with ____________________.
When should Cymbalta be avoided?
- Substantial alcohol use and or chronic liver disease
- Don’t give with any liver impairment
How do you administer Extended-release Effexor capsules:
- As a single dose
- With food to decrease GI upset
- Morning or evening
- At the same time each day
- Swallow whole with plenty of fluids
- Alternatively - open capsule and sprinkling the entire contents on a spoonful of applesauce, swallow immediately without chewing and follow w/ a glass of water
What are the major SE of Effexor?
HTN or a faster heart rate
What are TCAs usually used for?
What are the common SE of TCAs?
- Dry mouth (use gum)
- Dry eyes
- Blurred vision (used lubricating drops)
- Sun sensitivity
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