1
Q
What are prescription drugs?
A
- Require to be written by an ACREDITED PRESCRIBER PROVIDER
- Legal document that contains info required to dispense
- CHCS, hand written scripts only, NO FAX’d prescriptions
2
Q
** What is the DOD form to prescribe meds? **
A
DD 1289
- Used for all controlled drugs, unless directed by CO or Higher Authority
3
Q
What is the POLY-prescription form?
A
NAVMED 6710/6
4
Q
** What are all of the ways providers can submit prescriptions? **
A
CHCS
DD 1289
NAVMED 6710/6
5
Q
** What information must be written in ink, indelible pencil, or typewritten on prescriptions? **
A
- Pt’s full name
- Date script was written
- Patient’s DOB
- Full drug name, form of drug, dosage size/strength in METRIC, quantity dispensed, and written generically
- Directions for PT
- Legible signature of provider
- refill authorization
6
Q
How can IDC’s give meds without the DD 1289/NAVMED6710/6?
A
Proper SOAP Note documentation including drug administered
7
Q
What are the General Principles of Pharm?
A
(1) The factors that affect the actions of drugs.
(2) Factors that affect drug reactions.
(3) Various types of drug interactions.
(4) Factors influencing drug response interactions.
8
Q
What is Pharmacokinetic?
A
- Activities of drugs after it enters the body
- study of drug absorption, distribution, metabolism, and excretion
- fundamental concept: drug clearance, elimination of drugs from the body
8
Q
What are the different types of drug absorption in the body?
A
- Active Absorption
- Passive Absorption
- Pinocytosis
- Bioavailability
8
Q
What is active absorption?
A
Carrier Molecule such as a protein or enzyme activity moves the drug across the membrane
8
Q
What is passive absorption?
A
Diffuse across membrane from area of higher concentration to area of lower concentration
- Water Soluble Drugs
8
Q
What is Pinocytosis?
A
- Cells engulf the drug particle across cell membrane
- Pacman
8
Q
What are the factors that alter BIOAVAILABILITY?
A
- drug form (tabletm capsule, sustained release, liquid, trans-dermal, patch, inhalation, etc.)
- route
- changes in liver metabolism caused by dysfunction
- GI Mucosa and motility
- food and drugs
- solubility: I.E. fat soluble are absorbed faster than water soluble
8
Q
** What is bioavailability? **
A
- subcategory of absorption
- percentage of drug dose that reaches systemic circulation
- oral meds are only usable when metabolized/absorbed by liver
- Oral meds have 20-40% bioavailability
- IV meds have 100% bioavailability
8
Q
How does distribution of drugs in the body work?
A
Movement of a drug throughout the body typically by proteins known as ALBUMIN
9
Q
Where does metabolism of drugs happen?
A
Liver kidneys lungs plasma intestinal mucosa
10
Q
WHat is excretion?
A
Elimination of drugs from the body
- kidneys excrete inactive compounds through urine
11
Q
What is half-life?
A
- Time required for the body to eliminate 50% of the drug
- organ disfunction/ age, disease can increase risks of toxicity
12
Q
WHat is Pharmacodynamics?
A
Drugs actions and effects within the body
- primary = desired effect
- secondary (side effects) = desired/undesired
13
Q
Psychological dependence?
A
Compulsion to use substance to obtain a pleasurable experience
14
Q
Pharmacogenetic disorder?
A
genetically determined abnormal response to normal dose of a drug
15
Q
receptor?
A
specialized macromolecule that binds to the drug molecule, altering function of the cell and producing the therapeutic response
16
Q
What are the alterations in Cellular Environment?
A
A drug that alters cellylar function can INCREASE OR DECREASE the PSYCHOLOGIC Functions of the cell
- Example: Increased HR - Decreased BP
Therapeutic Response - Alteration of cell to achieve desires response
Agonist: Drug that binds with receptor to produce therapeutic response
17
Q
** What is an Antagonist? **
A
Drug binds to receptor stronger than agonist thus producing pharmacologic effect
- Narcan is antagonist to morphine
18
What is an adverse reaction?
Undesirable drug effects
19
What is allergic reaction?
- drug reaction when individuals immune system views drug as foreign substance
20
Drug idiosyncrasy?
AN unusual/abnormal reaction to a drug that a patient can have
- do not occur in the vast majority of patients taking the same drug
21
Drug Tolerance?
- Decreased response to a drug
| - requires increase in dosage to achieve desires effect
22
Cumulative Drug Effect?
drug effect that occurs when the body has not fully metabolized a dose of a drug before the next dose is given
23
*** Toxic? ***
Harmful drug effect if it is delivered in high dose or when blood concentration levels exceed therapeutic level
- may be reversible
- you have to know signs and symptoms of toxicity for drugs you are giving
24
Pharmacogenetics Reactions?
inherited traits that cause abnormal metabolism of the drug
| - G6PD patient taking aspirin or sulfonamides will have hemolysis of their RBC's
25
Pharmaceutic phase?
dissolution of a drug
| - applied to breakdown of tablets
26
Drug Interactions ?
When one drug interacts with/interferes with action of another drug
- antacid with oral tetracycline decrease effectiveness of tetracycline
27
*** Additive drug reaction? ***
A reaction that occurs when the combined effect of two drugs is equal to the sum of each drug given alone
28
*** Synergism? ***
A drug interaction that occurs when drugs produce an effect that is greater than the sum of their separate actions
29
Antagonist drug reaction:
WHen one drug interferes with action of another, causing neutralization or a decrease in the effect of one drug
- Protamine sulfate completely neutralizes the effects of heparin
30
Drug-Food Interactions?
Drug given orally, food may impair or enhance its absorption
| - Proton pump inhibitor should be taken 1 hour before meals
31
*** What are the factors influencing drug response? ***
- Age
- Weight
- Gender
- Disease
- Route of Administration
- Drug Use and Pregnancy
32
What are the basic Units for Dosage calculations?
- Weight = micrograms (mcg), Milligrams (mg), Grams (g), Kilograms (kg)
- Volume = Milliliter (mL), Liter (L), 1 mL = 1 cubic cm
Length = Meter (m)
33
Frequency used unit conversion for dosage?
- 1 kg = 1000 grams
- 1 g = 1000 mg
- 1 mg = 1000mcg
34
What is the most frequent route of drug administration that rarely causes physical discomfort when taken properly?
oral
35
*** What are the methods of oral medication administration?
- NG tube
- Buccal route: between cheek allowed to dissolve
- sublingual: Drug is placed or sprayed under the tongue
36
*** What are the methods of parenteral drug admin?
- Subcutaneous - SC, in between the tissue and muscle
- Intramuscular - IM, direct into the muscle
- Intravenous - IV, direct to blood via needle/catheter inserted into vein, action occurs immediately
- Intradermal - ID, sensitivity tests i.e TB
37
*** What are the applications of drugs through skin/mucus membranes?
- Topical
- Transdermal = small patch, Nicorette
- Inhalation = Albuterol
38
Pharmacological profile of Psychotherapeutics?
- Class: Sedatives and Hypnotics
- Sedative hypnotics = class that cause dose-dependent depression of CNS function: sedation, sleep, unconsciousness
- barbiturates, benzodiazepine, melatonin agonists
39
Barbiturates ACTION?
Action:
(a) Long-acting barbiturates sedative, and hypnotic, have anticonvulsant properties.
Barbiturates depress the sensory cortex, decrease motor activity, alter cerebellar
function, and produce drowsiness, sedation, and hypnosis. In high doses,
barbiturates exhibit anticonvulsant activity; barbiturates produce dose-dependent
respiratory depression.
Use:
(a) Sedation: Used as a sedative
(b) Seizures: Management of generalized tonic-clonic, status epilepticus and partial
Seizures.
40
Barbiturates ADVERSE EFFECTS?
```
Adverse Effects:
(a) CNS: Somnolence
(b) Respiratory: Hypoventilation
(c) GI: Nausea
(d) CV: Bradycardia
(e) Other: Agitation, confusion, nightmares, lethargy, vomiting, diarrhea, and
hypotension
```
41
Barbiturates CONTRAINDICATION/WARNING/CAUTION?
```
Contraindication/Warning/Caution:
- Hypersensitivity to phenobarbital
- barbiturates or any component of the
formulation; marked hepatic impairment
- dyspnea or airway obstruction;
porphyria (manifest and latent)
- intra-arterial administration
- subcutaneous
administration (not recommended)
- use in patients with a history of
sedative/hypnotic addiction; nephritic patients (large doses).
```
42
Barbiturates USES?
Use:
(a) Sedation: Used as a sedative
(b) Seizures: Management of generalized tonic-clonic, status epilepticus and partial
Seizures.
Example:
(a) Phenobarbital
(b) Thiopental (no longer manufactured in the United States or Canada).
43
Barbiturates CLASS?
SEDATIVES AND HYPNOTICS
44
`What are the PSYCHOTHERAPUTIC DRUGS?
- Barbiturates
- Anti-Anxiety
- Anti-depressants
- Anti-psychotic
- CNS-stimulants
45
WHat are the antiemetic drugs?
- Antiemetic
| - Anti-nausea
46
What are the Anesthetic drugs?
- Local
| - Induction
47
What are the Non-Narcotic Analgesics/Anti-inflammatory/Antipyretics?
- Salicylates
- Non-salicylates
- NSAIDS
- Urinary Anesthetic Analgesics
48
What are the bronchodilator drugs?
- Beta-2 agonist
- Muscarinic Antagonist
- Leukotriene Antagonist and Mast Cell Stabilizer
- Inhaled Corticosteroids
49
What are the Antihypertensive drugs?
- Ace inhibitors
- beta blockers
- calcium channel blocker
50
What are the Antihyperlipidemic drugs?
- Carbonic Anhydrase inhibitor
- loop diuretics
- osmotic Diuretics
- Potassium sparing diuretics
- Thiazide
- Hyperlipidemia
51
What are the Gastrointestinal System drugs?
- Antacids
- Histamine H-2 antagonist
- protein pump inhibitor
- Anti-diarrheal
- anti-flatulence
- hemorrhoid agents
- laxatives
52
WHat are the Anti-diabetic Drugs?
- Insulin
| - Oral Antidiabetics
53
What are the Profile of Hormone drugs?
- Thyroid
- Male Hormones (testosterone)
- Contraceptives
54
What are the Antibacterial Drugs?
- Sulfonamides
- Penicillin
- Cephalosporines
- Tetracyclines
- Macrolides
- Fluoroquinolones
- Aminoglycosides
- Carbapenem
- Amebicide/antiprotozoal/nitroimidazole
55
What are the Skin Disorder Drugs?
- Scabicide
- Topical anti-infective
- antiseptic and germicide
- topical corticosteroid
- keratolytic
- local anesthetic
56
What are the smoking cessation drugs?
- Anti-depressants
- nicotine replacement therapy
- partial Nicotine Agonist
57
What are the antianxiety drugs?
- Benzodiazepines
| - non-benzodiazepines
58
What are the actions of Benzodiazepines and non-benzodiazepines?
Generalized CNS depression, tolerance with long-term use, possible psychological/physical dependence
Benzo = bind to specific benzodiazepine receptors in the GABA receptor complex, which enhances binding of this inhibitory neurotransmitter
Non-Benzo = act on brain's dopamine and serotonin receptors
59
What are the uses for Benzo/Non-Benzodiazepines?
- Antianxiety, GAD (General Anxiety Disorder)
Short term use = benzodiazepines
long-term use = buspirone, doxepin (tricyclics), Fluoxetine (SSRI), paroxetine (SSRI), Sertraline (SSRI), venlafaxine (SNRI)
60
What are the adverse effects of Antianxiety drugs?
withdrawal syndrome after as little as 4-6 weeks
* **never discontinue abruptly***
- SX of withdrawal = fatigue, metallic taste, HA, numbness in extremities, sweating, dry mouth
61
What are the contraindications/warning/cautions of benzodiazepines/non-benzo?
DO NOT USE ON COMATOSE PATIENTS W/CNS DEPRESSION
- acute narrow glaucoma
- pregnancy class D
- CAUTION with kidney/liver disfunction
- NO ALCOHOL, tricyclic antidepressants, other antipsychotics
62
What are the examples of barbiturates?
- Phenobarbital
| - Thiopental (NO LONGER MANUFACTURED IN US/CANADA)
63
What are examples of Benzodiazepines?
- Alprazolam
- Diazepam
- lorazepam
64
What are examples of non-benzodiazepines?
- buspirone hydrochloride
- hydroxyzine
- sertraline (SSRI)
65
What does SSRI mean?
- Selective serotonin reuptake inhibitor
66
What are antidepressants class?
- Tricyclic Antidepressants (TCA's)
- Monoamine Oxidase Inhibitors (MAOI)
- Selective serotonin Reuptake Inhibitors (SSRI)
- Serotonin-norepinephrine reuptake inhibitors (SNRI's)
- Serotonin Reuptake inhibitor/antagonist
- Dopamine/Norepinephrine-reuptake inhibitor
67
WHat are the actions of antidepressants?
- TCA's
- increase levels of norepinephrine/serotonin by inhibiting reuptake, and block the action of acetylcholine
- MAOI - inhibits activity of Monoamine oxidase resulting in increased endogenous neuro-hormones
- SSRI - increase serotonin by inhibiting neuronal uptake to CNS
-
68
What are the uses of antidepressants?
- depressive symptoms
- anxiety (class dependent)
- obsessive compulsion disorder
- smoking cessation (bupriopion-wellbutrin)
69
WHat are the adverse effects of antidepressants?
- TCA's: Dry mouth, blurred vision, postural hypotension, urinary retention, constipation, and orthostatic hypotension
- MAOI's: Food interactions, vertigo, nausea, constipation, dry mouth, headache, and over-activity
- SSRI's: Nausea, vomiting (transient), sexual dysfunction, insomnia, and weight gain
70
Contraindications/warning/caution of antidepressants?
- TCA's: Hypersensitivity to TCA's/formulation, co-administration within 14 days or MAOI's, acute recovery phase after Myocardial infarction
- MAOI: CVA disease, hypertension, CHF, and elderly
- Wellbutrin: Contraindicated in patients w/seizure disorder or predisposition to seizures
- SSRI: fluoxetine less effective for smokers
71
What is the DOD Prescription, controlled drug prescription form?
DD 1289
72
What is the Poly-Prescription form?
NAVMED 6710/6
73
What must prescriptions include?
- Name/SSN/DOD ID
- Date prescription was written
- Patients age or date of birth
- Full GENERIC name of drug, form of drug, dosage size and strength written in
- Directions for the patient
- legible signature of the provider
- refill authorization
74
What is bioavailability?
The percentage of the administered drug dose that reaches the systemic circulation
75
List the factors that altar bioavailability?
- drug form
- route
- liver metabolism (disease/dysfunction)
- GI mucosa and motility
- food and drugs
- solubility
76
DEFINE antagonist?
Drug binds to receptor stronger than the antagonist thus producing no pharmacologic effect
77
DEFINE additive drug reaction?
Reaction that occurs when the combined effect of two drugs is equal to the sum of each drug given alone
78
DEFINE synergism?
A drug reaction that occurs when drugs produce an effect that is greater than the sum of their separate actions.
79
DEFINE antagonist drug reaction?
When one drug interferes with the action of another causing neutralization or a decrease in the effect of one drug
80
LIST the factors influencing drug response?
- Age
- Weight
- Gender
- Disease
- Route of administration
- Drug use in pregnancy
* **Teratogen - substance that may produce harm in human embryo or fetus
81
List the different types of drug administrations?
- Subcutaneous
- Intramuscular
- IV
- Intradermal
82
Define transdermal?
- Maintains a relatively constant blood concentration and reduces the possibility of toxicity
83
Define Inhalation?
- Local effect on the lungs
84
What is required and important about patient education for barbiturates?
Abuse potential
85
What are the different classes of antidepressants?
- Tricyclic antidepressants (TCA)
- Monoamine Oxidase inhibitors (MAOI)
- Selective Serotonin Reuptake inhibitors (SSRI)
- Serotonin Norepinephrine Reuptake Inhibitors (SNRI)
- Serotonin Reuptake Inhibitor/Antagonist
- Dopamine/Norepinephrine Reuptake Inhibitor
86
What do Tricyclic antidepressants (TCA) do?
- Increase levels of norepinephrine and serotonin by inhibiting their reuptake, and block the action of acetylcholine
87
What do Monoamine Oxidase Inhibitors (MAOI) do?
- Inhibits the activity of Monoamine oxidase resulting in increased endogenous neuro hormones
88
What is the function of Selective Serotonin Reuptake Inhibitors (SSRI)?
- increase serotonin by inhibiting neuronal uptake to CNS
89
What are and what is the purpose of CNS Stimulants?
- Amphetamines/Anorexiants
| - used in treatment of ADHD and narcolepsy
90
What are the adverse effects of Amphetamines/Anorexiants?
- Headache, dizziness, and apprehension
- Over stimulation of the CNS
- Insomnia, tachycardia, and blurred vision
91
How does Meclizine work?
- Acts as an antiemetic mainly by diminishing motion sickness
92
How do Local anesthetics work?
they inhibit the transport of ions across neuronal membranes thereby preventing initiation and conduction of normal nerve impulses
93
What are the effects of ketamine?
- Causes neuro-inhibition and anesthesia, where the patient is dissociated from surrounding
94
List the examples of Anesthetics?
- Lidocaine
- Bupivacaine
- Ketamine
- Propofol
- Etomidate
95
List the Non-steroidal anti-inflammatory drugs (NSAIDS):
- Anti-inflammatory
- Analgesic
- Antipyretic
96
What are come cautions/dangers of ibuprofen?
- may cause peptic ulcers
- GI bleeding
- HTN
97
What are Narcotic Analgesics used for?
- Short term management of moderate to severe pain
98
What type of drug is naloxone?
Narcotic Antagonist
99
What does naloxone do?
- Blocks opioid receptors
| - preventing the body from responding to opiates and endorphins
100
What type of drug is diphenhydramine?
Antihistamine
101
What warnings about topical nasal or ophthalmic decongestants?
- quickly develop tachyphylaxis thus long term use is not recommended
102
What drug is notorious for causing 'Rebound Congestion' when used for more than 3 consecutive days?
Oxymetazoline HCL
103
How do Beta2 Agonists work?
- Release stimulants and reuptake inhibitors that increase the levels of endogenous catecholamines
- Bets2 receptors are in the bronchioles
- when stimulated they relax and (dilate)
104
List the exampled of Antitussives?
- Codeine sulfate
- benzonatate
- dextromethorphan
- diphenhydramine
105
What is the function of Mucolytic/Expectorants?
- Loosens and mobilizes thick mucus from respiratory system
106
What is guaifenesin?
- expectorant
107
List the different actions of antiarrhythmics?
- blockade of Na or K channels
- raise the potential threshold
- block beta receptor stimuli
- block calcium channels
108
What are the characteristics of a Class 3 Antiarrhythmic?
Amiodarone blocks potassium channels in the heart
| - this is used for ventricular dysrhythmias and atrial fibrillation
109
How do Nitrates (Nitroglycerin) effect the body?
- Direct relaxing effect on smooth muscle of blood vessels, used in the treatment of angina pectoris
110
What are the adverse effects of ACE inhibitors (Lisinopril)?
Can cause a dry cough usually begins within 1-2 weeks
| - can be delayed 6 months
111
What are the adverse effects of Beta blockers (-olol)?
- Orthostatic Hypotension
- Bradycardia
- Bronchospasm
112
What are the contraindications of Beta blockers?
- sinus bradycardia
- heart block
- hypotension
- bronchial asthma
113
What are the actions of Diuretics?
| carbonic anhydrase inhibitor
- Leads to the excretion of sodium, potassium, bicarbonate and water
114
What are the actions of Antihyperlipidemic drugs?
- statins: inhibit an enzyme involved in cholesterol synthesis
- bile acid sequestrates: bind cholesterol in the GI tract
- Fenofibrate: stimulates the catabolism of triglyceride rich lipoproteins
115
What is a major side effect caused by antihyperlipidemic drugs?
- Rhabdomyolysis
116
What is important about antihyperlipidemic patient education?
- Obtain initial labs (LFT, lipid panel, chemistry)
- Allow 6-8 weeks for lifestyle changes prior to starting
- Advise on constipation
- advise on vitamins when using bile acid sequestrates
117
How do antacids work?
They neutralize or reduce the acidity of the stomach and duodenal contents by combining with hydrochloric acid and producing salt and water
118
What are the uses for Antacids?
- Heartburn
- GERD relief
- sour stomach
- acid indigestion
- peptic ulcer
119
What are the uses for Histamine H2 Antagonist?
| Cimetidine/famotidine
- treatment of gastric and duodenal ulcers
- gastric hyper secretory conditions
- gastroesophageal reflux
- prevention of stress related ulcers
- acute upper GI tract bleeding
120
What is the most common proton pump inhibitor?
Omeprazole
121
What drug decreases intestinal peristalsis?
Antidiarrheal (Loperamide)
122
What are hemorrhoid agents used for?
inflamed hemorrhoids
123
What will excessive/prolonged use of hemorrhoids agents lead to?
Atrophy
124
What are the effects of Sulfonylureas (oral antidiabetic) on the body?
- lowers blood glucose by stimulating beta cells of the pancreas to make more insulin
- can only be used in a patient with a working pancreas and not allergic to sulfa agents
125
What are the Estrogen actions?
- Protein anabolism
- thinning of the cervical mucus
- inhibitions of ovulation
126
The effectiveness of antibiotics depends on what?
- location of infection
- ability of the antibiotic to reach site of infection
- ability of bacteria to resist or inactivate the antibiotic
127
What are the examples of Sulfonamides?
- Silver sulfadiazine
| - trimethoprim/sulfamethoxazole
128
What are the uses for tetracycline (Doxycycline/minocycline)
- acne vulgaris
- rickettsia
- malaria
- chlamydia trachomatis (doxy)
129
What are some examples of Macrolide (-romycin) drugs?
- azithromycin
- erythromycin
- clarithromycin
- telithromycin
130
Antivirals are used to inhibit viral replication, what are the diagnosis most often prescribed for?
- herpes simplex
- HIV
- Influenza A/B
- chronic hepatitis C treatment
131
What are examples of Antivirals (-vir)?
- acyclovir
- vancyclovir
- penciclovir
- oseltamivir
132
What are topical antifungals?
- clotrimazole
| - tolnaftate
133
What are systemic antifungals?
- ketoconazole
- fluconazole
- terbinafine
134
What are some common effects of muscle relaxers?
| cyclobenzaprine, methocarbamol, metaxalone, diazepam, baclofen
- drowsiness is the most common reaction
| - patient must be carefully monitored
135
When are Corticosteroids contraindicated?
| hydrocortisone, prednisone, triamcinolone, dexamethasone
- serious infections, such as TB and fungal infections
136
When are antimigraine meds (rizatriptan/sumatriptan) CONTRAINDICATED?
- peripheral vascular disease
- uncontrolled HTN
- Wolff-Parkinson-White syndrome
- coronary vasospasm
- ischemic heart disease
137
What are ophthalmic preparations used for?
- treatment of bacterial or viral infections
- inflammatory conditions
- symptoms of allergy related to the eye
138
What are some examples of Eye preparations?
- artificial tears
- erythromycin ointment
- ciprofloxacin
- ganciclovir
139
What are examples of Nicotine Replacement Therapy (NRT)?
- Transdermal patch
- gum
- inhaler
- nasal spray
- lozenge
140
Who is ultimately responsible for CSIB?
CO
141
Who is the Controlled substance custodian?
Ship's medical department rep
142
Who is the Senior CSIB board member?
- Senior most officer on the CSIB board
143
What is the Senior CSIB member responsible for?
management, coordination, and execution of the CSIB program on behalf of the CO in accordance with SOP and all other references
- responsible for completion of all required forms, inventories and reports
144
What are the requirements for the CSIB board to follow for performing inventories?
- at least quarterly (every 90 days) if there has been no transactions
- within one month (30 days) of any transaction (prescription, receipt, survey) working stock custodian must notify the Senior CSIB member of any transaction
- at time of relief of CO or MDR
- at the request of the CO
- upon direction from higher authority
145
What are the forms required when conducting a CSIB inventory?
- NAVMED 6710/18
- NAVMED 6710/22
- NAVMED 6710/23
146
What form is used for Property loss?
DD 200
147
What is the official verbiage for a DD 200? Medical uses?
- shall be utilized during all destructions, loss or damage of controlled substances.
- DD 200 shall be used for each medication with different lot numbers
148
What are the forms associated with controlled substances?
- DD 200
- DD 1289
- DEA 106
- Issue/receive controlled substances on working stock log
- controlled medicinal inventory/audit report
149
What are examples of Antidepressants?
- Tricyclic - Amitriptyline: Elavil
- MAOI - Nardil
- Serotonin Reuptake Inhibitor/antagonist - Trazodone (desyrel)
- Serotonin-norepinephrine reuptake inhibitor (SNRI) - venlafaxine, duloxetine
- Dopamine/Norepinephrine-reuptake inhibitor - Bupropion (Wellbutrin), aminoketone (for smoking cessation)
150
What are the SSRI meds used for first line medication for depression?
- Citalopram - Celexa
- Fluoxetine - Prozac
- Sertraline - Zoloft
- Paroxetine - Paxil
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