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Therapeutic: sedative/ antiseizure
Phrmacologic: Barbituate, GABAA receptor agonist
Admin Alerts: schedule IV
OD severe resp. depression, CNS depression, coma and death
Drug-Drug:
Do not take with alcohol or other CNS depressants.

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- Treats fever and pain
- causes dilation of peripheral blood vessels, enabling sweating and dissipation of heat
NOT an anti-inflammatory

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T-class: antidepressant,
Pharmacological class: Tricyclic antidepressant

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Do not exceed 3,000mg in 24 hours
- Never administer to patients who consume alcohol regularly due to the potential for drug induced hepatotoxicity

- Overdose or long term use can cause severe and fatal liver injury, it is the number one cause of acute liver failure in the United States
Treatment for overdose: N-acetylcysteine (Acetadote)

- Inhibits warfarin metabolism, causing it to accumulate to toxic levels

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- Blocks reuptake of serotonin & norepinephrine into nerve terminals
- Used mainly for major depression, can be used to treat nocturnal enuresis in children.
- Off-label: intractable pain, anxiety disorders, & withdrawal from alcohol and cocaine

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- Paradoxical diaphoresis can be side effect of TCAs
- Anticholinergic effects: dry mouth, blurred vision, drowsiness, dizziness, constipation, n/v, & weight gain/loss; increased sweating may occur
- Do not discontinue abruptly because rebound dysphoria, irritability, or sleeplessness may occur.
- Pregnancy category C

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Drug to drug:
-  Cimetidine and methylphenidate may inhibit the metabolism of imipramine
- May reverse the antihypertensive effects of Clonidine and potentiate CNS depression

Lab tests:
- altered blood glucose test, serum bilirubin and alkaline phosphate

Food/ Herbal
evening primrose oil or ginkgo may lower seizure threshold, St John's wort

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- sedation
- drowsiness
- blurred vision
- dry mouth
- cardiovascular symptoms: dysrhythmias, heart block, & extreme hypertension
- some may experience photosensitivity & hypersensitivity to tricyclic drugs

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Antidepressants increase the risk of suicidal thinking and behavior, especially in children, adolescents, & young adults with major depressive disorder & other psychiatric disorders.
This drug is not approved for use in pediatric patients.

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does not cause GI bleeding or ulcers, as do the NSAIDs

- Advise patients that acetaminophen is found in many OTC products and that extreme

care must be taken to not duplicate doses by taking several of these products concurrently.

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- Long-acting barbiturate used to manage seizures
- acts biochemically by enhancing the action of the GABA  neurotransmitter, which is responsible for suppressing abnormal neuronal discharges that can cause epilepsy.
- used to promote sleep

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- acute recovery after MI
- defects in bundle-branch conduction
- narrow-angle glaucoma
- severe renal or hepatic impairment
- Do not use this drug within 14 days of discontinuing MAOIs

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- IM injection may produce a local inflammatory reaction
- IV admin rarely used b/c extravasation may produce tissue necrosis
- controlled substance: schedule IV
- Pregnancy category D

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- hypersensitivity to barbiturates
- severe uncontrolled pain
- preexisting CNS depression
- porphyria
- severe respiratory disease w/dyspnea or obstruction
- glaucoma
- prostatic hypertrophy

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Common: drowsiness, vitamin D, folate (B9) & B12 deficiencies & laryngospasms

Overdose: severe respiratory depression, CNS depression, coma, & death

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Drug-Drug:
Do not take with alcohol or other CNS depressants.

Lab Tests:
Bromsulphalein tests & increase serum phosphate

Herbal/Food:
Kava & valerian may potentiate sedation

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- no specific treatment
- general supportive measures are
recommended
- monitor cardiac rhythm & VS
- gastric lavage may be indicated, activated charcoal should be administered