123: Drugs to treat Depression

Question 1

Examples of Tricyclics

Answer 1

anytriptyline, Imipramine, nortriptyline, lofepramine

Question 2

Tricyclics interact with

Answer 2

other sedatives : opioids, alcohol, anxiolytics. drugs that prolong QT. SSRIs

Question 3

Examples of SSRIs

Answer 3

Citalopram, Fluoxetine, Paroxitine, Sertraline

Question 4

Examples of Monoamine Oxidase Inhibitors

Answer 4

Phenelzine, Moclobemide

Question 5

Examples of Receptor Blockers

Answer 5

Mirtazapine, Trazodone

Question 6

Examples of Serotonin and Noradrenaline reuptake inhibitors

Answer 6

Venlafaxine, duloxetine

Question 7

Tricyclic (Amytriptyline, Nortriptyline, lofepramine) adverse effects

Answer 7

sedation, postural hypotension, tachycardia, arrhythmias, antimuscarinic( dry mouth, blurred vision, urinary retention)

Question 8

Tricyclics safe in overdose?

Answer 8

nope: risk of ventricular arrhythmias

Question 9

SSRI adverse effects

Answer 9

nausea vomiting GI disturbances, GI bleed, hyponatremia, sexual dysfunction, QT prolongation

Question 10

citalopram max dose

Answer 10

due to QT prolongation 40mg per day

Question 11

citalopram safe in overdose?

Answer 11

safest

Question 12

citalopram contraindications?

Question 13

fluoxetine contraindications

Answer 13

clopidogrel - reduces antiplatlet effect

Question 14

antidepressant of choice in cardiac disease/ post MI

Answer 14

sertraline ( SSRI)

Question 15

fluoxetine interactions

Answer 15

inhibits cytochrome P450 ( liver enzyme)- increases levels of antipsychotics, TCAs , carbamazepine, phenytoin.

Question 16

Monoamine oxidase inhibitors interactions

Answer 16

acute hypertensive crisis when combined with tyramine-rich food (mature cheese, beer, yeast extracts, pickled herring)

Question 17

Monoamine oxidase inhibitor symptoms in overdose

Answer 17

hypomania, coma, hypo/hypertension.

Question 18

receptor blocker - mertazapine adverse/side effects

Answer 18

increased appetite, weight gain, postural hypotension drowsiness

Question 19

greatest risk of death seen

Answer 19

venlafaxine (serotonin and noradrenaline reuptake inhibitors

Question 20

5 sites to interfere with the life of a neurotransmitter

Answer 20

1. synthesising enzymes.
2. receptors post.
3. receptors pre.
4. transporter.
5. degrading enzymes.