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Week 23: Neuroscience > 23.5 Pharm: Antidepressants > Flashcards

23.5 Pharm: Antidepressants Flashcards

1
Q

What are some 1st gen antidepressants?

A

Tricyclic antidepressants, MAO inhibitors

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2
Q

What are some 2nd generation antidepressants?

A

SSRIs, SSNRIs

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3
Q

What are the 3rd gen antidepressant drugs?

A

‘Atypical’- novel monoaminergic, non-monoaminergic

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4
Q

How do tricyclics work?

A

Inhibit NA/5HT reuptake

Antagonists for His/Musc/a-adreno/5HT R’s

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5
Q

What can tricyclics do at high concentrations?

A

Block Na+ channels (membrane stabilising/anaesthetic, Quinidine like effects)

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6
Q

What drug are tricyclics structurally similar to?

A

Schozophrenia drugs

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7
Q

What are the pharmacokinetics of tricyclics?

A

Narrow therapeutic window, long half life

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8
Q

What are some side effects of tricyclics?

A

Sedation, anti-cholinergic, postural hypotension, weight gain

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9
Q

How do MAO inhibitors work?

A

Increase NA/5HT/DA

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10
Q

What reaction can occur with irreversible MAO inhibitors?

A

‘Cheese reaction’

Tyramine isn’t broken down (gut wall MAO usually does this)-in cheese/choc/wine/bananas

Tyramine releases NA (sympathomimetic effects)

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11
Q

What is a reversible MAO inhibitor selective for? What does this help with?

A

MAO A selective, less ‘cheese reaction’

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12
Q

How do SSRIs work?

What are some names?

A

Selective for serotonin

Fluoxetine, paroxetine, sertraline

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13
Q

What are the pharmacokinetics of SSRIs like?

A

Minimal toxicity alone, high therapeutic window

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14
Q

What are some side effects of SSRIs?

A

Nausea, decreased libido, weight change

Young people: increased anxiety and suicidal ideation

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15
Q

Why was an SSNRI developed?

A

For maintaining the serotonin:noradrenaline balance.

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16
Q

What are some atypical antidepressants? What has this shown us about treating depression?

A

Monoaminergic mechanisms, we’re moving towards targeting the receptors (not just focusing on NTM levels)

Also non-monoaminertic (e.g. opioids, supporting cell targets, herbal-St John’s Wort)

17
Q

What drug is used in bipolar depression?

A

Lithium carbonate

18
Q

How does lithium carbonate work?

A

Intracellularly, 2nd messenger calcium regulation

19
Q

What are side effects of lithium carbonate?

What are the pharmacokinetics?

A

Nausea, renal/thyroid/neurological problems

Low therapeutic index so need to monitor plasma

Week 23: Neuroscience (7 decks)

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