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PHARM 203 > 25: Antidepressants > Flashcards

25: Antidepressants Flashcards

1
Q

MAO theory

A 
depression = lacks NE and 5HT
mania = too much
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2
Q

TCA action

A

blocks NE and 5HT reuptake

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3
Q

MAOI action

A

increases NE and 5HT

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4
Q

reserpine action

A

inhibits NE and 5HT storage

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5
Q

alpha methyl tyrosine and methyldopa action

A

inhibits NE synthesis

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6
Q

ECT

A

increases CNS responses to NE and 5HT

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7
Q

tryptophan action

A

increases 5HT synthesis

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8
Q

issues with MAO theory

A

drect neurochemical effects appear rapidly, but antidepressant effects take weeks

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9
Q

neuroendocrine mechanisms of depression

A

HPA axis

  • NE and 5HT inputs
  • in depressed pts: CRH - ACTH - cortisol release
  • decrease in GH and increase in prolactin
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10
Q

trophic effects and neuroplasticity of depression

A

decrease levels of BDNF
increase Glu = excitotoxicity
neuronal loss in hippocampus and prefrontal cortex

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11
Q

list inhibitors of MAO reuptake

A 
SSRIs
NDRIs
SNRIs
TCAs
St. John's wort
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12
Q

MAOIs list

A

irreversible, noncompetitive, nonselective- MAOA and MAOB

reversible = MAOA selective

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13
Q

SARI

A

serotonin-2 antagonists/ serotonin reuptake inhibitors

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14
Q

serotonin ___ agonist/ serotonin reuptake inhibitor

A

1A

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15
Q

NaSSA

A

noradrenergic/ specific serotonergic agent

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16
Q

bupropion is a

A

NA reuptake inhibitor- NDRI

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17
Q

trazodone is a

A

5HT reuptake inhibitor

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18
Q

NE reuptake blockade effect

A

antidepressant

side effects: tremors, tachycardia, hypertension, sweating, erectile and ejaculation problems

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19
Q

5HT reuptake blockade effects

A

antidepressant, antianxiety, antipanic, antiobsessional effect

side effects: dyspepsia, nausea, headache, sexual
serotonin syndrome

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20
Q

DA reuptake blockade affect

A

mitigates against prolactin elevation

may aggravate psychosis

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21
Q

5HT1A agonism effect

A

antidepressant, anxiolytic, antiaggressive

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22
Q

5HT2A blockade

A

anxiolytic, antidepressant, antipsychotic, antimigraine, improved sleep
side effects: hypotension, ejaculatory problems, sedation, weight gain

23
Q

M1 blockade effects

A

dry mouth, blurred vision, anticholinergic effects

- second most potent action of TCAs

24
Q

TCAs actions in order of potency

A
  1. H1 blockage
  2. ACh M1 blockage
  3. NA
  4. 5HT
25
Q

H1 blockade effects

A

sedation, postural hypotension

26
Q

alpha 1 blockade effects

A

postural hypotension, dizziness, reflex tachycardia

potentiation of antihypertensive drugs

27
Q

alpha 2 blockade effects

A

possible decrease in depressive symptoms

28
Q

D2 blockade effect

A

antipsychotic

29
Q

paroxetine, sertraline, citalopram, and escitalopram are

A

SSRIs

30
Q

SSRIs in addition to their normal function, also

A

inhibit NE and DA reuptake

31
Q

what drug has risk of QT interval prolongation

A

citalopram

32
Q

what is the most obvious SSRI adverse reaction

A

enhanced 5HT levels = risk of serotonin syndrome

33
Q

TCA actions

A

NE and 5HT reuptake inhibitors that vary in selectivity and activity

also affect H1 and ACh blockage

34
Q

secondary amine TCA action

A

NE > 5HT

35
Q

desipramine and nortriptyline are

A

secondary amine TCAs

36
Q

amitriptyline, clomipramine, doxepin, imipramine, trimipramine are

A

tertiary amine TCAs

37
Q

tertiary amine TCAseffect

A

increased 5HT effect but still more inhibition of NA reuptake

38
Q

how do TCAs cause orthostatic hypotension

A

blocking alpha receptors

39
Q

what SNRI targets 5HT at low doses and NE at high doses

A

venlafaxine

40
Q

which has fewer side effects, TCA or SNRIs

A

SNRIs

41
Q

what is bupropion

A

NDRI

42
Q

what lowers seizure thresholds

A

NDRIs

bupropion

43
Q

trazodone is a

A

SARI

44
Q

trazodone action

A

blocks 5HT 2A and 2C receptors

blocks 5HT reuptake

45
Q

mirtazapine is a

A

NaSSA

46
Q

what does mirtazapine block

A

alpha2 adrenoceptors
5HT2A
5HT2C
5HT3

47
Q

what side effects does mirtazapine have

A

antihistamine side effects as it is a potent H1 receptor antagonist

48
Q

vortioxetine

A

serotonin modulator and sitmulator

49
Q

vilazodone

A

serotonin 1A agonist/ serotonin reuptake inhibitor

50
Q

what is the main target for antidepressant MAOIs

A

MAOA

51
Q

phenelzine and tranylcypromine are examples of

A

irreversible, noncompetitive nonselective inhibitors

52
Q

moclobemide is a

A

reversible, MAO-A selective inhibitor

53
Q

why is MAOI an last resort drug

A

hypertensive crisis can be triggered by tyramine- lots of food restrictions + OTC cough and cold agents can contain sympathomimetics

PHARM 203 (21 decks)

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