5-HT / CNS adrenergic

Question 1

MDD

Answer 1

major depressive disorder
depressive episodes with NO MANIA
2 week period + interfering with ADL

Question 2

types of MDD

Answer 2

typical ( melancholic )
atypical
psychotic

Question 3

BPAD

Answer 3

bipolar affective disorder

MANIC episode w or w/o depression

Question 4

inhibitors of 5-HT storage

Answer 4

amphetamine
methamphetamine
methylphenidate

modafinil
dextroamphetamine
lisdexamfetamine

Question 5

ADHD

Answer 5

dextroamphetamine

lisdexamfetamine

Question 6

modafinil

Answer 6

atypical depression
narcolepsy
obstructive sleep apnea

Question 7

irreversible MAOIs

Answer 7

iproniazid
phenelzine
isocarboxazid

no longer 1st line therapy b/c of SE

Question 8

SE of MAOI

Answer 8

*tyramine toxicity - hypertensive crisis

precipitate manic or hypomanic episodes in bipolar patients

Question 9

MAO-A inhibitors

Answer 9

brofaromine
befloxatone
moclobemide

reversible
less tyramine toxicity

Question 10

MAO-B inhibitor

Answer 10

selegiline
-also MAO-A at higher doses

transdermal patch
better freedom w diet

Question 11

MDMA

Answer 11

methylenedioxymethamphetamine

SSRI + 5HT agonist

Question 12

tyramine located in

Answer 12

red wine, processed meats, aged hard cheeses

Question 13

MAOIs metabolized by

Answer 13

cytochrome P450 enzymes

lots of drug interactions

Question 14

reserpine

Answer 14

blocks uptake of DA,5HT,NE by VMAT into vesicles

can induce depression

Question 15

TCA

Answer 15

• TRIPTYLINE ( amitriptyline )

- IMPRAMINE ( imipramine )

Question 16

TCA mechanism of actions

Answer 16

blocks NET and SERT

Question 17

TCA SE

Answer 17

*conduction delays
*orthostatic HTN in elderly
MI
jaundice, seizure

Question 18

SSRI

Answer 18

*fluoxetine
*paroxetine
*sertraline
fluvoxamine
citalopram

Question 19

SSRI SE

Answer 19

SEROTININ syndrome when given with MAOI
- muscle rigidity, hyperthermia, myoclonus, mental state/vital sign changes

sexual dysfunction
GI
-diarrhea ( SERTALINE causes you to Shit your pants )
-constipation ( PAROXETINE )

Question 20

SSRI uses

Answer 20

typical depression
anxiety
OCD
PTSD
pain syndromes

Question 21

SNRIs

Answer 21

venlafaxine
duloxetine
desvenlafaxine
milnacipran

Question 22

neuropathic pain

Answer 22

duloxetine

gabapentine

Question 23

MDD

Answer 23

desvenlafaxine

Question 24

milnacipran

Answer 24

fibromyalgia

Question 25

NRIs

Answer 25

atomoxetine

Question 26

atomoxetine

Answer 26

ADHD | once daily dosing

Question 27

bupropion mechanism

Answer 27

weakly inhibits uptake of DA,5HT,NE

Question 28

bupropion uses

Answer 28

smoking cessation atypical depression fewest sexual SEs less mania

Question 29

mirtazapine mechanism

Answer 29

blocks 5HT2 and alpha2 receptors | decreases 5HT and increases NE transmission

Question 30

mirtazapine use

Answer 30

depression | *stimulate appetite and weight loss in elderly

Question 31

TCAs uses

Answer 31

depression nocturnal enuresis ( imipramine ) pain syndromes - migraine, chronic fatigue

Question 32

5-HT agonists

Answer 32

buspirone - 5HT1 -TRIPTANs ( suma- near- riza- ) - 5HT1B/1D

Question 33

buspirone

Answer 33

anxiety

Question 34

triptans

Answer 34

migraines

Question 35

5-HT receptor antagonist

Answer 35

``` ketanserin ondansetron tegaserod prucalopride alosetron ```

Question 36

ketanserin

Answer 36

5HT2A/2C glaucoma HTN

Question 37

ondansetron

Answer 37

5HT3 antagonist nausea

Question 38

tegaserod | prucalopride

Answer 38

5-HT4 ( Gs ) | use - IBS with constipation

Question 39

alosetron

Answer 39

5-HT3 ( ligand gated ) use - IBS with diarrhea alosetron "resets" the 5HT tone to decrease intestinal motility

Question 40

lithium MOA

Answer 40

enters via Na+ channels | blocks PIP2 pathway which inhibits adrenergic, muscarinic, and serotonergic

Question 41

lithium reacts with which other common drug

Answer 41

NSAIDs + hyponatremia | causes increased lithium reabsorption

Question 42

lithium SE

Answer 42

``` nephrogenic DI lithium toxicity ( ataxia, tremor, sedation, vomiting, hyperkalemia, increased ICP ) ```