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Alex's First Aid Cards > 519-520: Psych Drugs 2 > Flashcards

519-520: Psych Drugs 2 Flashcards

1
Q

Name 4 SSRI’s

A

Fluoxetine
Paroxetine
Sertaline
Citalopram

“Flashbacks paralyze senior citiznes”

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2
Q

What are the clinical uses for SSRIs?

A 
Depression
GAD
Panic disorder
OCD
Bulimia
Social Phobias
PTSD
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3
Q

How long does it take for antidepressants to take effect?

A

4-8 weeks

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4
Q

Are SSRIs or TCAs more toxic?

A

TCAs

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5
Q

What are the toxicities of SSRIs?

A

GI distress
Sexual dysfunction (anorgasmia, ↓ libido)
Serotonin syndrome

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6
Q

What drugs can cause serotonin syndrome?

A

Any drug that ↑ SSRIs (e.g. MAO inhibitors, SNRIs, TCAs)

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7
Q

What are the symptoms of serotonin syndrome?

A

seizures
myoclonus
confusion

hyperthermia
flushing
cardiovascular collapse

diarrhea

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8
Q

What do you treat serotonin syndrome?

A

Cyproheptadine (5-HT2 receptor antagonist)

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9
Q

List 2 SNRIs

A

Venlafaxine, duloxetine

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10
Q

Mechanism of SNRIs:

A

Inhibit 5-HT and NE reuptake

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11
Q

Clinical use of SNRIs:

A

Depression
GAD and panic disorder - venlafaxine
Diabetic peripheral neuropathy - duloxetine

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12
Q

Toxicity of SNRIs:

A

Stimulant effects
Nausea
Relaxxation (sedation)
Increased BP - most common

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13
Q

List as many TCAs as you can:

A

-triptyline: amitriptyline, nortriptyline
-imprame: imipramine, desipramine, clomipramine
doxepin, amoxapine

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14
Q

Mechanism of TCAs:

A

Block reuptake of NE and 5-HT

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15
Q

Clinical use of TCAs:

A

Major depression
OCD (clomipramine)
Fibromyalgia

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16
Q

Toxicities of TCAs:

A 
Anticholinergic: tachycardia, urinary retention, dry mouth; confusion and hallucinations in elderly
α1-blocking effects (e.g. postural HTN)
Respiratory depression
Hyperprexia
Sedation

Tri-C’s: convulsions, coma, cardiotoxicity (arrhythmias)

17
Q

Name the MAO inhibitors

A

Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline (selective MAO-B inhibitor)

(MAO Takes Pride In Shanghai)

18
Q

MAO inhibitor effects on levels of amine transmitters:

A

↑ levels of NE, 5-HT, dopamine

19
Q

Clinical use of MAO inhibitors:

A

Atypical depression
Anxiety
Hypochondriasis

20
Q

Toxicities of MAO inhibitors:

A

Hypertensive crisis (esp. w/ tyramine ingestion)
CNS stimulation
Contraindicated with SSRIs, TCAs, St. John’s wort, meperidine, and dextromethorphan (to prevent serotonin syndrome)

21
Q

What is the difference in side effect profiles between second and third generation TCAs?

A

third generation TCAs (amitriptyline) have more anticholinergic effects than second (nortriptyline)

22
Q

List three atypical antidepressants

A

Bupropion, mirtazapine, trazodone

23
Q

What are the clinical uses for bupropion?

A

Depression, smoking cessation

24
Q

What neurotransmitters are involved in the actions of bupropion?

A

↑ NE and dopamine (unknown mechanism)

25
Q

What are the toxicities of bupropion?

A

stimulant effects (tachycardia, insomnia)
headache
seizure in bulimic paitents

26
Q

Regarding its side effect profile, what is an advantage to the use of bupropion for treating depression?

A

no sexual side effects

27
Q

What receptor does mirtazapine act on, and what neurotransmitters are involved?

A

α2-antagonist (↑ release of NE and 5-HT)

28
Q

Toxicity of mirtazapine

A

Sedation
↑ appetite
Weight gain
Dry mouth

29
Q

Which antidepressant might you consider using for a depressed patient with insomnia?

A

mirtazapine

30
Q

Which antidepressant might you consider using for a depressed patient with anorexia, or an elderly patient who is in danger of wasting away?

A

mirtazapine - it causes weight gain

31
Q

What is the mechanism of trazodone?

A

Primarily blocks 5-HT and α1-adrenergic receptors

32
Q

What are the clinical applications for trazodone?

A

Insomnia is the primary use b/c high doses are needed for antidepressant effects

33
Q

What are the toxicities of trazodone?

A

sedation
nausea
priapism (“trazobone”)
postural hypotension

Alex's First Aid Cards (20 decks)

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