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3b_Boards - SketchyPharm > (6) Neuro & Psych: Antidepressents (3.1-3.4) > Flashcards

(6) Neuro & Psych: Antidepressents (3.1-3.4) Flashcards

1
Q

Name 4 SSRIs

A

(1) Fluoxetine
(2) Paroxetine
(3) Sertraline
(4) Citalopram

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2
Q

Name 2 SNRIs

A

(1) Duloxetine
(2) Venlafaxine
* (Also the “-nacipran” drugs)*

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3
Q

Indications (4) : SSRIs/SNRIs

A

(1) Depression
(2) Generalized anxiety disorder
(3) Panic disorder
(4) PTSD

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4
Q

Indications (3) : SSRIs (not SNRIs)

A

(1) OCD
(2) Bulimia
(3) Social anxiety disorder

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5
Q

Indications (3) : SNRIs (not SSRIs)

A

(1) Diabetic neuropathy
(2) Chronic pain
(3) Fibromyalgia

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6
Q

How long does it take for SSRIs/SNRIs to achieve maximum effect?

A

1-2 months

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7
Q

Adverse Effects (4) : SSRIs

A

(1) SIADH
(2) Sexual dysfunction
(3) Weight gain
(4) Drowsiness

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8
Q

What are the symptoms of serotonin syndrome?

A

(1) Hypertension
(2) Hyperthermia
(3) Hyperreflexia

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9
Q

What are two drug classes which could cause serotonin syndrome when combined with SSRIs/SNRIs?

A

(1) TCAs
(2) MAO inhibitors

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10
Q

Treatment: Serotonin syndrome

A

Cyproheptadine

(Considered an H1 antagonist with secondary anti-serotonergic effects)

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11
Q

What is the main side effect of SNRIs?

A

Hypertension

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12
Q

Rapid withdrawal of SSRIs/SNRIs can cause what?

A

Flu-like symptoms

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13
Q

Suffix: TCAs

A

(1) “-pramine”
(2) “-triptyline”

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14
Q

MOA: TCAs

A

(1) Inhibit NET/SERT
(2) Inhibit muscarinic receptors
(3) Inhibits H1 receptor
(4) Inhibits α1 receptors

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15
Q

Indications (5) : TCAs

A

(1) Resistant depression
(2) Diabetic neuropathy
(3) Chronic pain
(4) Migraines
(5) OCD

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16
Q

Adverse Effects (8) : TCAs

A

(1) Sexual dysfunction
(2) Anti-muscarinic effects
(3) Sedation
(4) Weight gain
(5) Orthostatic hypotension
(6) Seizures
(7) Serotonin syndrome
(8) Torsades

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17
Q

Which TCAs have reduced anti-cholinergic effects?

A

(1) Nortriptyline
(2) Desipramine

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18
Q

Why are TCAs relatively contraindicated in the elderly?

A

Severe anticholinergic and antihistamine effects

(⇒ Excess sedation)

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19
Q

What is the most common cause of death in TCA overdose?

A

Fatal arrhythmia

20
Q

Describe the mechanism of arrhythmia in a TCA overdose

A

Inhibition of cardiac fast Na+ channels

(∝ Class IC antiarrhythmic)

21
Q

What would the EKG show in a TCA overdose?

A

Widened QRS complex

22
Q

Which antidepressant class is associated with Torsades de Pointes?

23
Q

What is the treatment for widened QRS and arrhythmia in TCA overdose?

A

Sodium bicarbonate

24
Q

What does MAOA degrade?

A

(1) Dopamine
(2) Norepinephrine
(3) Serotonin

25
What does MAOB degrade?
Dopamine
26
Are MAO inhibitors reversible or irreversible?
Irreversible
27
Name 3 non-selective MAO inhibitors
(1) Tranylcypromine (2) Phenelzine (3) Isocarboxazid
28
**Indications** (2) : Non-selective MAOIs
(1) Atypical depression (2) Treatment-resistant depression
29
Name a MAOB selective inhibitor
Selegiline
30
**Indication**: Selegiline
Parkinsons disease
31
When taking MAO inhibitors, what type of food should be avoided?
(1) Aged meats (2) Cheeses (3) Wine
32
How is Tyramine usually metabolized?
MAOA in GI tract
33
**Adverse Effects** (2) : MAOIs
(1) Hypertensive crisis with Tyramine ingestion (2) Serotonin syndrome
34
What drug can be used to manage hypertensive symptoms of tyramine toxicity?
Phentolamine
35
**MOA**: Bupropion
Inhibits NET and DAT
36
What is Bupropion used to treat?
(1) Atypical depression (2) Tobacco dependence (3) Somnolence
37
**Adverse Effect**: Bupropion
Seizures
38
**Contraindications** (2) : Bupropion
(1) Bulimics (2) Anorexics
39
Name 2 benefits of Bupropion over other antidepressants
(1) No sexual side effects (2) No weight gain * (Also reduces desire to smoke ∴ indicated with comorbid tobacco addiction)*
40
**MOA** (4) : Mirtazapine
(1) Inhibits α2 **receptors** (2) **↑ Release** of 5-HT and NE (3) Inhibits 5-HT2 and 5-HT3 **receptors** (4) Inhibits H1 **receptor**
41
**Adverse Effects** (2) : Mirtazapine
(1) Sedation (2) Weight gain
42
What is the benefit of Mirtazapine over other antidepressants?
No sexual dysfunction *(Also causes weight gain ∴ indicated in anorexia)*
43
**MOA** (4) : Trazodone
Inhibition of: (1) 5-HT **reuptake** (2) 5-HT2 **receptors** (3) α1 **receptors** (4) H1 **receptors**
44
What is the distinctive side effect of Trazodone?
**Priapism**
45
**Adverse Effects** (4) : Trazodone
(1) Orthostatic hypotension (2) Sedation (3) Sexual dysfunction (4) Serotonin syndrome

3b_Boards - SketchyPharm (32 decks)

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