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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?

A

TCAs

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
Q

What does MAO<strong>B</strong> degrade?

A

Dopamine

26
Q

Are MAO inhibitors reversible or irreversible?

A

Irreversible

27
Q

Name 3 non-selective MAO inhibitors

A

(1) Tranylcypromine
(2) Phenelzine
(3) Isocarboxazid

28
Q

Indications (2) : Non-selective MAOIs

A

(1) Atypical depression
(2) Treatment-resistant depression

29
Q

Name a MAOB selective inhibitor

A

Selegiline

30
Q

Indication: Selegiline

A

Parkinsons disease

31
Q

When taking MAO inhibitors, what type of food should be avoided?

A

(1) Aged meats
(2) Cheeses
(3) Wine

32
Q

How is Tyramine usually metabolized?

A

MAOA in GI tract

33
Q

Adverse Effects (2) : MAOIs

A

(1) Hypertensive crisis with Tyramine ingestion
(2) Serotonin syndrome

34
Q

What drug can be used to manage hypertensive symptoms of tyramine toxicity?

A

Phentolamine

35
Q

MOA: Bupropion

A

Inhibits NET and DAT

36
Q

What is Bupropion used to treat?

A

(1) Atypical depression
(2) Tobacco dependence
(3) Somnolence

37
Q

Adverse Effect: Bupropion

A

Seizures

38
Q

Contraindications (2) : Bupropion

A

(1) Bulimics
(2) Anorexics

39
Q

Name 2 benefits of Bupropion over other antidepressants

A

(1) No sexual side effects
(2) No weight gain
* (Also reduces desire to smoke ∴ indicated with comorbid tobacco addiction)*

40
Q

MOA (4) : Mirtazapine

A

(1) Inhibits α2 receptors
(2) ↑ Release of 5-HT and NE
(3) Inhibits 5-HT2 and 5-HT3 receptors
(4) Inhibits H1 receptor

41
Q

Adverse Effects (2) : Mirtazapine

A

(1) Sedation
(2) Weight gain

42
Q

What is the benefit of Mirtazapine over other antidepressants?

A

No sexual dysfunction

(Also causes weight gain ∴ indicated in anorexia)

43
Q

MOA (4) : Trazodone

A

Inhibition of:

(1) 5-HT reuptake
(2) 5-HT2 receptors
(3) α1 receptors
(4) H1 receptors

44
Q

What is the distinctive side effect of Trazodone?

A

Priapism

45
Q

Adverse Effects (4) : Trazodone

A

(1) Orthostatic hypotension
(2) Sedation
(3) Sexual dysfunction
(4) Serotonin syndrome

3b_Boards - SketchyPharm (32 decks)

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