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Psychosocial Medicine > Adtl. Practice: Pharmacology > Flashcards

Adtl. Practice: Pharmacology Flashcards

1
Q

SSRI MOA

A

Selective serotonin reuptake inhibitor

-inhibits serotonins reuptake in presynaptic neurons in CNS

1st line tx for depression, generally well tolerated

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2
Q

SSRI drugs (6)

A
  1. sertraline
  2. citalopram
  3. escitalopram
  4. paroxetine
  5. fluoxetine
  6. fluoxetine
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3
Q

SSNRI MOA

A

selective serotonin NE reuptake inhibitor

inhibits reuptake serotonin and NE in presynaptic neurons
-more specific than TCAs, safer and better tolerated

also 1st line tx for depression

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4
Q

SSNRI drugs (4)

A
  1. duloxetine
  2. venlafaxine
  3. disvenlafaxine
  4. levominalcipran
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5
Q

TCAs MOA

A

Tricyclic antidepressants

inhibitor presynaptic reuptake of norepineprhine and serotonin

antagonizes histamine, alpha-adrenergic and muscarinic receptors, cardiac sodium channels

*3rd line, OD can occur in 1 week supply

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6
Q

TCAs (9)

A
  1. amitriptyline
  2. imipramine
  3. Doxepin
  4. Clomipramine
  5. Despipramine
  6. Nortriptyline
  7. meprotiline
  8. proptriptyline
  9. desipramine
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7
Q

Bupropion MOA

A

1st line tx, augmenting agent for depression

inhibits reuptake transporters of synaptic dopamine, NE- with not serotonergic effects

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8
Q

Mirtazapine MOA

A

1st line agent with compelling reason for depression

antagonizes presynaptic alpha-1 adrenergic receptors
-increases NE, 5-HT at postsynaptic 5-HT receptors

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9
Q

Vortioxetine MOA

A

1st line agent for depression

SSRI with 5-HT 1a agonism, mixed antagonist, partial agonist

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10
Q

Nefazodone/Trazodone MOA

A

3rd line/augmenting

antagonist at postsynaptic 5hts, inhibits reuptake serotonin

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11
Q

Vilazodone

A

3rd line agent(new) for depression

serotonin reuptake inhibitor and 5-ht 1a receptor partial agonist

SPARI

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12
Q

MAOIs MOA

A

3rd+ line agent for MDD

inhibition monamine oxidizing enzymes MOAs, causing increased concentrations of NE, 5-HT, and dopamine in neuronal synapse

**food and drugs contraindicate often

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13
Q

MAOIs drugs (4)

A
  1. tranylcypromine
  2. isocarboxazid
  3. phenelzine
  4. selegiline
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14
Q

Esketamine-sporavato

indication

A

augmentation MDD

  • severe depression that failed 2 trial antidepressants for adequate dose and duration
  • REMS program
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15
Q

Antipsychotics in depression (4)

A
  1. ariprazole
  2. brexpiprazole
  3. olanzapine
  4. quetiapine
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16
Q

Lithium

indication
MOA

A

I: bipolar disorder in acute manic episode and mtnc.

M: inorganic cation with multiple functions in CNS

  1. alter cation transport across cellular membranes
  2. influences reuptake of serotonins, NE, GABA
  3. postsynaptic D@ receptor sensitivity decreases
  4. cAMP second msgr system
17
Q

Lithium monitoring

A
  1. CBC, TSH, CMP w Ca 2x within 1st 6 months then periodically
  2. pregnancy, cardiac abnormalities can occur in 1st trimester
  3. EKG
  4. Serum levels
    * narrow therapeutic index
18
Q

Lithium drug ineractions

A 
Thiazides
Ace-inhibitors
Loop diuretics
Arbs
Nsaids
Sodium
19
Q

Valproic Avid/ Divaloprex

indication
MOA

A

bi polar disorder, actor manic of mixed epidosed

  • enhances GABA, inhibits reuptake
  • normalized sodium and calcium channels
20
Q

Carbamazepine

indication
MOA

A

bipolar disorder in acure manic or mixed episodes

-blicks voltage-sensitive sodium channels, stimulates release of ADH, NMDA

21
Q

Lamotrigine

A

bipolar I disorder-maintenance

  • can be used in depression as well
  • not for acute mania

MOA: black voltage-gates sodium channels
-decreases glutamate release

22
Q

Antipsychotics for Bipolar (4)

A
  1. cariprazine
  2. lurasidone
  3. olanzapine/fluoxetine
  4. quetiapine
23
Q

Antipsychotics for manic/mixed epsiodes

A
  1. ariprazole
  2. asenapine
  3. cariprazine
  4. olanzapine
  5. quetiapine
  6. risperidone
  7. ziprasidone
24
Q

1st genration/Typical antipsychotics MOA (4)

A
  1. dopamine- DA D2 receptor blockade
    - therapeutic effect
  2. muscarinic- M1 receptor blockade
  3. Histaminic- H1 receptor blockade
  4. Alpha-a1 receptor blockade
    * agents differ in potency and receptor affinity
25
Q

1st gen/ typical antipsychotics (8)

A

1st line tx

  1. chlorpromazine
  2. fluphenazine
  3. haloperidol
  4. loxapine
  5. molindone
  6. trifluoperazine
  7. thioridazine
  8. thiothixene
26
Q

Second generation/atypical antipsychotics MOA

A

1st line

similar to 1st generation
increased D2 receptor dissociation

additional serotonin 5HT2s antagonism

27
Q

2nd generation antipsychotics

A
  1. aripirazole
  2. asenapine
  3. brexpiprazole
  4. cariprazine
  5. clozapine
  6. lurasidone
  7. iloperidone
  8. lumaterperone
  9. olanzapine
  10. paliperidone
  11. quetiapine
  12. risperidone
  13. ziprasidone
28
Q

extrapyramidal affects seen in which class medication?

A

1st generation antipsychotics

Psychosocial Medicine (19 decks)

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